An investigative committee is formed to understand the conditions of people with mental, emotional, neurodivergent, and cognitive disabilities. The committee reports in February 1856 that the number of "lunatics" confined in the poorhouses outside of New York and Kings Counties is 837.

Dorothea Dix, known as an advocate for the "mentally ill," goes to the New York Legislature to plead for patients to be moved from poorhouses to state-run facilities, which are assumed to be safer with better conditions. The legislature votes against county judges transferring people in poorhouses to Utica Asylum. Nothing changes until a Dr. Willard begins to build a case for a new state asylum in 1864.