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Antonia Hylton’s ‘Madness,’ the painful history of a segregated asylum


CROWNSVILLE, Md. — “I get teary-eyed every time they do this,” Janice Hayes-Williams, an Annapolis historian, said.

On a bright, cold morning in January, cadaver dogs, specially trained to find human remains, paced the snowy grounds of Crownsville Hospital. They were searching for places patients had been buried. Only some of the graves had been marked, and Hayes-Williams and other local leaders were trying to find an appropriate spot for a memorial to honor those who had lived and died at the asylum, which opened its doors in 1911 and closed in 2004. Even the graves that did have stones, journalist Antonia Hylton pointed out, were carved with numbers, not names.

Crownsville’s painful past is at the center of Hylton’s new book, “Madness: Race and Insanity in a Jim Crow Asylum,” which takes up the hospital’s history to open a window on America’s views of race and the social order. For much of its 90 years, Crownsville was segregated, and the only mental institution in Maryland that treated Black people. That “treatment” often took the form of forced labor: Its first dozen patients arrived to an open field and were ordered to start clearing the nearby woods for the hospital’s construction.

Though “industrial therapy” was popular in many American mental hospitals at the time, Crownsville’s program wasn’t geared toward vocational training, Hylton notes; it was “uniquely focused on contributions to internal functions.” These practices extended unusually deep into the 20th century, ingrained not only in Crownsville’s culture but in its basic ability to operate: Patients poured concrete, carted brick, tended crops, cooked and cleaned. They also wove baskets and rugs to sell, served food to the superintendent in his private dining room, and were hired out to local businesses. At its peak, Crownsville encompassed 1,500 acres and, in addition to paid staff, housed some 2,700 patients — a population that included people arrested for loitering, drunkenness or any other behavior seen as undesirable, along with those in need of psychiatric care. The hospital was so locally notorious that Black Annapolitans told stories of “night doctors” who scooped people off the street and brought them to Crownsville, where they were never heard from again.

Hylton’s research into this history — which she undertook over the course of a decade, conducting dozens of interviews and digging into frustratingly state-restricted and incomplete records — grew out of very personal curiosity. She traces it back to her teens, when she asked her parents if she could start therapy. They flatly — and fearfully, she realized in retrospect — refused. Their attitude was, “Black people don’t go to therapists,” she recalled, when we initially met over Zoom. “I didn’t understand, and I was really angry at them.” In college, she leaped at the chance to study the history of medicine, particularly psychiatry, which led her to research by social worker Vanessa Jackson that mentioned Crownsville. Curious, Hylton began contacting people who had worked at the hospital, and “it all snowballed from there.”

Her college thesis focused on the middle chapters of Crownsville’s history, when in the 1940s it hired its first Black psychologist, Vernon Sparks, and grew into one of the county’s major employers. Black employees, Hylton notes, saw their jobs as an opportunity for upward mobility — and, in some cases, as a chance to care for patients from their community, people they’d grown up knowing.

But the hospital’s segregated status and scant resources were a recipe for low morale. When it strained to accommodate patients, neighboring institutions refused to fill their vacant beds with transfers from Crownsville; local agencies were reluctant to help discharged patients return to their communities. “The panic and racial rhetoric of the community surrounding Crownsville, and the pressure that that community applied to the asylum, crushed its therapeutic capacity,” Hylton said. After she graduated and started working in journalism, “I started to get the sense, very quickly, that I hadn’t emotionally let this experience go.”

Hylton, now a correspondent at NBC News and MSNBC, kept in touch with sources like Hayes-Williams and Paul Lurz, a longtime Crownsville employee who had helped preserve the hospital’s records when it closed. (Despite Lurz’s efforts, many files from before 1960 had been destroyed, lost or contaminated with asbestos.) She visited them whenever she was in the area, keeping up with the latest on Anne Arundel County’s plans to turn the hospital campus into a park and community center. They sent her encouraging notes and updates about new photos or documents they found, and she tucked away copies in an ever-fattening digital file. Strangers called and emailed Hylton, asking if she could help them find relatives who had spent time in the hospital.

“Around 2020, it became clear to me that the book was the right format — probably inspired by many of the same things that were affecting a lot of Black people, and this moment in my family, when all of the same issues that I’ve been researching for so long actually just collided with my own personal life,” Hylton said. “It all just felt so inescapable.”

That year, every couple of weeks, Hylton drove from Brooklyn to her hometown outside Boston to visit a relative who was going through a psychiatric episode. “When you have a loved one who’s experiencing psychosis, you realize very quickly that in order to keep a relationship with them, you have to meet them where they are,” she said. “And that doesn’t mean add to the delusion, or imagine I’d seen things that I didn’t see. But it does mean validating them, listening to things you don’t want to listen to, for quite a long time, and helping them sometimes strategize around things that I knew were not actually happening.”

She felt too close to her subject matter at times: “It’s really hard for me to describe what that was like — to be going through that with somebody in my immediate family, and then to be reporting on it. To see the parallels between what they were going through and what some of my sources or records described,” she said. “It left me in this weird place where I was so grateful — I still loved this story and these people in this place, but I was also feeling very, very low while working on it.” So when she sat down to write the introduction to her book, there seemed to be no choice but to be forthright about these personal experiences: “It came tumbling out of me.”

“Madness” becomes startlingly intimate in some chapters, as Hylton widens her lens from Crownsville and its immediate political context to take in her family history. She tells stories about her great-grandfather Clarence, who began having nervous breakdowns upon fleeing North during the Great Migration; her father’s cousin Maynard, who was killed by police during a mental episode; her grandmother’s sister Idalia, who after the birth of her second child began to dissociate and hear voices; and the current-day relative, whom she identifies as “my loved one.”

Including this background seemed, in some ways, like a journalistic necessity. But the disclosures also felt personally urgent to Hylton. Growing up, she sensed a quiet shame shrouding any talk of these relatives: “They’ve been shoved into some dusty box. Their photos are in the basement. They don’t get to be part of the official story,” she said. “I didn’t like that.” Hylton writes in the book, “After years of observing my own family, I’ve grown convinced that when you swallow your pain it never does digest.”

The discussion sparked by her work on the book has helped her family talk more openly, Hylton said. “It can hurt in a good way to revisit these memories. You don’t have to disappear people. We can talk about them, and our family can be okay.”

She also hopes that Crownsville’s story prompts broader conversations about mental health — and more searching ones. “We’re in this weird place right now where everyone wants to talk about self-care. Everyone wants to talk about therapy. A lot of people are much more comfortable admitting that they’re seeking these services, right? But there’s also this understanding that there’s not a lot available,” she said. “It’s like we’re talking about this thing, but at such a surface level all the time. And I just really don’t think you can build something better, that you can offer people better mental-health-care services, if you don’t understand how we got here.”

Race and Insanity in a Jim Crow Asylum


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