ADMINISTRATIONS OF LUNACY

A penetrating study of color-line injustices in the realm of psychiatry.

Some 25,000 bodies lie buried behind the Central State Hospital in Milledgeville, Georgia, the world’s “largest graveyard of disabled people,” part of the world’s largest mental asylum. Founded in 1842 and operational until a decade ago, it was part of a system that, as with other institutions in the Deep South, was divided by race. Mentally ill (or so declared, at any rate) African Americans were put to work in fields and factories and deprived of books, writing materials, and personal items; mentally ill whites were given more leeway and greater privileges. Social justice activist Segrest interrogates the records to give specific weight to such charges. She notes, for example, that when it came to calico dresses at the time of the supposedly separate-but-equal tenet of Plessy v. Ferguson, “white women got one thousand and colored women got a negligible thirty-five.” (The term “colored,” she explains in the opening pages, is a term of art of statisticians of the period, as are such designations as “imbeciles” and “lunatics.”) Valuably, the author also examines psychiatric files to investigate presumed offenses that brought African Americans to Milledgeville in the first place. Many women, for their part, were hospitalized with what would now likely be characterized as PTSD following physical abuse, rape, and other assaults. The hospital operated on “modern” theories promulgated by specialists who were likely in the early 20th century to advocate sterilization of the mentally ill in the interest of eugenics, with Georgia standing at “the epicenter of race and psychiatry” in inflicting this punishment on African Americans disproportionally. For those who suppose that all is well now, Segrest concludes, pointedly, that the “struggle for equity in medicine and health in the United States and globally is not won, and may not be for a while.”

A valuable contribution to the history of mental health care and of the racist applications of medicine.