Madness: Race and Insanity in a Jim Crow Asylum

In the tradition of The Immortal Life of Henrietta Lacks, this New York Times bestseller is a page-turning account of one of the nation's last segregated asylums..."a book that left me breathless" (Clint Smith).

For centuries, Black patients have been absent from our history books. Madness transports readers through the ninety-three-year history of Crownsville Hospital, one of the last segregated asylums with surviving records and a campus that still stands to this day in Anne Arundel County, Maryland. Antonia Hylton blends the intimate tales of patients and employees whose lives were shaped by Crownsville with a decade-worth of investigative research and archival documents. Madness chronicles the stories of Black families whose mental health suffered as they tried, and sometimes failed, to find safety and dignity. Hylton also grapples with her own family's experiences with mental illness, and the secrecy and shame that it reproduced for generations.

As Crownsville Hospital grew from an antebellum-style work camp to a tiny city sitting on 1,500 acres, the institution became a microcosm of America's evolving battles over slavery, racial integration, and civil rights. Hylton traces the legacy of slavery to the treatment of Black people's bodies and minds in our current mental healthcare system. It is a captivating and heartbreaking meditation on how America decides who is sick or criminal, and who is worthy of our care or irredeemable.

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Published Jan 23, 2024

368 pages

Average rating: 8.4

10 RATINGS

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Community Reviews

anaaurora
Jan 29, 2025
10/10 stars
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.
A.Strong
Feb 26, 2024
8/10 stars
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.
Just 3
Feb 26, 2024
This was a great book. It shed light on how Black mentally ill people were treated and how they are still treated today 2024.

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