Along with negligence and abuse, patients were also subjected to unsafe living conditions. There were no fire precautions in the building, and it was very overcrowded. All doors were locked individually making them impossible to unlock and get everyone out in the case of an emergency.
Accompanying both negligence and abuse of patients and unsafe living conditions, the patients in asylums and institutions weren't necessarily meant to be there. Many patients did not have a mental detriment and were instead committed for a myriad of absurd reasons.
Nellie Bly was one of the multiple activists who worked to rectify the abuse and negligence of patients, safety conditions, and free falsely committed patients in institutions. Institution officials did not care properly for their patients. They abused them in multiple ways, including pushing them around, giving them cold showers, and being rude to them. The work that Nellie Bly did to rectify these faults helped greatly to reform institutions and transform them into the safe, supporting and progressive environments they are today.