Mental health reform in the mid-1800s addressed the mistreatment of the mentally ill, who were often incarcerated and treated like criminals, sometimes facing beatings and abuse. Dorothea Dix campaigned vigorously for mental health reforms, leading to significant changes. As a result, state governments established dozens of mental health facilities across the country.

The mental health reform in the mid-1800s was primarily a response to the dire conditions under which individuals with mental illnesses were living. Before these reforms, people with mental health issues were frequently confined in jails, almshouses, or were left to fend for themselves on the streets. They faced severe neglect, and often endured harsh and inhumane treatments. Dorothea Dix, a teacher and a social reformer, was instrumental in changing these conditions.

During her work, Dorothea Dix discovered the poor treatment of the mentally ill, and she began her crusade to improve their conditions. She conducted investigations into how those with mental illnesses were treated and compiled her findings into reports that she would later present to legislators. Through her persistent efforts, she was able to shine a light on the issue and rallied public and political support for change.

Dorothea Dix's campaigning led to a sweeping reform movement wherein state governments began to take responsibility for the care of the mentally ill. Dozens of state mental health facilities, often called asylums during that time, were established across the country to provide more humane treatment. These facilities sought to provide care and treatment in a supportive environment, moving away from punishment and neglect. The reform movement aimed for a more scientific and compassionate approach to mental illness, which laid the foundation for modern mental health care practices.