In the mid- to late-1800s, the work by Dorthea Dix and the follow-up to the case of Mary Ellen served to:

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Dorothea Dix was an advocate for the mentally ill who, through her work in the mid- to late-1800s, significantly improved the conditions and treatment of the mentally ill and troubled children. The case of Mary Ellen, which involved severe child abuse, led to the establishment of the New York Society for the Prevention of Cruelty to Children. Both Dix's advocacy and the Mary Ellen case highlighted the need for more humane treatment for troubled children, rather than focusing on genetic factors or medication.

In the Mid- to Late-1800s, the Work by Dorthea Dix