Madness: Race and Insanity in a Jim Crow Asylum
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- Create Date：2024-02-21 13:21:44
- Update Date：2025-09-07
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- Author：Antonia Hylton
- ISBN：B0C9S83JN4
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Summary
In the tradition of The Immortal Life of Henrietta Lacks ， a page-turning 93-year history of Crownsville Hospital， one of the nation’s last segregated asylums， told by an award-winning journalist on her decade-long search for sanity in America’s mental healthcare system。
On a cold day in March of 1911， officials marched twelve Black men into the heart of a forest in Maryland。 Under the supervision of a doctor， the men were forced to clear the land， pour cement， lay bricks， and harvest tobacco。 When construction finished， they became the first twelve patients of the state’s Hospital for the Negro Insane。 For centuries， Black patients have been absent from our history books。 Madness transports readers behind the brick walls of a Jim Crow asylum。
In Madness ， Peabody and Emmy award-winning journalist Antonia Hylton tells the 93-year-old history of Crownsville Hospital， one of the last segregated asylums with surviving records and a campus that still stands to this day in Anne Arundel County， Maryland。 She blends the intimate tales of patients and employees whose lives were shaped by Crownsville with a decade-worth of investigative research and archival documents。 Madness chronicles the stories of Black families whose mental health suffered as they tried， and sometimes failed， to find safety and dignity。 Hylton also grapples with her own family’s experiences with mental illness， and the secrecy and shame that it reproduced for generations。
As Crownsville Hospital grew from an antebellum-style work camp to a tiny city sitting on 1，500 acres， the institution became a microcosm of America’s evolving battles over slavery， racial integration， and civil rights。 During its peak years， the hospital’s wards were overflowing with almost 2，700 patients。 By the end of the 20th-century， the asylum faded from view as prisons and jails became America’s new focus。
In Madness， Hylton traces the legacy of slavery to the treatment of Black people’s bodies and minds in our current mental healthcare system。 It is a captivating and heartbreaking meditation on how America decides who is sick or criminal， and who is worthy of our care or irredeemable。
On a cold day in March of 1911， officials marched twelve Black men into the heart of a forest in Maryland。 Under the supervision of a doctor， the men were forced to clear the land， pour cement， lay bricks， and harvest tobacco。 When construction finished， they became the first twelve patients of the state’s Hospital for the Negro Insane。 For centuries， Black patients have been absent from our history books。 Madness transports readers behind the brick walls of a Jim Crow asylum。
In Madness ， Peabody and Emmy award-winning journalist Antonia Hylton tells the 93-year-old history of Crownsville Hospital， one of the last segregated asylums with surviving records and a campus that still stands to this day in Anne Arundel County， Maryland。 She blends the intimate tales of patients and employees whose lives were shaped by Crownsville with a decade-worth of investigative research and archival documents。 Madness chronicles the stories of Black families whose mental health suffered as they tried， and sometimes failed， to find safety and dignity。 Hylton also grapples with her own family’s experiences with mental illness， and the secrecy and shame that it reproduced for generations。
As Crownsville Hospital grew from an antebellum-style work camp to a tiny city sitting on 1，500 acres， the institution became a microcosm of America’s evolving battles over slavery， racial integration， and civil rights。 During its peak years， the hospital’s wards were overflowing with almost 2，700 patients。 By the end of the 20th-century， the asylum faded from view as prisons and jails became America’s new focus。
In Madness， Hylton traces the legacy of slavery to the treatment of Black people’s bodies and minds in our current mental healthcare system。 It is a captivating and heartbreaking meditation on how America decides who is sick or criminal， and who is worthy of our care or irredeemable。
Reviews
Jess
，
Really great case study from a journalist about black history and mental health system history。 If you've ever wondered why mental health is still a hard discussion for the black community， read this book！ Really great case study from a journalist about black history and mental health system history。 If you've ever wondered why mental health is still a hard discussion for the black community， read this book！ 。。。more
Cheryl Robertson
，
An important and uncomfortable book。 If we don't face our past， we can improve our humanity。 An important and uncomfortable book。 If we don't face our past， we can improve our humanity。 。。。more
Colleen Yerton
，
This nonfiction account delving into the history of Crownsville Hospital is excellently written。 The amount of research that Hylton must have done to write this book is impressive， along with her concise way of putting it together。 You can tell that she also has a lot of compassion for the patients of the asylum， along with those that ran the facility。 I did not realize that as the asylum populations dwindled in the USA， the prison populations grew。 Not a surprising fact， just something I never This nonfiction account delving into the history of Crownsville Hospital is excellently written。 The amount of research that Hylton must have done to write this book is impressive， along with her concise way of putting it together。 You can tell that she also has a lot of compassion for the patients of the asylum， along with those that ran the facility。 I did not realize that as the asylum populations dwindled in the USA， the prison populations grew。 Not a surprising fact， just something I never thought about before。 I highly recommend this book。 。。。more
Lisa Wells
，
Shocking and superb。 I have lived miles from the Crownsville Hospital for decades and have wondered about this place。 Antonia Hylton meticulously researched the history and tells a tragic story that we must understand and reconcile。 This will be an important work in our community’s history， as well as our state and country。
June
，
I don't know why I even become surprised when I find out about a new atrociousness that Black people have suffered through。 After reading this book， I now know that supposedly mentally unstable people had to clear the land and build their own Asylum！ WHAT！！Adding insult to injury was the fact that they were also loaned our to work on other outside projects for no pay for themselves， but the Asylum was paid for their services！They rarely received therapy。 But when they did become better if they w I don't know why I even become surprised when I find out about a new atrociousness that Black people have suffered through。 After reading this book， I now know that supposedly mentally unstable people had to clear the land and build their own Asylum！ WHAT！！Adding insult to injury was the fact that they were also loaned our to work on other outside projects for no pay for themselves， but the Asylum was paid for their services！They rarely received therapy。 But when they did become better if they were good at their "unpaid job" they weren't considered possible for release because。。。 'they were good at their "unpaid job。'Talk about being Black and just can't win。 Damn。 。。。more
Ben Jameson
，
This reads like a very very long USA Today-quality article， with a title borrowed from a New Yorker buzzword generator machine。 What a weak book。 Disappointing
Alicia
，
This book was very informative and interesting。 I think I didn’t realize how hyper focused it would be on just this one asylum， not necessarily a larger picture view。 Lots of focus on specific individuals who worked there or were sent there for treatment。 At times， it did feel as though it lagged。 That being said， it’s a very important piece of history and I am glad I read this book。
Parkway
，
Painful to read。 Lawd have mercy！
Nicole Brooks
，
Well researched， but absolutely gut wrenching。
Greg
，
Very good， solidly researched， illuminating。 The author tells us that there is much material in Maryland State archives she could not access， so I think there is more to be said。 I want to know the WHOLE story。
Glenda Nelms
，
Very impactful and important nonfiction book is a call to action in addressing mental health in our communities。
Megan
，
A great work of investigative journalism， Antonia Hylton’s Madness: Race and Insanity in a Jim Crow Asylum is by equal measures incredibly engrossing and expectedly unsettling。 Hylton talks her own familial struggles with mental health issues: the hard truths and the painful realities she encountered before and during the writing of this book。 It allows for her to come across as a very sympathetic author， speaking with compassion and concern on a difficult and sensitive subject。 When one conside A great work of investigative journalism， Antonia Hylton’s Madness: Race and Insanity in a Jim Crow Asylum is by equal measures incredibly engrossing and expectedly unsettling。 Hylton talks her own familial struggles with mental health issues: the hard truths and the painful realities she encountered before and during the writing of this book。 It allows for her to come across as a very sympathetic author， speaking with compassion and concern on a difficult and sensitive subject。 When one considers how horribly the United States has historically treated mentally ill patients （especially those institutionalized） in the early and mid 1900s， it’s not difficult to imagine just how much worse black patients had it。 Even with that in mind， so many of the individual stories are downright heartbreaking。 So many of these patients did not suffer from any type of demonstrable mental illness whatsoever， but were simply locked up in asylums because they had been a “nuisance” to white communities at any given point。 The ones that were truly ill and in need of comprehensive treatment were at best ignored and at worst， restrained to the point of abuse， or in some cases， forced to undergo electroshock and lobotomy “therapy。” The lucky ones were the ones who had supportive and loving families， that made sure they knew they were wanted and loved。 Those are the patients that made it out。 Many others never did， and in the worst cases， some had been placed inside the Crownsville facility with their families never being informed。 Some instances are particularly harrowing: ”Betty Hawkins …did what she could to get patients she felt didn’t belong there released。 One afternoon， a patient in the HY Building approached one of her student interns in desperation。 For some time， this patient had been begging for any and everyone to listen。 He said he didn’t belong in an asylum…but no one had taken him seriously。 The patient gave this student a phone number and address of his brother， who he said lived in Washington， D。C。 and begged them to call。 Betty Hawkins discovered everything the patient said was true。 His brother had been looking for him for years and had no idea where he was。 He thought his brother had been kidnapped or killed， but he was just waiting around in Crownsville the entire time。Betty notified the necessary administrators of the ‘mix-up’ and got him out。 That patient wasn’t the only one。 Another patient Betty worked with had been at the hospital for twenty-seven years。 After worrying about how isolated this patient had become， Betty contacted their relatives in Baltimore。 The family was in shock。 They， too， had no idea their loved one was there…for twenty-seven years， they had assumed the worst。”I think it’s pretty much a given that if the staff is so understaffed and overwhelmed that they wouldn’t even bother to make a phone call on a pleading patient’s behalf， then any real standard of care would be absent。 Fortunately， Hylton does speak of nurses like Betty and other black staff who did their best to make a difference when and where they could。 The advent of more black staff allowed more positive outcomes like proper care and discharge home to their families to occur。 My only real complaint（s） - and thus the four stars - was that a disconnected narrative often didn’t follow a linear path - something I believe would have been preferable for a story taking place over the course of nearly a century。 Also， for as long and as well-researched as the book was， Hylton doesn’t organize her sources as neatly as she could have， and at times， I didn’t see a source at all， which made me wonder if conclusions hadn’t been drawn too quickly in order to save time。 An example of this would be on p。 111， when she surmises about a woman’s pregnancy and if the stressful birth may have contributed to the premature death of the child， to which the woman said she had no way of knowing。 The problem here is， the baby was already three months old。 It’s already mentioned the cause of death as pneumonia （aligning with the fact that the woman and her family lived in a shack with no heat during a freezing cold season）。 I know， I know， I might sound like I’m being too nitpicking here， but if the storyteller herself doesn’t mention this as the cause of the tragedy， and a very plausible explanation exists， then I just don’t understand the need for further speculation。 I could write a lot more on this， but I think I’ve gone on long enough。 :） I definitely recommend as a must-read book。 For it is the very true and painful experiences found within Hylton’s book that allow white readers to gain a better understanding of how horribly unjust things truly were for blacks in a segregated community。 I hope to see more from this author in the future。 Sorry for any errors… I’m tired。 😴 。。。more
Sarah Morris
，
So good！
Percy
，
This book was incredible。 Antonia Hylton destigmatizes mental illness and hospitalization， while also criticizing the historical and current mistreatment of Black people by mental healthcare systems。 Who does deinstitutionalization benefit most？ Drawing parallels between the decline of asylums and the rise of mass incarceration was a connection I had never before considered。 I appreciate the nuance and vulnerability with which Hylton handles her investigation。 Truly brilliant work。
Kristine
，
My first thought reading this book is， Why can we not extend ourselves and do the right thing？ It is just that simple。 Leaving our most vulnerable to struggle in an Asylum and trying to forget these individuals are people with feelings， need for community， safety， and peace is wrong on every level。 This book examines Crownsville Institute。 It is extremely well written and researched。 It is also clear the author has much empathy and compassion for this important story。 Crownsville Institute only My first thought reading this book is， Why can we not extend ourselves and do the right thing？ It is just that simple。 Leaving our most vulnerable to struggle in an Asylum and trying to forget these individuals are people with feelings， need for community， safety， and peace is wrong on every level。 This book examines Crownsville Institute。 It is extremely well written and researched。 It is also clear the author has much empathy and compassion for this important story。 Crownsville Institute only black people went to。 It was located in Annapolis， Maryland which I did not even know operated under Jim Crow Segregation。 State Mental Hospitals have a long history of very questionable practices。 So， now add in rascism， lack of funding， overcrowding， and initially the staff could only be white。 How could this possibly work out well？ It is doomed to have severe problems。 These are obvious。 When the staff doesn’t know or understand the population they are caring for， this is a problem。 When we mix individuals from jail， the homeless， the severely mentally ill， the displaced showing mild signs of mental distress， individuals with disabilities， and children we have a serious problem。 That is a given， yet it was done。 Experimenting on patients without their knowledge or consent causes fear and mistrust。 Using the Negro Hospital as a dumping ground for all sorts of problems and the staff must take that person as I patient will not create good results。 We hurt， each and every person when we dehumanize them and just try to look away。 I applaud Antonia Hylton for writing this book。 It deeply affected me and was disturbing。 She has a family member with a serious mental illness。 I understand this since anxiety and depression run in my family as well。 That is enough to have to struggle through。 If you are fortunate， you have family able to carry much of the caretaking and oversight。 If you are not， you are probably not going to have a good outcome。 This is too much to ask families to carry alone。 We must admit the damage afflicted toward black individuals。 Most have had to navigate a way of life that does not expect much success to come their way。 Now， if you are sick， you add a serious additional hurdle that many just can not overcome。 It hurts communities， it hurts society， it hurts our basic dignity。 We owe the mentally ill， and this addresses black individuals， much better。 Care and healing must be our goals or do not be surprised when these communities have absolutely no trust in doctors， therapists， or anyone claiming they can help。 No one who sees such injustice over generations is going to easily think their well being is a priority。 This is shameful and it cuts the ability of many who could strive and bring incredible success to the United States。 We must do better， starting immediately。 I read books like this to stay informed。 If I don’t know the past history， how can I possibly even suggest solutions？ I felt for so many of these individuals。 It was quite clear Ms。 Hylton is trying to be fair and give informed information。 She is trying to bring the complete story out including many employees that cared deeply for some of these patients。 Black people working at the institution were in a better position to understand the people living at Crownsville， some for decades。 She does not have an ax to grind or not credit those who made contributions。 She does one outstanding job with a difficult story to tell。 May we read and learn from our mistakes and have decency and kindness finally prevail。 It will make each and every one of us feel proud and know we stand behind those struggling with an illness or sometimes just a different kind of personality。 Our overall thinking must change and there is a need to strive for excellence。 We need to listen to those who know this population and of course ask the individuals their needs。 This goes a long way。 Thank you NetGalley， Antonia Hylton， and Grand Central Publishing for a copy of this book。 I always leave reviews of books I read。 。。。more
Caitlin （CMAReads）
，
Such excellent research went into this engrossing and enraging nonfiction。 I learned a lot， and liked how she told individual stories - how important that is in a book that talks about such heavy topics。 This will definitely be one of the nonfictions that I recommend to everyone and will be a favorite of 2024。
Jill L。
，
Really， really well written and narrated account of the systemic racism that has infected mental health care from its beginnings until now。 The personal stories of the individuals who worked at Crownsville and that of the author were very riveting。
Breanna
，
2。5 stars Unfortunately， this felt just like a list of the usual horrifying and grotesque racism of the time。 I applaud the author for taking this on， as they clearly did immense research。 This book will benefit some readers， even if it didn’t add anything new for me。
Kathy Houser
，
Fantastic and informative read that taught me some sad history for our country and the state of of Maryland。 Very sad story of what our Black sisters and brothers were forced to endure in Crownsville Asylum for "Negroes"。 Back in the day it was asylums for racist treatment in our country， now it is the pipeline to prison we must end！ Fantastic and informative read that taught me some sad history for our country and the state of of Maryland。 Very sad story of what our Black sisters and brothers were forced to endure in Crownsville Asylum for "Negroes"。 Back in the day it was asylums for racist treatment in our country， now it is the pipeline to prison we must end！ 。。。more
Erin
，
4。5 Stars！ Madness is the harrowing story of not only one of the last segregated asylums in the U。S。 but also a look at how the mental health of Black people has been mistreated for decades。 Crownsville was located in Maryland as the only mental hospital to serve Black patients and it was a substandard institution from day one。 Racism in healthcare was and still is a huge problem。 Madness shows why we need to view healthcare as a civil rights issue。 I can't say I enjoyed this book but I did lear 4。5 Stars！ Madness is the harrowing story of not only one of the last segregated asylums in the U。S。 but also a look at how the mental health of Black people has been mistreated for decades。 Crownsville was located in Maryland as the only mental hospital to serve Black patients and it was a substandard institution from day one。 Racism in healthcare was and still is a huge problem。 Madness shows why we need to view healthcare as a civil rights issue。 I can't say I enjoyed this book but I did learn alot。 Antonia Hylton is a masterful truth teller。 I can't imagine how hard all this research was to conduct。 Every review I've read calls this book a revelation and I whole heartedly agree。 A Must Read for Everyone！ 。。。more
Emily
，
I chose this book in honor of Black History Month。 It largely focuses on the history of the Crownsville Hospital in Maryland， one of the last segregated asylums。 The book is well-researched， including interviews with patients and employees， information from surviving records， and general contextual history。 Hylton also included personal stories about her family’s experience with mental illness。 The lack of services for people with mental illness in the early 1900s， especially for people of color I chose this book in honor of Black History Month。 It largely focuses on the history of the Crownsville Hospital in Maryland， one of the last segregated asylums。 The book is well-researched， including interviews with patients and employees， information from surviving records， and general contextual history。 Hylton also included personal stories about her family’s experience with mental illness。 The lack of services for people with mental illness in the early 1900s， especially for people of color， is sad， but unfortunately not surprising。 The asylum contained a mix of people with developmental disabilities， people with actual mental illness， and people that had been dropped off for a variety of nonmental health reasons （e。g。， to keep them silent， for being drunk）。 Some families had no idea their family member had been taken there， only to find out years later （after assuming they had died）。 Also surprising--the patients were the ones that actually built the hospital， and chronic underfunding and understaffing， coupled with the idea of work therapy as a key to recovery， continued the use of patients as workers， both on and off the campus。 While there were some good employees， the conditions and treatment by an all-White， untrained， overworked staff were exploitative and cruel （especially at the beginning）。 Hylton also explains the relationship between the decline in mental institutions and rise in mass incarceration。 Interesting and well-researched。- Drapetomania – a term coined by a doctor in the mid-1800s to describe the “mental illness” that caused Black people to want to flee enslavement。 Can you imagine thinking that not wanting to be enslaved was a mental illness？ This was one of many shocking things discussed in the book。 。。。more
Jennifer
，
Seemed more like a book complaining about basic mistreatment of blacks in general， with a bit of the asylum thrown in occasionally。 It’s common knowledge that the majority of asylums during that time period had the same issues-black， white， red， or yellow。 The constant capitalization of Black was distracting and annoying。Not what the title leads you to believe。
Madeline
，
absolutely fantastic book
Jean
，
This is a gripping， powerful， fascinating， and utterly heartbreaking book。 It is thoroughly researched and extremely well-written。 Hylton does an excellent job of blending the research and interviews and puts together a compelling narrative of a story that hasn’t been explored enough。 Highly recommend。
Amy Andrews
，
What is most striking about this at times unbelievable history is that it was the circumstantial black workers who lead the way in managing to squeeze anything good and productive out of the institution。 What began under white management and dismissive intention ended up being as helpful under black management as it could possibly be given the range of constraints。 Equal parts horrifying and inspiring depending on how you look at it。
Quinetta
，
This book was such a difficult read…not the quality of the book but the content。 The information provided was so eye opening but also sad because of the disparity in mental health services and care between the different races。 Crownsville hospital began with such evil intentions and so many tried to change the environment over time but white supremacy is so insidious and hard to get rid of that when you mange to do so…it’s too late。 I encourage everyone to read this book， confront the realities This book was such a difficult read…not the quality of the book but the content。 The information provided was so eye opening but also sad because of the disparity in mental health services and care between the different races。 Crownsville hospital began with such evil intentions and so many tried to change the environment over time but white supremacy is so insidious and hard to get rid of that when you mange to do so…it’s too late。 I encourage everyone to read this book， confront the realities of the availability of mental health services over the years， how it’s dealt within familial spaces and how it’s handled within the black community。 。。。more
Lucy
，
How do you rate a book that is filled with such true horror？ Not fantasy - actual facts。 I rated it 5 for the detailed historical research done by the author。 The author also was the narrator of the audiobook， and provided her family experience with Crownsville， helping to reinforce the cases she detailed。 I， a former Annapolis resident， was unaware of any of this。 And once again， reading history from a black perspective has made me so much more aware of how deep the pain and suffering of black How do you rate a book that is filled with such true horror？ Not fantasy - actual facts。 I rated it 5 for the detailed historical research done by the author。 The author also was the narrator of the audiobook， and provided her family experience with Crownsville， helping to reinforce the cases she detailed。 I， a former Annapolis resident， was unaware of any of this。 And once again， reading history from a black perspective has made me so much more aware of how deep the pain and suffering of black people at the hands of white people。 It's beyond upsetting。 。。。more
Charles Grand
，
Shocking and insightful at the same time， wow！
Angela Christopherson
，
Continued RacismThe research is impressive and educates many， such as myself， that had no idea of the cruelty， however; I see prejudice displayed throughout the book in such that Black is written with a capital letter but white is all lower case。 How are we ever going to get past the hatred for each other if little things such as how a word is written continues to act as a dagger to others？ It's terrible that the historic government allowed people to be treated so inhumanely but to continue to c Continued RacismThe research is impressive and educates many， such as myself， that had no idea of the cruelty， however; I see prejudice displayed throughout the book in such that Black is written with a capital letter but white is all lower case。 How are we ever going to get past the hatred for each other if little things such as how a word is written continues to act as a dagger to others？ It's terrible that the historic government allowed people to be treated so inhumanely but to continue to cut each other with words and actions， insignificant as it may seem， will only prolong the resentment and prevent healing and love to prevail。 。。。more
Amber
，
I am overwhelmed with the care， emotion， and research that went into putting oral history， medical records， and legal documentation together to tell the stories of the Crownsville asylum。
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madness race and insanity in a jim crow asylum madness race and insanity in a jim crow asylum by antonia hylton