Reform movements for treatment of the mentally ill were related in this period to other progressive causes: abolitionism, temperance, and voter reforms. After returning to America, in 1840-41 Dix conducted a statewide investigation of care for the mentally ill poor in Massachusetts. Dorothea's interest for helping out the mentally ill of society started while she was teaching classes to female prisoners in East Cambridge. She saw how these individuals were locked up and whose medical needs weren't being satisfied since only private hospitals would have such provisions. It was during her time at the East Cambridge prison, that she visited the basement where she encountered four mentally ill individuals, whose cells were "dark and bare and the air was stagnant and foul". She also saw how such individuals were labeled as "looney paupers" and were being locked up along with violently deranged criminals and received treatment that was inhumane.