Madness: Race and Insanity in a Jim Crow Asylum

by Antonia Hylton

Shame, because days earlier, I had begged a police officer who had entered my loved one’s home to tell his fellow officers to never shoot. I had spoken to the officer at a mile a minute, listing every single one of my loved one’s credentials. A pitiful feeling had come over me, making me convinced I should try to prove to this officer that my loved one was a good and worthy person.

The specter of racial violence had become so effective that it was hovering over my loved one without ever having to come knock at the door.

“Toward the Black patients especially there’s an attitude of ‘Don’t even talk to me,’” they explained. “It’s a form of remote incarceration. You’re really not trying to deal with the person in a human way.”

But unbeknownst to him and his family, he would never return to that home or that work again after going to Crownsville. William’s daughter, Pauli Murray, would go on to become a celebrated legal scholar and civil rights activist.

auctioneers, all anticipating their arrival. The history of Annapolis and Anne Arundel County, and the place of their Black citizens, is told out on the water. It was a beginning and an end all in one.

“When I look for my people, I look for where they are buried,” Janice once told me.

Historians of slavery and prisons have long argued that the commercial value of enslaved Black people in the American South was inextricably bound to their health status and their capacity to labor in the agricultural or domestic settings that had defined the Southern economy.

It reached the point where local chants of “Lynch Lane” prompted the state attorney general to leave the city. The grand jury declined to indict anyone. One thousand white supporters cheered as the accused were released. There were no further efforts to prosecute anyone for George Armwood’s murder.

One basic message was that they had killed people like Williams and Armwood before and, if necessary, would do it again. But the more subtle and crucial message was that they still owned Black people.

I suspect that untreated pain curdles your blood and changes your code.

It is hard to identify or diagnose mental illness in those conditions. It makes the symptoms look logical.”

The leaders of newsrooms make choices about what they cover and how often they cover it, and sometimes they can overemphasize one community’s dysfunction as they downplay another’s.

But instead of spending money on therapy, employee salaries, or the reduction of overcrowding, the state spent money on new tools for imprisonment—tools that they knew weren’t actually going to work.

He was no Eagle Scout—he had never spent much time outdoors—but Thomas somehow convinced the hospital to let him plan camping and hiking trips in a park called Camp Puh’tok near Monkton, Maryland, in Baltimore County.

I learned so much about storytelling from my grandmother—about how people engage in mythmaking to survive.

Black employees, many of whom came from the same neighborhoods and conditions as their patients, found themselves working under impossible and ethically compromising conditions. They were not always confident that their work was enough to outweigh the harm, but the alternative—a return to the days of a white-only professional staff—seemed far worse.

For these families, this Great Migration was not a careful and calculated choice—it was terrorism. It was a sudden expulsion.

To put it simply: Black Americans refused to quiet their pain or to live as second-class citizens any longer.

Behaviors that had once been associated with poverty and illness became part of a growing list of crimes that could land you in jail.

As many historians have previously argued, rising hostility toward Black protest and criminality fostered much of this new enthusiasm for expansive policing initiatives—and those initiatives were often narrowly aimed at America’s Black citizens.

The Elkton Three were an example of this kind of infiltration, an early sign that some white leaders and doctors would, wittingly or unwittingly, misread Black anger as mental illness and use tools of psychiatry to punish, not to heal, the communities they were meant to serve.

The title of Metzl’s book came from a 1968 piece in Archives of General Psychiatry, in which two psychiatrists redefined schizophrenia as “a protest psychosis” that involved Black patients who had become hostile, aggressive, and developed “delusional anti-whiteness” after listening to leaders like Malcolm X or showing interest in the practice of Islam.

There is often the assumption that people with diagnoses like schizophrenia are the most likely among us to commit acts of violence and become hardened criminals. The truth is, they are far, far more likely to be the victims than the perpetrators.

Forty-one days passed inside Crownsville before she was seen by a psychiatrist, and when she was finally released, she returned home to find her food business was ruined. As one delegate remarked at the time: landing in Crownsville was not unlike jail, “as they are actually losing their liberties.”

At a time when the hospital was supposed to be focused on discharging patients and prioritizing bonds with families and communities, Crownsville was still an appendage to Maryland law enforcement, mediated by officers and judges who actively collaborated in a process that seemed to care little for distinctions like those between “mental illness” and “criminality.”

In Vietnam, white superiors would break the news to their Black subordinates, but not before seizing their weapons to ensure none of the rage was turned back on them.

Hundreds of thousands of Vietnamese people died from Agent Orange exposure. An immeasurable number of families were harmed, and many of their children were born with congenital disabilities. It seemed the toxin not only altered the person exposed to it, it changed their DNA and their family’s future.

Chemicals powerful enough to destroy an ecosystem likely had the power to fundamentally reconfigure this soldier.

I pushed her, asking why she wasn’t angry with the patient at all. Even just a bit. He almost killed her after all. She shot back, “Why should I be?”

“By the time I entered,” he explained, “chains had been replaced by drugs. So the chains were still there.”

In Maryland, you can often trace the story of Black families by looking at the water.

The dream died a death by a thousand different cuts. President Reagan helped close the casket and lower that dream into the grave.

It is precisely the fact that our incarcerated populations look closer to Crownsville’s demographics that led me and other journalists and historians to raise questions about who benefited from deinstitutionalization and who did not.

In only half a century, the United States achieved arguably the greatest and swiftest institutional shift in history, at once making the mental hospital redundant and law enforcement and incarceration of astonishing prevalence.

Through the stories of employees and patients like those at Crownsville, we can trace the desertion of the first institution and the development of the second.

There’s just this feeling of dreams deferred. You know, what if these people were cared for in a proper manner? What could they have been? What could they have accomplished? What would their lives have been?”

back. But you cannot outrun pain. It will creep down the branches of your family tree until it finds someone who is tiring of the sprint.

For now, Dr. Benton believes the best way forward is to train a generation of healthcare providers in “cultural humility,” or, in other words, the strength to acknowledge the limits of what they know and to remain open to asking new questions.