MADNESS

A thoroughgoing, often shocking exposé of segregation in the treatment (or nontreatment) of mental illness.

NBC News reporter Hylton documents the history of Crownsville Hospital in Maryland, founded in 1911 as the Hospital for the Negro Insane. Getting to the story was not easy: The archives were incomplete because “the state had destroyed or lost most of the files preceding the year 1960, and others they had allowed to become contaminated with asbestos.” Unsurprisingly, the more controversial the past episode, such as the murder of a patient or systematic abuse, the likelier the documents were to have disappeared. Even so, in digging into the archives and seeking out those with firsthand or secondhand memories of the place, the author uncovered profoundly unsettling stories. One concerns an educator who, upon entering Crownsville after a case of typhoid fever had affected his mental health, “was just another inmate.” He was also effectively enslaved, and though Maryland was not in the Confederacy, it did permit slavery until 1864. In the Jim Crow era, Crownsville’s population swelled, its inmates growing tobacco and food crops under the supervision of white overseers; inside the walls of Crownsville, whites also governed the lives of Black people who were less treated than incarcerated. “Crownsville’s founding took vestiges of chattel slavery—from the style of the rolls to the financial recordkeeping format used on plantations—and translated them to a clinical setting,” writes Hylton, and the administration of the hospital remained remarkably consistent even after Maryland ordered the desegregation of state mental hospitals in 1962. Meaningfully, Hylton closes by examining the racialized discrepancies in mental health care today as they played out in the New York subway murder of Jordan Neely in 2023.

An excellent work of journalism and a strong contribution to the literature of both mental health care and civil rights.