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4.35 AVERAGE
4.35 AVERAGE
dark
emotional
informative
sad
medium-paced
challenging
emotional
informative
reflective
sad
slow-paced
challenging
emotional
informative
reflective
sad
slow-paced
"Madness: Race and Insanity in a Jim Crow Asylum" is a powerful and meticulously researched account of the Crownsville Hospital for the Insane, exposing how systemic racism shaped the treatment of Black patients in America’s psychiatric history. Antonia Hylton blends archival work, oral histories, and cultural analysis into a compelling narrative that shines light on long-neglected voices. At times, the pacing can feel uneven and the dense detail overwhelming, but the book’s importance and emotional resonance far outweigh those moments.
for several years now, i’ve been thinking a lot about pathologization; namely, the pathologization of suffering from state sanctioned neglect and violence. thinking about how much of what we know today is built on racism; how the foundations of the mental health field in this country were built on beliefs such that enslaved people desiring freedom were considered a mentally ill for wanting freedom, how several recorded subjects were committed to crownsville not due to mental health needs but due to anti-vagrancy laws, due to the crime of being black in public, and how the patrons of crownsville were originally just another source of cheap labor to maintain antebellum profit margins.
i’m thinking about the ongoing issue of reasonable and rational responses to such violence being disregarded — being labeled as having “covid anxiety,” despite all the research that asserts how dangerous covid still is; the act of being labeled as “mentally unwell” in liberation movements, and the denial of sanity in an attempt to undermine activists and their work. i think of these things in conjunction with many aspects of our ongoing responses to mental health crises, with overarching extensions of the carceral system, and with threats of violence and refusal of autonomy for those who won’t fall in line. hylton shows time and time again in the text that community support and person-to-person care, specifically from people who understand you and your experiences, are what allows for healing and rehabilitation. without this, these structures are only used as threats that keep people from seeking help — see the threats of “night doctors” looming over the children of the community in the text, and the ever-developing conversations we have about tip toeing around doctors to avoid being involuntarily committed in our day to day.
beyond and in tandem with this, we have to consider how often the police are still called to respond to mental health crises, despite not being adequately trained in de-escalation and/or trauma informed care. i think of the names and memorials of disabled people killed by police, and of these rare incidences that don’t end in violence or death that then often result in the incarceration of those struggling with their mental health. further, the unpaid labor present in the text has by no means disappeared — unpaid or severely underpaid labor is a cornerstone of the prison industrial complex. and black people make up the biggest portion of the incarcerated when you consider population percentage. centuries after the fact, modern day slavery continues uninhibited.
outside of the more blatant carceral issues, i think it’s impossible to read this and not see the echoes present in how even benign counseling and mental health programs function today. “[personnel] were not highly trained. the attendants were the lowest paid and worked the longest hours of all state employees;” i see direct parallels between this, decades ago, with current community programs, which also don’t have sufficient staff coverage to assist with elopements and individual client needs. by extension, “clinical notes often privileged the provider’s point of view, and enforced hierarchies in power. doctors and nurses were the ones who decided what was valuable information, and what would constitute the stories of patient’s lives…by neglecting almost all personal and contextual information about their patients and doing little to preserve even a doctor’s account of clinical encounters, the hospital erased the patients’ humanity.” – how often do we hear about those seeking support being labeled “drug seeking”? how often do BIPOC with mental illnesses and disabilities get labeled as having oppositional defiant disorder for exhibiting symptoms that would get a white counterpart diagnosed with autism? how often are BIPOC, especially black people, subjected to medical abuse and neglect that leads to lasting trauma? even the widely-accepted assumption that “scary” mental illnesses like schizophrenia make a person inherently violent is based in racism.
overall, it’s sobering and nauseating to see how much has stayed the same in the last century. with that in mind, hylton maintains notes of optimism in her reporting: stories of people going out of their way to connect with clients, bringing them into their homes, bringing them clothes and treats, buying copies of their school photos like members of their families. there is hope to be had when communities support those in need, and that’s comforting and affirming to remember, even with the weight of the legacies of abuse, negligence, and disregard bearing down on you. with this in mind, her reporting is a scathing rebuke of a system riddled and rotted through with neglect and disregard for those most in need.
i’ve seen several reviews that call the book disjointed or disorganized, but i think hylton’s flipping back and forth between sources, time periods, and regions is intentional for the reasons mentioned above: showing the lasting impacts of the rhetoric, sentiments, and practices that led to crownsville’s founding, and how these behaviors and themes contribute to structural racism and ableism to this day. this work is not only an analysis of the mental health field within the microcosm of one facility, but is also an assertion of the importance of humanizing, remembering, and honoring those who the system has determined are undesirable and therefore forgettable.
i’m thinking about the ongoing issue of reasonable and rational responses to such violence being disregarded — being labeled as having “covid anxiety,” despite all the research that asserts how dangerous covid still is; the act of being labeled as “mentally unwell” in liberation movements, and the denial of sanity in an attempt to undermine activists and their work. i think of these things in conjunction with many aspects of our ongoing responses to mental health crises, with overarching extensions of the carceral system, and with threats of violence and refusal of autonomy for those who won’t fall in line. hylton shows time and time again in the text that community support and person-to-person care, specifically from people who understand you and your experiences, are what allows for healing and rehabilitation. without this, these structures are only used as threats that keep people from seeking help — see the threats of “night doctors” looming over the children of the community in the text, and the ever-developing conversations we have about tip toeing around doctors to avoid being involuntarily committed in our day to day.
beyond and in tandem with this, we have to consider how often the police are still called to respond to mental health crises, despite not being adequately trained in de-escalation and/or trauma informed care. i think of the names and memorials of disabled people killed by police, and of these rare incidences that don’t end in violence or death that then often result in the incarceration of those struggling with their mental health. further, the unpaid labor present in the text has by no means disappeared — unpaid or severely underpaid labor is a cornerstone of the prison industrial complex. and black people make up the biggest portion of the incarcerated when you consider population percentage. centuries after the fact, modern day slavery continues uninhibited.
outside of the more blatant carceral issues, i think it’s impossible to read this and not see the echoes present in how even benign counseling and mental health programs function today. “[personnel] were not highly trained. the attendants were the lowest paid and worked the longest hours of all state employees;” i see direct parallels between this, decades ago, with current community programs, which also don’t have sufficient staff coverage to assist with elopements and individual client needs. by extension, “clinical notes often privileged the provider’s point of view, and enforced hierarchies in power. doctors and nurses were the ones who decided what was valuable information, and what would constitute the stories of patient’s lives…by neglecting almost all personal and contextual information about their patients and doing little to preserve even a doctor’s account of clinical encounters, the hospital erased the patients’ humanity.” – how often do we hear about those seeking support being labeled “drug seeking”? how often do BIPOC with mental illnesses and disabilities get labeled as having oppositional defiant disorder for exhibiting symptoms that would get a white counterpart diagnosed with autism? how often are BIPOC, especially black people, subjected to medical abuse and neglect that leads to lasting trauma? even the widely-accepted assumption that “scary” mental illnesses like schizophrenia make a person inherently violent is based in racism.
overall, it’s sobering and nauseating to see how much has stayed the same in the last century. with that in mind, hylton maintains notes of optimism in her reporting: stories of people going out of their way to connect with clients, bringing them into their homes, bringing them clothes and treats, buying copies of their school photos like members of their families. there is hope to be had when communities support those in need, and that’s comforting and affirming to remember, even with the weight of the legacies of abuse, negligence, and disregard bearing down on you. with this in mind, her reporting is a scathing rebuke of a system riddled and rotted through with neglect and disregard for those most in need.
i’ve seen several reviews that call the book disjointed or disorganized, but i think hylton’s flipping back and forth between sources, time periods, and regions is intentional for the reasons mentioned above: showing the lasting impacts of the rhetoric, sentiments, and practices that led to crownsville’s founding, and how these behaviors and themes contribute to structural racism and ableism to this day. this work is not only an analysis of the mental health field within the microcosm of one facility, but is also an assertion of the importance of humanizing, remembering, and honoring those who the system has determined are undesirable and therefore forgettable.
challenging
informative
medium-paced
emotional
informative
sad
medium-paced
The book gives stories on how Crownsville came to be and all the things that went on during the years if it being operational. The author cut in stories of her family and the situations they have dealt with involving mental health and while I understand these parts took me out of the history surrounding the hospital and made me just want more backstory of the hospitals patients and workers
Must read. A story that must be told. Left me in tears. Not as easy read. Horrendous acts of abuse, torture, and neglect.
challenging
informative
reflective
medium-paced
Content Warnings
Moderate: Chronic illness, Confinement, Death, Drug use, Mental illness, Racism, Forced institutionalization, Medical trauma