In telling the story of Maryland’s Crownsville Hospital, Emmy Award-winning NBC News correspondent Antonia Hylton illuminates a troubling chapter in America’s treatment of its Black citizens. Readers of Madness: Race and Insanity in a Jim Crow Asylum will come away from Hylton’s disquieting book with a keen knowledge of our country’s profound historical failings in mental health care, as well as the persistence of these failings when they are compounded with racism today.
In March 1911, 12 Black men were delivered to a forest in rural Maryland just northwest of the city of Annapolis. For the next three years, their task was to construct the asylum that would house them, then called the State Hospital for the Negro Insane. At the hospital’s height in the mid-20th century, some 2,700 patients, including children, lived in “prisonlike conditions,” overcrowded and understaffed, at times with “one doctor per 225 patients.” Hylton traces the history of Crownsville over 93 years until its closure in 2004, revealing that even as some of its leaders strove to implement more humane policies, the hospital’s fundamental flaws persisted.
Hylton began work on the project that became this book a decade ago while a student at Harvard University. In 2014, she first accessed records stored in the Maryland State Archives, but these only partially revealed Crownsville’s dismal history—any records dating before 1960 were allegedly destroyed. To supplement her extensive archival research, she relied on reporting from Black-owned publications and conducted more than 40 interviews. Among her most fruitful conversations were ones with Paul Lurz, a former chief of social services who became an unofficial records preservationist, especially as the institution approached its final days; and Sonia King, a onetime patient who finished her education after her recovery and returned to Crownsville as a therapeutic recreation specialist.
In Hylton’s author’s note, she is candid about her inspiration for this research: Her own family history of mental illness motivated her to uncover where racial injustice and mental illness intersect. She interviewed family members in the process, writing, “I wanted to model the kind of self-exploration and judgment-free discussion that I hope my book inspires in others.”
Hylton’s account of the mistreatment of generations of Black patients at Crownsville and the callous approach of many caregivers and public officials makes for painful, but essential, reading. Madness is an unsparing reckoning with a fraught past and a clear-eyed call for a more responsible, compassionate future.
