All Of It (WNYC) – “The History of a Segregated Mental Health Asylum”

Mental Health Mondays – February 2, 2024
Host: Alison Stewart
Guest: Antonia Hylton, author of Madness, Race and Insanity in a Jim Crow Asylum

Episode Overview

This episode of All Of It delves into the harrowing history of Crownsville State Hospital, a segregated mental health asylum in Maryland, as chronicled in Antonia Hylton’s new book, Madness, Race and Insanity in a Jim Crow Asylum. Through deeply researched journalism and personal connection, Hylton explores how the legacy of slavery, racism, and systemic neglect shaped the treatment of Black Americans with mental illness—and how this legacy reverberates through contemporary attitudes toward mental health care in communities of color.

Key Discussion Points and Insights

1. Establishment and Intentions of Crownsville (02:31)

• The hospital was built in 1911 explicitly for Black patients by a staff of white doctors and politicians.
• Paradoxically, the first patients—Black men, women, and even children—were forced to build their own asylum.
• White officials justified the institution as relief for Black suffering, but underpinning this was “a belief that, in some way, emancipation had been a mistake and Black people couldn’t handle freedom.” (03:10)

Quote:
“In Crownsville's case, it becomes the only hospital in the state of Maryland and quite possibly in the country that is so against paying for their patients’ health care that they force the patients to go into the woods and build it from the ground up.”
— Antonia Hylton (03:57)

• The institution reflected broader post-slavery strategies of segregated and substandard care for Black Americans.

2. Who Were the Patients? (05:04)

• The patient population spanned adults to children as young as ten, many without any mental health diagnosis—some were orphans, abandoned, or disabled.
• The criteria for admission often overlapped with criminalization of poverty; people were institutionalized for vagrancy or “unusual” behavior.
• Example: One man institutionalized for using a British accent—he was, in fact, British, but deemed insane by a white supervisor. (06:03)

Quote:
“There were people living with substance abuse challenges or who were arrested and brought to Crownsville for what some would call crimes of poverty... And it’s really not until the 50s and 60s that employees begin to question who should actually be there.”
— Antonia Hylton (06:42)

3. The Legacy of Henrietta Lacks’ Daughter (07:17)

• Elsie Lacks, daughter of Henrietta Lacks (whose immortal cells were used in medical research without consent), was a patient at Crownsville.
• Elsie, diagnosed with epilepsy and labeled “an idiot” due to her inability to communicate, was subjected to painful, non-consensual experimental procedures.
• Her fate illustrates the exploitation and medical abuse of Black patients.

Quote:
“Her daughter ends up being used by science in a different way... subjected to a horrible brain study... without her consent, without contacting the family.”
— Antonia Hylton (08:44)

• The story of Elsie and others fueled deep communal distrust of medical institutions.

4. Historic Distrust and Mythmaking (09:58)

• Stories like Elsie’s shaped local legend and real fear: rumors of doctors abducting Black people at night were rooted in true accounts.
• The boundaries between myth and history blur; institutional violence underpinned these communal narratives.

Quote:
“You come to realize they knew these stories. They heard these whispers... The line between fact and fiction becomes very blurry.”
— Antonia Hylton (10:40)

5. Barriers to Historical Research (11:19)

• Hylton spent over a decade accessing records, requiring extensive ethics reviews and facing bureaucratic resistance.
• Most patient records from before the 1960s were destroyed—systematically or due to poor storage conditions—leaving mainly the official, often biased, accounts.
• Oral histories from former patients, staff, and families were crucial to supplement the archival gaps.

Quote:
“All the records prior to about the 1960s have either been systematically and purposely destroyed, destroyed by asbestos or bug infestations... The records that had been preserved would have told a very one sided and very biased story.”
— Antonia Hylton (12:30)

6. Unsung Heroes and Lost Records (14:43)

• Some staff, like Paul Lurz, preserved fragments of history by saving documents and patients’ writings from destruction.
• The survival of these materials was not institutional, but due to personal commitment.

Quote:
“He put it into a fireproof cabinet in his own office... It's just a couple of these individuals who did everything they could on behalf of patients and the broader story that made this work possible.”
— Antonia Hylton (15:15)

7. Redefining Recovery: Community, Love, and a Vision for Care (16:02)

• The stories of Faye Belt and Sonya King, Black nurses and former patients, illustrate the importance of community-based, compassionate care.
• Recovery often resulted less from new medical technologies or medications, and more from daily, supportive human relationships rooted in shared experience.
• A glimpse is offered of what community mental health care could have been had the promises of the 20th century been fulfilled.

Quote:
“It was not medication... What changed everything for Sonya King is that Faye Belt, along with a bunch of other nurses who knew her, wrapped their arms around the King family... That kind of support and those messages save lives.”
— Antonia Hylton (17:15)

8. The Closure of Crownsville and the Aftermath (20:19)

• Shuttered in 2004 after decades of decline and systemic shifts including deinstitutionalization and civil rights advocacy.
• The 1960s marked a critical period as the civil rights movement intensified, community sympathies shifted, but so too did criminalization of Black protest and youth.
• Some civil rights activists were pathologized and institutionalized for challenging segregation.

Quote:
“The writing on the wall for Crownsville... comes in the 1960s and during the Black Power and protest movement... those things got pathologized and the medical field... often responded with backlash.”
— Antonia Hylton (21:57)

Notable Quotes & Timestamps

• “My wish is that madness will help us understand both our current broken mental health care system and our carceral one.” (00:59, Hylton quoting from the book’s introduction)
• “They force the patients to go into the woods and build it from the ground up, then to run a highly modern and productive farm for decades – what you see at Crownsville... is something unlike what any other group of patients have really been subjected to in American history.” (03:40, Hylton)
• “You come to realize they knew some of these stories... The line between fact and fiction actually becomes very blurry.” (10:40, Hylton)
• “The records that had been preserved would have told a very one-sided and very biased story.” (12:50, Hylton)
• “Those relationships, that love and commitment to your neighbor, to seeing a patient as a human being, that begins to really change health outcomes.” (17:57, Hylton)
• “You get a glimpse for a few decades of what that could do, what that could be, especially in a community of color at Crownsville... It changed my entire view of what good mental health care treatment looks like.” (18:23, Hylton)

Memorable Moments

• The story of Paul Lurz (former staff) rescuing documents in the hospital’s last days (14:43).
• The convergence of civil rights and mental health—how protestors were institutionalized for activism (21:10).
• The personal connection of the author, who comes from a family with histories of trauma and distrust, informing her empathetic approach to the subject (04:44).

Listener Takeaways

• The legacy of systemic racism in mental health care has longstanding effects, manifesting in mistrust and disparities that persist today.
• Crownsville exemplifies how American institutions often criminalized poverty and difference among Black populations instead of offering support or healing.
• Oral history and community memory are crucial when official records are missing or biased.
• The possibilities for humane, community-driven mental health care remain a lesson—and an opportunity—for today’s system.

Episode Contacts

Guest:
Antonia Hylton, in-person event at NYU Institute for Public Knowledge, 20 Cooper Square, Wednesday at 5:30pm.

Book:
Madness, Race and Insanity in a Jim Crow Asylum (Antonia Hylton)

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