The day that Dorothea Dix found work at the East Cambridge Women's Prison was the day her life, as well as the lives of the many mentally ill, changed. After witnessing firsthand the inhumane treatment of the inmates, she immediately wrote a report of her findings in a document called a memorial. Samuel Howe presented the "Dix Memorial" to the legislature of Massachusetts in January 1843; the details of the document identified both the institutions that mistreated the mentally ill, as well as the public officials responsible for them. This shocked the legislature into taking action to improve conditions for the imprisoned and the insane.
Dorothea Dix continued her tour of the country's treatment of the ill, and managed to establish humane asylums for the mentally ill, and founded hospitals in Rhode Island, New York, New Jersey, Pennsylvania, Indiana, Illinois, Kentucky, Tennessee, Missouri, Maryland, Louisiana, Alabama, South Carolina and North Carolina.
Dix also advocated for the mentally ill at a federal level; in 1848, she requested Congress to grant over twelve million acres of land as a public endowment for the use of treating the mentally ill, as well as the blind and the deaf. She argued that this should be similar to the system that created state universities. Millard Fillmore, the president at the time, had spoken in favor of the bill until the end of his presidential term in 1853. Its success had been stifled in the meantime as many people did not want to give up their own public lands to support asylums in other states. Both houses of Congress had approved the bill, but Franklin Pierce, the fourteenth US president, vetoed and stopped the six-year effort in 1854.
Disheartened, but not defeated, Dix went to Europe to continue her work for the next two years. She traveled to Liverpool in September of 1854, and continued to travel throughout Europe, pursuing her mission. She found that there was a large difference between public and private hospitals, as well as disparity between different countries. In Rome, she met with Pope Pius IX, whom ordered the construction of a new asylum after hearing her report.
In her travels to Constantinople, Cyrus Hamlin, a Turkish doctor who had been her host there told his impression of Dix to his biographer: "She had two objects in view, the hospitals and prisons. To these she seemed wholly devoted, although her conversation and her interest, embraced a vast variety of subjects . . . Miss Dix made the impression [of being] a person of culture, judgement, self-possession, absolute fearlessness in the path of duty, and yet a woman of refinement and true Christian philanthropy."
She returned to the US in 1856, and served as the superintendent of nurses during the Civil War. After it was over, she intended to go back to her lobbying for mental illness, but she had grown weak. While she had to cease her aggressive traveling, she continued to write for her causes. She died at the hospital she had founded 35 years earlier in Trenton, New Jersey.