Shocking 'Madness' shows that formerly enslaved people were forced to build their own 1900s asylum

When the first patients — 12 of them — arrived at Maryland's Hospital for the Negro Insane in 1911, the asylum had yet to be built.

"It would be the first and only asylum in the state, and likely the nation, to force its patients to build their own hospital from the ground up," Antonia Hylton writes in "Madness: Race and Insanity in a Jim Crow Asylum." In it, the Peabody- and Emmy-winning journalist traces the nearly 100-year history of the notorious facility later renamed Crownsville State Hospital.

Its construction was in response to a 1906 Maryland State Lunacy Commission report, primarily based on the spurious post-Civil War belief that Black Americans suffered mental illness not from the trauma of enslavement but because they didn't know how to handle freedom: "The progress of the negro from slavery has been attended with a very marked increase of insanity." Something must be done, the all-white commission decided, but Maryland, being "too much of a Southern state," wouldn't countenance the mixing of races. A separate facility was needed, and it had to be built cheaply.

To white officials and doctors, Hylton writes, therapy for Black Americans meant "labor, and a return to the antebellum social order." In other words, Crownsville's "patients" were viewed as unpaid laborers and were put to work, but not just for the asylum. Once the hospital was completed and crops were planted and harvested on the grounds, patients were sent out to labor on adjoining farms — just the beginning of the abuses heaped upon Crownsville patients, Hylton would discover.

Through careful research spanning 10 years, including gathering archival documents, patient and employee testimony, government reports and newspaper articles and photographs, Hylton unearthed harrowing details of what it meant to be committed — more like sentenced — to Crownsville.

At no time in its history was the facility staffed or funded properly. It was consistently overcrowded, reaching a peak population of more than 2,700 in the 1950s. (The original three-building facility would eventually grow to a 1,500-acre campus.) Treatment, if administered at all, was torturous. Beatings and isolation were the tools of control in wards where every kind of patient, from children to the criminally insane, was housed together. Unsurprisingly, many didn't survive and were buried in a nearby field. Numbered gravestones — no names — were the only markings.

Honoring the generations of mistreated patients is one of Hylton's purposes in writing "Madness." Another is to set the record straight, to show how Crownsville sat at "the center of a critical juncture in American institutional history": For Black Americans, the horror of institutions like Crownsville has morphed into today's carceral system. Yet another — and perhaps Hylton's most important purpose — is to confront what has gone before, to change what is to come.

Hylton quotes a man whose aunt was committed to Crownsville and never returned: "How do we not duplicate the same stuff again and again and again?"

It starts by reading this very necessary book.

Maren Longbella is a Star Tribune copy editor.

Madness: Race and Insanity in a Jim Crow Asylum By: Antonia Hylton. Publisher: Legacy Lit, 288 pages, $30.