Madness: Race and Insanity in a Jim Crow Asylum

by Antonia Hylton

Community healthcare, of course, rests on the assumption that there is a community that will welcome someone home. But sometimes the reality that Delores saw was bleak. The most vulnerable people were those abandoned at Crownsville precisely because they had no one in their corner.

For Crownsville, it always seemed to be one step forward, one step back. The hospital, for example, established its first outpatient clinic in Baltimore in 1961 with the hope of preventing relapse in some of its discharged patients. But in that same year, the State Department of Corrections attempted, though ultimately failed, to acquire 159 acres of land belonging to Crownsville “for use as a prison camp,”

Throughout the sixties, the line between patient and inmate, criminal or insane, continued to get blurred.

On November 30, 1961, President Kennedy approved the use of chemicals in Vietnam. Soon, fifty-five-gallon drums arrived on air bases, clearly marked with an identifying orange stripe.

For a young Black man from Maryland, all of this might as well have been happening on another planet. Hell, another solar system. He was traveling through a land and climate that looked nothing like home, fighting shoulder to shoulder with white men—the kind who would’ve paid him no mind back in Baltimore. This was the first racially integrated war. On the surface, they all shared the same mission. Everything about that was surreal. But Earth found ways to creep in around soldiers like him. After a few drinks, the N-word would start slipping out. White

As activists like the Elkton Three launched actions at home, Black soldiers found their ways to build power and call out hypocrisy, too. They would don Black amulets, beads, and accessories to represent their Black pride, and during downtime they would retreat into their own world, drinking together and listening to soul music.

On February 25, 1967, Martin Luther King Jr. stood at a podium in Los Angeles and asked the nation to make a full accounting of the atrocities committed at home and abroad. “We see the rice fields of a small Asian country being trampled at will and burned at whim; we see grief-stricken mothers with crying babies clutched in their arms as they watch their little huts burst forth into flames; we see the fields and valleys of battle being painted with humankind’s blood; we see the broken bodies left prostrate in countless fields; we see young men being sent home half-men—physically handicapped and mentally deranged.”

In April 1968, Martin Luther King Jr. would be assassinated in Memphis. Riots would break out in cities across America, and Baltimore was no exception. Faye Belt, who was just a teenager at the time, remembers walking through a cornfield that connected Crownsville’s campus to her family’s backyard, and hearing her sister, Frederica, shout from a window, “They shot Martin Luther King!”

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. Black soldiers were in shock. It seemed like the air had been sucked out of the jungle. They would mourn together, exhausted and reeling over the loss of a hero many of them had believed was capable of liberating them. They listened as white soldiers partied and joked in the distance. On some bases white boys paraded around, joking about the murder.

As sociologist James M. Fendrich put it: Black Vietnam veterans came back to America and had to face “the transition from ‘democracy in the foxhole’ to discrimination in the ghetto at home.” Their anger and alienation from American society was simmering, not dissipating. The military, as it turned out, was ahead of most large American institutions in its pace and willingness to integrate.

the forty-seven patients that they attempted to trace who had been recommended for mental health aftercare services, only eight made it to the clinic as the result of a referral. They then found that the clinics had no records or knowledge of thirty-four of the other thirty-nine patients. On the other hand, Rosewood—the children’s institution that only two decades prior fought tooth and nail to keep a handful of Crownsville children from entering its premises—arranged direct placement for its patients with local providers and offered a year’s worth of follow-up and assistance in transition to other public or private facilities.

It appeared Crownsville’s patients were not only receiving less care, but when they did get support, they were more likely to have contact with people adjacent to the criminal justice system than the kinds of professionals who would have welcomed them back into jobs and school—the fundamental pillars that form community.

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

As patients at Crownsville became more subject to isolation and punishment, Black Marylanders living outside of institutions experienced a different type of isolation and restraint. In several parts of the country, Black communities were starting to see early signs of gentrification. Black Annapolitans were being pushed off their land and out of their homes and moved into urban centers and public housing.

In Maryland, you can often trace the story of Black families by looking at the water. From its earliest foundations, when Annapolis was a slave port, water acted as a symbol of the racial divide.

In the 1970s, developers and wealthy families decided that water was recreational and made for great real estate. Suddenly everything changed. “Developers started to move in, and that waterfront property was snatched up,” Rodney recalled. He watched as his friends and family dispersed. People who’d lived along the water and next door to one another for decades were being moved out to public housing on the outskirts of town with limited public services.

In 1957, Baltimore’s Clifton Park Junior High School had 2,023 white students and thirty-four Black students. One decade later, the same school had 2,037 Black students and twelve white students. Middle- and upper-middle-class white families abandoned the city’s public schools in shocking numbers.

During that same period, Baltimore brought law enforcement officers into its urban schools for the first time. Many of the state’s young, poor, and minority students were subject to police scrutiny for infractions that at any earlier time would have been handled by school administrators.

It was the asylum, not the prison, that had long been America’s mammoth institution. In 1952, less than 150 per 100,000 people were incarcerated in state and federal prisons, while over 600 per 100,000 were living in some form of asylum. And at the close of World War II, the ethnoracial makeup of American convicts was proportional to our national demographics: approximately 70 percent of the prison population identified as white and 30 percent as “other.” By the end of the twentieth century it had completely overturned to 70 percent African American and Latino and 30 percent white.

Crownsville’s records suggest that, while the story is nowhere near as simple as one institution morphing into the other, it is no coincidence that the end of the twentieth century marks both the decline of the mental hospital and the expansion of the prison system. And so in trying to better understand what happened to America in this period, Crownsville urges us to start the story of mass incarceration a little earlier—at a time when the prison and the asylum coexisted.

Historian Anne Parsons has long studied the effect of these policies on asylums and the criminal legal system more broadly. She found that during the 1970s and 1980s dozens of developmental centers, mental hospitals, and sanatoriums were converted to prisons, and that, in some cases, the annexation of mental hospitals into penal institutions allowed states to preserve union jobs that “were important to the financial welfare” of their communities.

“Politicians and policymakers worked on these issues in tandem,” she argued, “as funding decisions in one realm affected funding decisions in the other and as the infrastructure of mental hospitals and prisons often guided decision-making.”

when his sister Charlotte and brother Thomas both died from sickle cell disease within five years of each other in the 1980s, Nick felt less connected to being alive. He fell into something that was less like the dark depression he’d seen take hold of his childhood friend John, and more like a rupture. An unhinging. A former friend introduced him to crack cocaine in 1988, and feeling indifferent, Nick gave it a try. Within four years, the drug had taken everything, including his marriage and his career.

When he looks back, he realizes his grief had manifested as anger. “I was thinking, ‘Why is everybody dying?’” he told me. He had seen neighbors perish from AIDS and then watched two siblings die from sickle cell, two diseases that were disproportionately harming Black people and, at the time, there was no cure in sight.

Nick felt like his community had just reached new heights in their professions and influence in Maryland, only for illness, gentrifica...

Today, Nick works as a chef. He spends most of his time with his four kids, twenty-two grandkids, and nine great-grandkids. Despite everything that he’s been through, he’s one of the few kids from his block on the Old Fourth Ward who has lived to see his seventies.

</3

He started asking the nurses questions and found that the ward was divided over the girl’s case, and those divisions fell along racial lines. According to Paul, the teen had made remarks perceived as threatening toward a white staff member—the Black staff thought that was bullshit. A white staff member had placed the girl in the restraints for far longer than allowed by hospital guidelines and “it seemed there was no plan to end them,” he told me. “This was a commonly heard complaint, that Black patients were secluded more quickly and for longer periods than whites.”

Crownsville Hospital Center: 1911–2004

She started to question whether deinstitutionalization had been a noble project or an abject failure and a violation of human rights.

But some of Crownsville’s physicians told me they estimated that up to 90 percent of the homeless people they saw in the area in the early 2000s were former Crownsville patients. There had to be a better way forward.

In recent years, investigations in Maryland and across the country have found consistent patterns of state-funded, privately run group homes that are filthy, struggling to maintain basic services, and violating safety precautions. Many of them fall back on the same restraint-heavy punitive measures that they were explicitly designed to replace.

At times, patients end up deciding that homelessness is preferable to the turmoil and abuse in the homes. When she runs into patients like R, Faye grieves. She wishes Crownsville had never closed down.

Hendler had arrived to a hospital in crisis; the state had hired thirty-three-year-old Haroon Ansari to run Crownsville in 1994, only to discover that he had completely fabricated his résumé. Somehow the Department of Health and Mental Hygiene had overlooked Ansari’s claim that he had run a mental health program in Kansas City at the ripe age of thirteen.

Many of them came from families just like mine, where for years there was a refusal to talk about mental health or to acknowledge a loved one lost. Generations have kept on running, afraid to turn and look 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. It will take hold of that person who is willing to acknowledge that it is there, and demand that they find their way back through the forest.

“I feel as though the county, just like the country, we are a microcosm, demographically and politically—that the county still needs to heal.”

“It’s part of the philosophy of Annapolis,” Dr. Sims told me. “We have to find an audience that even wants to listen. But if they do want to listen, boy, do we have a story to tell.”

Perhaps that is part of what makes us so unsettled when we encounter others who can’t conceal how sick, lost, and distraught they feel. We are confronted with a choice—when what we really want to do is to shirk responsibility. We are reminded that we are not so healthy and virtuous after all. We’re forced to consider the role we might have played in isolating our neighbors, and how crazy it was that we ever thought we could alienate them, cut funding for the programs that helped them, dispose of the park benches where they might have found rest, and then somehow avoid a public confrontation. It’s cruel. It’s madness.