How were persons with mental illness treated before the reform efforts of Dorothea Dix?

Before the reform efforts of Dorothea Dix, persons with mental illness were often neglected and housed in poor living conditions, including jails and almshouses. They were subject to inhumane treatment, such as chaining and confinement in unsanitary facilities. There was minimal understanding of mental illness, and little effort was made to provide proper care or treatment.