Review – Madness: Race and Insanity in a Jim Crow Asylum
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Have you ever heard that many states had asylums specifically for black people in America? This book traces the history of Crownsville Hospital in Maryland from its very beginning, 1911. The history is not pretty, and it’s not an uplifting story. Unfortunately, it fits right in with other books I’ve read recently, which I’ll get to.
It’s a story of an asylum that promised healing and rehabilitation but rarely provided anything of the sort. Antonia also brings the receipts to compare what was supplied at Crownsville to white mental health asylums in Maryland at the time. White children diagnosed with mental illness were given an education along with treatment. In contrast, black children with the same diagnosis were considered dangerous and left to fend for themselves among the adult population of Crownsville with no education. That’s just one of many examples.
She also documents how Crownsville was used strategically during the Civil Rights era to have black protesters, agitators, or unemployed black men “committed” to the asylum, with little to no medical basis, just to keep them out of society. She shares details of family members sent to Crownsville, never to be heard from again, and families left only with a mystery of what might have happened to a brother, child, and father.
As I said, this isn’t a pleasant read. However, it did make a nice segue into an older book on a similar topic, The New Jim Crow: Mass Incarceration in the Age of Colorblindness.
What the two books together taught me is how our justice system has continuously created crimes and punishments meant to hide away problems and how mental health issues become criminal issues when they involve people of color and lower social castes. As we have discussed many times, there are far too many people in the US who need mental health treatment. Far too many of them live in poverty and with cultural trauma that is contributing to their mental health issues, and yet we seem determined to house them in a place that only makes it worse.
We do that by criminalizing things like loitering, being homeless, and disturbing the peace and selectively applying those charges to people of color and some poor whites. We also do it by handing down massive criminal penalties for acts of self-medicating involving drugs that we don’t hand down for drinking and driving or taking illegal pills to self-medicate our mental health issues.
The asylum system in the US was not great for many people. What these books make clear, however, is that it was especially difficult for black patients in segregated mental health asylums. We shut down almost the entire asylum system because of documented mistreatment of patients, but instead of providing resources for treatment, we put people in prison now. Where they still don’t get any treatment and where they are easily ignored and forgotten by most of us.
We have failed at this for over 100 years and show no sign of improving it. I’d argue that this is only going to get worse. We elect people who don’t care about the situation being played out in our prison systems and who benefit from the way things are now. In turn, they keep telling us how scared we should be of immigrants, minorities, the mentally ill, etc.
If we want to advocate for mental health, we need to advocate against policies that make mental health issues worse for so many people. Prisons do that. Putting more people in jail does that. The number of incarcerated people in the US is the highest in the world. Many of them need mental health treatment, not criminal records, and a felony conviction that prevents them from getting jobs, housing, and care even once they are outside of prison.
We are failing members of our society because we don’t see them as fully human. This failure transcends race, even if much of it started with racism. The Jim Crow laws that had blacks put in prison and mental asylums in the 50s and 60s became the War on Drugs in the 80s and 90s. Poor whites then got caught up in the same system when the opioid epidemic hit, and they were being dumped into the same penal system. Not one designed for treatment and rehabilitation, one designed to lock up people we don’t like. The lack of mental healthcare leads to more interactions with law enforcement, which leads to more violent deaths and more mental health issues that get worse in prison, leading to further deaths.
It’s not clear that enough of us care to do anything to change this. It may be that we like believing that there is always some group beneath us in society, and the addicts with mental health problems will do well enough for that purpose.
If I may make one more book recommendation in this post. The Sum of Us: What Racism Costs Everyone and How We Can Prosper Together, by Heather McGhee, is a book that takes a hard look at the things we’ve all lost because of past racist policies. It’s especially interesting to take a good, hard look at how we all want to preserve our standing in society by keeping someone else below us and how policies we put in place to ensure some are always at the bottom wind up hurting all of us. From the community pools filled with concrete to avoid having to be desegregated through anti-immigrant sentiment that limits the growth opportunities in struggling small cities and out to not providing mental health care and addiction treatment to people who don’t “deserve it.”
There’s always an assumed reason not to provide something to prevent misuse, but we all miss it when it’s gone. We all pay the price for a lack of mental health options and addiction treatment, even as we vote against creating spaces to provide that before people end up in prison.
It’s too easy to seek simple answers to complex issues involving mental health treatment, but simple answers are rarely good ones. All three of these books show us a broken system: We kept trying to find simple answers that made us feel safe instead of complex answers that made things better for everyone. We have not learned a lesson yet.
