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In most cases, towns contracted with local individuals to care for mentally ill people who could not care for themselves and lacked family/friends to do so.
Unregulated and underfunded, this system resulted in widespread abuse.
Reform movements for treatment of the mentally ill were related in this period to other progressive causes: abolitionism, temperance, and voter reforms.
During the Civil War, she served as a Superintendent of Army Nurses.
Soon afterward she also began teaching poor and neglected children out of the barn of her grandmother's house, but she suffered poor health.