Madness: Race and Insanity in a Jim Crow Asylum

Crownsville Hospital Center, formerly Maryland’s Hospital for the Negro Insane, opened in 1911 and operated until 2004. For decades this was the only mental health hospital in Maryland that would accept Black patients but it suffered from overcrowding, low staff, and barely any funding. From the very beginning this hospital housed patients in terrible conditions and didn’t really work to treat their issues, mainly just drug them into compliance. At least until Black staff were finally able to work with the patients and tried to change the way patients were treated, but it wasn’t enough. This book weaves the testimony of more than forty patients and employees of Crownsville with materials from the Maryland State Archives to reveal the history and truth of this institution. This book was eye opening, emotional, and a bit hard to read at times. Crownsville is not a place I have ever heard of before but it’s clear from the very beginning that it played an important part of history. I learned so much from this book and was amazed, and horrified, at what I learned about how patients were treated at Crownsville. I normally read a book pretty quickly, but this one took me two weeks as I slowly read about what happened and just sat with what Black patients experienced at this institution. Not only does this book take us through the history of Crownsville from its creation, through desegregation, deinstitutionalization, and closing, it also takes us through the lives and families of patients and employees who worked there. I really loved the blend of history with personal stories because it created a more impactful read for what it was like at this institution and how it wasn’t always a bad place for people, it did actually help some people. I will say that there were two things in this book that really surprised me in this book. One, was that Henrietta Lacks' 10 year old daughter, Elsie, ended up in Crownsville because she had cerebral palsy, epilepsy, and what was labeled “idiocy” and needed constant supervision. Hospitalization was supposed to be best for her but instead she suffered abuse, mistreatment and medical experimentation that she couldn’t consent to since she was nonverbal. She died at the hospital when she was 15. Elsie’s story was heartbreaking, especially considering her mother most likely would have pulled her from the hospital if she had been alive because of how she was being treated. Secondly, I never really knew about the history of deinstitutionalization or the deinstitutionalization to prison pipeline. It was crazy learning that so many of the institutions that closed became prisons. Or that the rise of mentally ill people being imprisoned because of mental health issues started to rise at the time of deinstitutionalization and it has never stopped. Now mentally ill people are sent to prison all the time instead of being sent to a mental health facility to actually help them so the cycle never breaks. Overall, this was a very emotional and heartbreaking book, but also a very important one to read. It shows the heartbreaking history of mental health institutions for Black patients and how it has changed over the years, but also stayed the same. In 2026, mental health access for marginalized communities is still an issue and prisons are filled with people who really just need mental health access. TW: mental illness; involuntary institutionalization; slavery, racism, segregation and Jim Crow laws; indentured servitude; lynching; murder; racial slurs; police brutality and murders; racial profiling; pregnancy complications; child death; child molestation; nonconsensual medical experimentation; suicide; sexual assault and rape; murder; PTSD; physical abuse; Agent Orange use and side effects; drug use and overdose; homelessness;

Madness was 10/10! I highlighted and annotated so much reading this book. It’s a multifaceted book in my opinion. While the main premise is about the Crownsville Hospital in Maryland (an asylum). But the author weaves themes of racism, the history of psychiatry, mental health, criminal justice, biography and political tones in a way that I haven’t seen done before. Needless to say, I learned a lot. I highly recommend reading Madness.

What an excellent book for this black history month. I knew science/medicine wasn't the best surrounding the disabled and mentally ill back then, but I never put two and two together that it's exponentially worse if you were black. Like duh, there's an intersection here! Makes me understand more why black folks talking about mental health just isn't a thing in some generations. A heartbreaking read or listen, cause I was on audio books for this one. It's a story that needed to be told, that needed to make ppl uncomfortable. One part that really stuck with me, because I've always thought this way: Chapter 16, black soldiers, fighting for freedoms they've never even experienced and won't experience if they return home. Fighting ppl just as impoverished as them. Fighting for a country that has and will always find a way to de-humanize them. Finally someone said the quiet part out loud! Definitely a perspective I never thought about, but I'm glad their history has been shared.

This was a great book. It shed light on how Black mentally ill people were treated and how they are still treated today 2024.