Dix spent a few years studying the conditions in prison and insane asylums in Massachusetts. She discovered that a large number of people suffering from mental illness were confined in prisons and were receiving no medical treatment. Even in mental asylums the patients were often confined in cages and bound with ropes and chains. Shocked by what she discovered, Dix decided to compare conditions in these institutions with other countries. She visited Europe and from 1842-1845, Dix travelled more than 10,000 miles during her investigations.