Concerned with the treatment of people with mental, emotional, neurodivergent, developmental, and cognitive disabilities in the county poorhouses in the state of New York, Dr. Sylvester D. Willard writes an investigative report on the horrific conditions, describing people shackled to the floors and "walls in windowless basements and rooms." This leads the New York State Legislature to pass the Willard Act: "to authorize the establishment of a State asylum for the chronic insane and for the better care of the insane poor."