Nonfiction: Madness by Antonia Hylton

The full title of Antonia Hylton's book is Madness: Race and Insanity in a Jim Crow Asylum. In a little more than 300 pages, Hylton explores the history of the Crownsville Hospital in Maryland, which first opened in 1911 with a specific focus on the Negro Insane. Her investigation and findings will cover the hospital's entire lifespan, with crucial insights from former patients and staff.

Genre, Themes, History: This nonfiction book is a thorough look at what was originally known as the Hospital for the Negro Insane of Maryland, but referred throughout the book simply as Crownsville. Beginning in 1911 when 12 Black men were sent to work building the hospital, alongside the first superintendent Dr. Robert Winterode, Hylton carefully moves through history, exploring the hospital's early years through World War I; the struggle for integration of both the staff and the patients; through the tumultuous Civil Rights era of the 1960s and 70s; and ultimately to its slow decline in patient numbers before its seemingly inevitable closing in 2004. It is a complicated history centered on race, politics, and the changing attitudes on mental health, as well as a look at the history of Maryland, specifically the Baltimore area. 

My Verdict: Taking on a book that deals with the topic of the history of mental health care in this country is no small thing, even if the ultimate focus is one specific hospital such as Crownsville. The memories of the terrible conditions, brutal treatment, and overcrowding are not fun to confront. Adding race and discrimination to the narrative only complicates matters, but Hylton tackled all of it, and provided readers with an absorbing presentation of the history of Crownsville. The amount of research that had to be done is nearly unimaginable, and getting people to talk about such a thing is daunting enough to cause many journalists to pick an easier topic. But Hylton does not shy away from any of it, and the information presented is well-organized, informative, and important to remember and know given the current state of affairs regarding both mental health and race.

Favorite Moment: There is one scene where some of the staff are watching an outdated instructional video on how best to restrain a patient, but the example given does not at all match the reality of what it is like to restrain an agitated human being, and is therefore not at all useful. 

Recommended Reading: The Heaven & Earth Grocery Store by James McBride is a work of fiction that is not necessarily about mental health or institutions, but I was reminded of certain scenes in the latter half of the book while reading Madness. I also recommend When Crack Was King by Donovan X. Ramsey.