Before Peer Support Had a Name

What does it take to make a society listen to people it has already decided not to believe?

For generations, people labeled mentally ill have faced a devastating imbalance of power. Others could declare them insane, confine them, discredit their testimony, and make decisions about their lives. Their own accounts of what happened could be dismissed because of the very label used to justify their treatment.

People resisted. They spoke out, took their stories to the public, challenged the courts, and demanded change. Long before peer support had a name, people were fighting to reclaim their voices.

Elizabeth Packard: Confined for Her Beliefs

In 1860, writer Elizabeth Packard was committed to the Illinois State Hospital for the Insane by her husband, a minister who opposed her religious beliefs. Illinois law allowed married women to be committed at their husbands' request without the same legal protections afforded to other adults.

Packard spent three years confined, refusing to accept the judgment imposed upon her. After her release, she published accounts of her experience and campaigned for legal reform. In 1867, Illinois passed a law guaranteeing people accused of insanity the right to a jury trial.

Packard turned her own fight for freedom into a campaign for the rights of others.

Nellie Bly: Inside the Asylum

In 1887, investigative journalist Nellie Bly went undercover at New York’s Blackwell’s Island asylum, feigning mental illness to gain admission. Once committed, she stopped pretending, but her repeated assertions that she was sane and pleas for release were ignored. After ten days, a lawyer sent by the New York World secured her release.

Her reporting, published as Ten Days in a Mad-House, exposed abusive conditions and the vulnerability of women whose freedom rested in the hands of the institution holding them. Her investigation prompted public scrutiny and increased funding for the asylum.

Bly showed the public what could happen behind locked doors—and how difficult it was for the people inside to make themselves heard.

Clifford Beers: A Mind That Found Itself

In 1908, Clifford Beers published A Mind That Found Itself, recounting the mistreatment he experienced during psychiatric hospitalization. His book brought national attention to institutional abuses and contributed to launching the organized mental hygiene movement. In 1909, he co-established the National Committee for Mental Hygiene.

Beers transformed his experience into a campaign for reform. Yet his story also reveals a tension that would follow mental health reform for generations: even when people with lived experience exposed the failures of the system, professional authorities continued to hold much of the power over how reform was defined and carried out.

The question of who gets to lead change—and whose knowledge counts—was far from settled.

A Century of Resistance

Packard. Bly. Beers.

Their lives and methods differed, but each challenged a world in which the label of insanity could strip a person of credibility, autonomy, and freedom.

Their stories unfolded alongside a wider culture that often treated people with psychiatric labels as inferior or dangerous. Eugenic policies went further, branding people deemed mentally or intellectually unfit as threats to the nation's future. Across the United States, people were institutionalized, segregated, and subjected to forced sterilization.

These were not merely failures of compassion. They were abuses of power, supported by laws, social attitudes, and institutions that could treat a person's own account of their life as less trustworthy than someone else's judgment.

Exposing the harm did not make it disappear.

A newspaper investigation could provoke outrage. A book could bring reformers together. A court victory could change the law. Yet the assumptions beneath the abuses persisted, and reform did not automatically put people with lived experience in control of their own lives or free from social stigma.

Generations passed between exposing institutional harm and building a movement powerful enough to challenge the system collectively. It was important to have Packard, Bly, and Beers be the precursors to the current Peer Support movement. They contributed to a powerful impetus in systemic reform. Mental health stigma still and injustice still exist; step by step, we improve them through sharing our own stories and contributions.

As Pier 360 celebrates 31 years of peer support in Southwest Washington, we honor the people who came before, and the people who continue this work today. Stigma and injustice remain, and people living with mental health and substance use challenges still face barriers to dignity, autonomy, and recovery.

Our own stories and lived experiences matter. By sharing them, standing together, and continuing to challenge what needs to change, we carry this history forward.

---

Read about how you can contribute to the ongoing conversations with your own here.

For a more complete history of Peer Support, visit the article by Mental Health America, A Brief History of Peer Support.