“deinstitutionalization didn’t happen for everyone—at least, not with equal opportunity. And as a population that had effectively been twice damned and dishonored, many Black patients couldn’t benefit from the open arms of deinstitutionalization’s community-centric mental health mantra because they were allegedly responsible for the nation’s apparent moral decline and utter lawlessness. Historical records and employee testimony suggest Crownsville became emblematic of a broader, shape-shifting carceral ecosystem in the late twentieth century. The lines between incarceration and treatment, jail and hospital, became even muddier than they were before. As the patient became the inmate, the hospital’s story raised the question: what was the difference between deeming Black populations irredeemable or incurable?”