The Terrifying Truth about Crownsville Hospital
with Antonia Hylton
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In an enlightening interview with Jermaine Fowler, Antonia Hilton, a distinguished Peabody Award-winning journalist, takes us deep into the heart of darkness that once was Crownsville Hospital. Known to many as a 'house of horrors,' Crownsville Hospital's story is a chilling reminder of past injustices in the realm of mental health care.
Through Hilton's decade-long research, this conversation sheds light on the shadows of Crownsville, connecting the dots between historical maltreatment and the ongoing struggle for reform in mental health care.
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Be sure to grab a copy of Antonia’s book ‘Madness: Race and Insanity in a Jim Crow Asylum,’ in this episode we cover:
The Horrors of Crownsville Hospital
Antonia Hilton's journey into the history of Crownsville Hospital uncovers a series of harrowing truths:
The Birth of a 'House of Horrors': An overview of Crownsville Hospital's inception and its evolution into an institution where racism and neglect were rampant.
Racial Disparities in Mental Health Care: The conversation delves into the systematic mistreatment of Black patients, including the overdiagnosis of schizophrenia and the medicalization of resistance to oppression.
The Plight of Civil Rights Protesters: Insights into how civil rights activists were unjustly labeled insane and committed to psychiatric institutions, highlighting the weaponization of mental health diagnoses against Black communities.
Connect Past to Present
Hilton emphasizes the critical importance of connecting Crownsville Hospital's grim history with current mental health care challenges:
Learning from the Past: Understanding how historical injustices inform present-day disparities in mental health treatment and access.
The Role of Black Providers: The conversation spotlights the transformative impact of Black mental health care providers and the story of recovery and resilience of former patients like Sonia King.
The Power of Storytelling for Change
Inspiring Action: Antonia Hilton discusses how her findings on Crownsville Hospital aim to spark conversations and inspire change in the mental health care system.
Advocacy and Reform: The urgent need for dialogue, recognition of past wrongs, and committed action towards a more equitable mental health care landscape.
Antonia Hilton's exploration of Crownsville Hospital is not just a recounting of its dark history but a call to action. By bringing these stories to light, Hilton and Fowler invite us to confront uncomfortable truths, advocate for those whose voices have been silenced, and work tirelessly for a future where mental health care is accessible, fair, and free from the shadows of racism and neglect. Join us in this crucial conversation and be part of the movement towards healing and justice.
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Jermaine (00:01)
Antonia Hilton, you are a powerhouse in journalism, Peabody Award winner, Harvard alumni, correspondent with NBC. I'm so impressed by your background and your history from Vice Media, you're covering gang violence and immigration and just really impressed with your work. Welcome to the show, welcome to the Humanity Archive. So excited to get into this conversation.
antonia (00:28)
Thank you. I am so excited to be here and to be part of your community.
Jermaine (00:33)
Absolutely. So before we get into the book, which we're going to do, I've got my copyright here, but I really want to know a little bit more about who you are and where you've come from having grown up in a large close-knit family and being the first born of seven. How do you think that your family dynamics influenced who you are today, both personally and professionally?
antonia (01:00)
So I'm actually number three of seven, and I am solidly a middle child. That's a big part of my personality. I think it's a big draw for me that brought me into media and into the arts and into creative spaces. Because while me and all my six siblings, the seven of us, we're really close. You know, when you're in an environment like that, you need to find your voice. You need to learn to stand up for yourself pretty quickly.
or you'll kind of fade into the background and struggle. And so I became someone who was very outspoken, very interested in issues of justice and fairness from a very young age. And so really nobody in my family was surprised when I decided to become a journalist, when I wanted to tell people stories and travel the world. It seemed like a good fit. And they were all like, yeah, okay, that makes complete sense. And so it's kind of been in my blood, I think.
Um, but I, we grew up in this small town right outside of Boston called Lincoln, Massachusetts, which was not diverse, not very large, not a lot going on. And so to be black kids and on my father's side, African-American, on my mom's side, Afro-Cuban, uh, in an environment like that, where there were not a lot of kids who had family members from other countries and not a lot of kids who.
were of another color or a different hair texture. I think it again, it kind of propels you into this place of okay, I'm already kind of hyper visible in this community in which I live. So what am I going to say to the world? Who am I? How do I present myself? And what do I wanna fight for? And so I think those are all the things that drove me to be the kind of storyteller and reporter that I am now. I think some of my earliest memories of
wanting to tell stories or to do public speaking or to, you know, present for others, go back to kindergarten, first, second grade, that kind of thing. So for me to be able to publish my first book at 30, I'm shocked by it. I'm amazed. I'm so grateful to be here. But a lot of people in my family are kind of like, yeah, yeah.
Jermaine (03:17)
Well, I mean, and I was a middle child too. And I think for me, that made me like fiercely independent. I was always kind of going off and doing my own thing. And so that really shaped who I am as well. And I often think about the family environment that we grow up in. When you have a family that is supportive, when you have a family that is like a family that has your back, it's kind of like this personal sanctuary where you're understood and where you can grow.
I know that's had a profound influence on my work and what I do, but then if you flip that you're kind of in a rough spot, right? And that kind of bleeds into everything, your interactions. So that family dynamic, good or bad, I'm sure as I'm hearing kind of shaped your worldview and your work and both of my parents being teachers and then me looking at the world as my classroom. But I do want to talk about your aunt, Soledad O'Brien. I just wonder.
As being someone in your life, is there any piece of advice or wisdom that she's given you because you kind of have this family background, right? Your parents were lawyers, you have this aunt in journalism, and then you're in journalism now, so the apple's not falling too far from the tree between your parents and your aunt,
antonia (04:23)
Oof! Yeah.
Not at all. And Soledad O'Brien gives out the best advice. So if you ever see her on the street or you go to an event that she's hosting or something, ask her for her advice because she has like, she just drops wisdom like it's nothing. You know, I really got some of my best training under her because when I was so young and it became clear to me what I wanted to do.
I would follow her at work, I would watch her report, I would watch her write scripts. And so I really understood how does a reporter, how does a storyteller work from A to Z? What does the research and building and pre-interview process look like? What does the, how do you craft the final product, right? And so I learned a lot from her by just watching. I think one of the best pieces of advice she's always given me too is as you pursue what you love.
to always be saving and thinking about an FU fund, which is the money that allows you to keep your integrity, the money that allows you to say things like no, to things that jeopardize who you are and what you know your mission is and would put you in uncomfortable situations. And so I've thought about that from the moment I graduated from college. How do I...
pursue a career in media, how do I think about the stories I wanna tell and the type of reporter I am in the world, but how do I also make sure I'm in a place where if I was ever put in a position where I really couldn't be what I wanna be anymore, that I could make a plan B. And so I live and make all my decisions around that kind of strategy.
Jermaine (06:08)
Yeah, that's so important, right, to be able to craft your own path, right, and be able to turn things down if they don't align with your values, with your integrity. And I find that important too. That's a great piece of advice. And I think one of the things that is amazing about your story and just really speaks to what went into this book, right, as you faced some adversity in your own life, right, suffering from cancer at a young age.
I know that had to be a challenge, right? And for you to still be able to push forward and present this book to the world through the challenges you faced, how do you think that experience impacted your outlook on life and your career?
antonia (06:53)
I think that part of me is still, I think part of me is still coming to terms with all that because it was so shocking. It all happened this past year as I was trying to finish the book. So, you know, you have these deadlines. I still have my day job at NBC. And then I get this news from my doctor that they found a type of rare cancer called a neuroendocrine tumor in my colon. Thankfully, it was found really early. You know, many people, I mean,
Most people don't get screened until they're closer in their 40s and then in their 50s. But because of what we're seeing happen, especially to Black Americans across the United States right now, these rising rates of colon cancer and other cancers, problems with our gut, our diets, there's a real crisis there. And I just count, while I, it was heartbreaking to get this news and it really knocked me off my feet for a little while there.
It really is a happy story. It has a happy ending, right? Because my doctors found this, they cut it out. There's no chemo. There's no long-term treatment other than I'm gonna have to be checked every year to make sure it doesn't grow back. But I'm empowered now. I have the information. I have the tools that I need to make sure that I'm really healthy. And if I had waited 10 more years, this could be a very different story. But I took that early action and early intervention. And that's really the greatest tool that we have, whether it's...
cancer or you're talking about actually mental health challenges. Early intervention is everything. And so I think that my body was sort of taught this lesson about speaking up for itself, taking care of itself right before I go into this busy season, right. Of talking to other people about their health, obviously more in the realm of, of mental and emotional wellbeing. But I think that they're of course connected.
And so for me to go through that lesson and then be ready to have these conversations with others, I think it's actually really expanded my worldview. It's expanded my patience and kindness for myself and my own physical capacity and all that I was able to just get done in that period. I beat cancer and cut out cancer and I finished a book at the same time. That's kind of crazy. So, you know, as tough as it all was, I actually now sit with it and I'm like, okay, I feel...
Jermaine (09:06)
Yeah.
That's a lot.
antonia (09:16)
I feel blessed, I feel very lucky. And so I can share that message with people and they can hopefully take it as an example, a reminder to set that appointment, to go get checked out, to take a day off from work if that's what they need to do, because it can make all the difference.
Jermaine (09:30)
Yeah, that's profound because there's this connection with this, you're talking about health, mental health, but then you have your own kind of health crisis, but then there's a story of overcoming to where it's like, okay, you're taking your health into your own hands and getting screened early and kind of taking the lessons kind of the past, right? Like we know the institutions haven't taken good care of black people at all, so there's this kind of self-empowerment and self-care narrative and story within.
that as you're writing this book. And I think that's very empowering, you know, for everybody to hear, right? That we have to take our health into our own hands to a certain degree, right? While you could still call out and fight against the injustices within the system, but there's also that level of self care. And I'm glad to hear more and more people talking about that. And speaking of mental health, you have reported on some very intense topics, some very heavy topics from gang violence to immigration issues.
I'm curious, Antonio, how do you maintain and balance and manage the emotional weight of these stories? Or even in your book, Madness, how do you balance that? Because that's something that I find myself to challenge, to dive into that darkness, but not get lost in it. So what kind of practices do you have in your personal life to decompress or find peace when diving into these darker stories and narratives?
antonia (10:42)
Yeah.
a couple practices. The first thing that I do is that while I'm actually out in the field and I'm covering a tough story, so for example I spent a long time covering the case of Tyree Nichols out of Memphis. That was a heartbreaking, incredibly disturbing case. I had to watch all the footage of how he was beaten that night and it really affected me. I had nightmares about it for a while. But while I was out there trying to get the job done, I
did some small acts every day to kind of take care of my body and try my best to sort of shake out the pain that I was feeling in a way. So I would do these stretching routines. I would stand while I was on TV, you know, talking to the country about what was happening in Memphis. I would stand in a particular way, rooting my feet and my heels down to try to give myself this additional strength and sort of momentum to get through talking about things that were really difficult.
You know, I think people are very familiar with talk therapy. You know, there's a major effort, of course, now to de-stigmatize, reaching out to psychiatrists and therapists. And I do that too. I have a therapist, but there's a lot physically that you can do to also work on symptoms and kind of unlock trauma. And so things as simple as adding just 10 minutes of stretching when you wake up or before you go to bed or in between really difficult, you know, conversations that you have to have.
that can change everything. And so I took those steps. And then of course, like I had the conversations that I needed to have with my doctor when I came back. I met up with my therapist and processed my emotions as I was going through that. Same thing when I covered family separation at the border. I had to find people who, you know, either a fellow reporters who had covered it or.
You know, I have immigrants in my own family. So to talk to people about those experiences from the different, you know, places they approach them from, that really helped me. And so it's, it's speaking up. Being someone who is, tries not to lock things down inside and stuff them away. I try to actively process them in the moment so that they don't catch up with me later.
Jermaine (13:10)
Yeah, I really appreciate that. And I've always thought that the challenge is not just to expose and articulate the pain and the darkness, but also find ways to sustain ourselves. So I'm glad to hear that you have, it seems to me to be some very well thought out practices and that you've put a lot of energy into this to make sure that you are sustaining yourself. Because I think a lot of people ask themselves like how, either when they're reporting on or studying or just immersing.
themselves in these narratives. How do you speak to that despair? How do you speak to, you know, death and all these things, right? And still find life and still find joy and still find hope. So, you know, how do we anchor our humanity and our interconnectedness? And I think within that we find resilience and not only bear witness to the pain but then also contribute to healing as well. And so I want to get into your book now and as you said
antonia (13:49)
Yeah.
Jermaine (14:07)
before this is a decade long research effort into Crownsville Hospital. Can you tell everybody just a little bit about the background of this story, right? And how did you find yourself involved in this story and what pulled you to it a decade ago?
antonia (14:18)
Yeah.
So I was just a teenager at Harvard's campus, and I was really fascinated by the history of psychiatry and the care of people who were mentally ill. I have always been a history lover. I knew I wanted to study some realm of history when I got to college, but I also knew that I came from a family with a history of mental trauma. And when you look at the history of the treatment of mentally ill people, often...
We only talk about patients in Europe who are white, or patients in America who are white. It is very hard to find any information about black communal practices to take care of each other, or the experiences of black patients in some of these famous asylums. And so I made a huge effort as an undergraduate to try to find something. And so many of these former institutions, these segregated wards,
They shut down and they destroyed records. They tore down buildings, or in some cases, the buildings have been turned into haunted mansions you can visit around Halloween. And so when I came across a footnote that mentioned Crownsville Hospital, and I found out that not only had the state actually saved some of the records of this formerly segregated asylum, but that the buildings still stand to this day in Anne Arundel County, Maryland. And then there are former employees and patients who are still living.
I became sort of obsessed and it was this personal journey as much as it was an academic journey. Because for me, I was searching for information. I wanted to put this out and share it with the world. But I also was frankly trying to better understand some of my own ancestors and elders who had spent time in some of these places, who had been harmed by some of these institutions. And the pain in my family that had come from this history had re-
reproduced a kind of stigma and shame at times. And there were members of my family who really didn't wanna talk about loved ones who were lost or people who had suffered in that way. And so it was hard when I was a kid to get people to talk about it. So I felt like, okay, studying it is the only way I'm going to be able to understand my own family, my own people. And so it was this personal and academic journey all in one.
And at first I thought, okay, it's just gonna be my senior thesis and I'm gonna give this to the Harvard community and move on. But the story just kept nagging at me and my relationships that I built with people over those first few years, like say the first two to three years, they just stuck with me. I mean, I remained pen pals. I was constantly calling or scheduling Skypes or checking in with people who I had met along the way.
And through that process, I kept gathering new reporting, new information, new documents, new photographs. And I realized, you know, this is so much bigger than I initially thought it could be. And I think the other thing I realized in recent years, particularly around 2020, was it's not just me who wants to have this conversation. I actually think a lot more people, you know, of every background, but particularly in the black community.
want to talk more about mental health right now. They, and I don't just mean young people, Gen Z or kids graduating from college who were kind of like me back then. I mean my 91 year old great aunt who I ended up having amazing conversations with that helped me uncover and unpack some of the stories that are in the book. And so I think this is an intergenerational thing. I think we're in this fascinating moment where people are ready for a conversation that really needs to be.
that we've been deprived of that's been hidden and kept away from us in some ways. And so I feel like madness is a piece of that. It gives people an understanding of our history because I think it's really hard to imagine a better system, a better way forward. It's hard to even know what to ask for, right? We all know the system isn't treating us well. There's not enough resources to go around. There aren't enough beds and...
and therapists have these long waiting lists before they can see black patients, right? So we know something's wrong. But I think in order to figure out a solution, we need to understand, well, why does it work this way? How did our country get here? And that's what madness tries to answer.
Jermaine (18:49)
Yeah, and I think that it's so important, the work that you did in this book, by connecting the past to present, by connecting one generation to another, by getting the stories from the ancestors, right? The people who came before us, and while they're still here with us, while they are wanting to tell their stories and have that release to get their stories out, right? And I think that's so, so important because if you didn't get these stories.
They could have been lost. They could have went to the grave with so many of the people that you talked to. And I wonder about the journalistic process, right? How do you get people to open up? I mean, this is a years long endeavor of getting to know people. And there's such a humanity in that, right? Where you're getting to know people. You said you still have pen pals and it seems like you formed some very deep relationships with the people who you are interviewing and some of which were in your book. So can you just explain a little bit about
you know, that process, like how do you go into that? And you know, how do you draw those stories out? I'm sure there had to be some people who were reluctant to tell their stories as well.
antonia (19:44)
Yeah.
Definitely. There are people who I had to, you know, build trust and really show them my heart for years before they agreed to be interviewed. I mean, like five to seven years it took to before they said, okay, you can turn that recorder on and we can really talk. And so that's why, you know, when people say, Whoa, 10 years, that's a long time to work on something. Well, for a story like this, where you're asking people to open up about some of the darkest
toughest moments in their life takes time. And you have to show them that you're committed to doing the work and that you're patient and that you're a safe person for them to sit with and to talk about all that way. And so it really started just one by one, almost like dominoes. So I would meet one person and have an initial say two hour conversation with them. And then they'd introduce me to another person who then.
few months later introduced me to another person and then it just kind of spiraled from there. And I'm so glad I started this 10 years ago because so many of the elders who worked at this hospital or who were patients or had some connection to it, they're starting to pass away, we're losing them. And so if I had waited, if I hadn't stumbled upon all of this as a teenager and just decide to get started, even though I wasn't a professional journalist at that time, I didn't really know what I was doing.
but I just got started and I hit record and I took my notes, you know? But that is what allowed me to build and to have such a solid foundation that took me through these 10 years. But each person I met along the way opened a new door. They helped me build another relationship. I didn't just call people and zoom with them. I made several, many trips to the Annapolis and Baltimore area to actually sit on people's couches, to have meals with them, to show them my commitment.
I told them a bit about my life and my family's experiences in our country's mental health care systems. And so I think that level of sort of intimacy and authenticity helped make the difference there. And to this, and now that the book is even, it's over, right? Like I finished it, it's printing, and it's gonna be in stores soon. I'm still talking to all of them constantly. I mean, they call me several times a week. It's almost like...
They're a permanent part of my life and my family now. And so who knows, there may be a madness part two, there may be something else that I create out of all this because this is a community that has been desperate to have their story told, but for so long they didn't know who they could trust, for so long they didn't know how to process all of it. And so for me to just be able to play a small role in opening that dialogue, there's so much more to be done still.
Jermaine (22:35)
Yeah.
antonia (22:46)
when it comes to the issue of mental trauma and mistreatment of black patients in this country, this is just a small piece of it. But I think to be able to play a role in that, to give this community a platform, it's really the greatest honor of my life.
Jermaine (23:01)
Yeah, and it is an honor and I think it also makes you wonder, you know, how many other stories you know, not only aren't being told that could be told now, but the ones that were lost. And I want to get a little bit more into the book itself. At one point, you kind of describe Crownsville Hospital as this house of horrors, right? Can you elaborate on the conditions and the treatments that earned it this title?
antonia (23:30)
Yeah, well, let's start at the very beginning. Crownsville Hospital is the only hospital I've been able to find in American history that forced its own patients to build their own asylum. So to break down for you what that was really like, a white doctor named Dr. Robert Winterode marched a bunch of black men deep into a cold,
wild forest in the heart of Maryland in 1911. And he forced them to start clearing roads, pouring cement, harvesting tobacco and food and constructing an asylum, doing real backbreaking labor. I mean, these are not just, oh, we're carrying a bag here and there and helping people out, they were working side by side with contractors and electricians.
And there are photographs of this. There are diary and other hospital records that describe the immense work that they forced these patients to do. Something they had never forced white patients in the state of Maryland to do. So that's how the hospital's history begins with something incredibly unusual. And it raises a question, right? This is one of the first things that nagged at me when I began this research.
The state was calling all of these black men so mentally ill that they were no longer allowed to be in public. They were no longer allowed to have jobs. They had been sent to county jails and almshouses and locked up in chains. But they were well enough, somehow, they could do the work of building stunning, massive brick buildings in the middle of the woods. They could move a railroad. They could construct new roads.
They operated a highly productive modern farm. And so there's a lot of unanswered questions in there, right, of how sick were these men really? Why were they being forced to do all this? What was the state really hoping to get out of this? So that's the very beginning of its founding. And then what I...
explore in Crownsville is in this early period, the first several decades from the 1910s really up to the 1950s and early 60s. The hospital forces its patients to do an unbelievable and unusual amount of labor. Extremely difficult agricultural labor, crafts work, laundry, cooking. They are both patients, but they're almost like servants who are also serving the white employees and the white superintendent of the hospital.
The conditions are terrible. Many of them are sleeping on porches, on floors, on wooden benches. There is no school for the children who are locked up there for decades. And for a while, the state is kind of able to keep them in these conditions, right? Because so few people know what's going on. But eventually the patients start writing to black reporters and reaching out to people in the community and saying, something's going on here.
And so there's this push in the 40s and 50s to start investigating the asylum and to get the truth of what was happening there out. But in many ways, those early years, it was a house of horrors. These patients were being treated as subhuman and they were, to not mince words, being subjected to a sort of re-enslavement. And keep in mind, many of these patients had been alive for slavery. It was just 1911.
many of them, particularly some of the older patients, had been enslaved at some point in their lives. And so to find themselves back in that kind of antebellum system, you can only imagine how heartbreaking and re-traumatizing all of that would be. And I think it's really important that people understand that that's part of the beginning of the genesis of our kind of modern mental healthcare system.
this disparate treatment of patients, the very discriminatory way in which white doctors viewed black patients. I mean, they would write about them and argue that basically black people were going to become mentally ill because they couldn't handle freedom. And so the best thing you could do for a black person was to force them to do hard labor. And so when you see that as part of the sort of founding and development of our system,
even as those pieces start to go away and the civil rights movement comes and changes come, you can see how the roots affect the rest of the system all the way until 2004 when the hospital closes.
Jermaine (28:37)
That was a long time for it to be open into the modern day. And I think you're right. Yeah, yeah. When you look at the history of mental health concerning Black people, right? We're essentially unpacking this chronicle of racist ideologies masquerading as medical diagnosis, right? I'm thinking about drapedomania, which was that made up condition in the 19th century that said enslaved people, if they wanted their freedom, they were mentally ill.
antonia (28:41)
93 years.
Jermaine (29:07)
and this being an excuse to justify slavery by essentially medicalizing resistance to oppression. There's other diagnoses that are bogus that kind of are trying to explain laziness and they couldn't be human and not just want to work or not want to work in these brutal conditions because they're treated horribly, right? There's these medical diagnoses associated with that. And something that I recently found out about and
I study so much history, but this is more recent that I found out about this and I didn't know about it, was this disproportionate diagnosis of schizophrenia in black patients compared with white people, which still happens, but in the late 1960s, there was this huge shift in the diagnosis of schizophrenia in black people. And before it was seen as this condition that only affected like withdrawn individuals.
But it gets crazy because you think about schizophrenia then start to be redefined with attributes like aggression and hostility. And this is being applied to black patients. And so this coincided with the civil rights movement, right, the height of the civil rights movement. So psychiatrists then began to label like black activists protesting racial inequality as having a more aggressive type of schizophrenia. And it was termed
protest psychosis right when the civil rights movement was at its peak. So suddenly then schizophrenia is getting tagged with stuff like aggression and hostility. And you don't just want your rights, you're crazy. So we're going to lock you up. And I try to always stay shocked because I don't never want to not be shocked and numb to the history. I always want to kind of feel it. But yeah, I was definitely shocked about that. And that's just...
antonia (30:54)
Mm-hmm.
Jermaine (31:00)
kind of ties into what you were talking about in terms of this, the undergirding of the medical system today and how recent that this is even just starting to shift, right? It's by no way far enough away or not enough work.
antonia (31:10)
right. But that's what I mean. When I say this, every era builds upon the era that comes after it. When I say that the founding of a hospital in 1911 is still connected to what's happening in the 50s, 60s, 70s, 80s, 90s. That's what I mean, because I actually dig into that history in the book as well. We look at the protest psychosis by Jonathan Metzl, who's an amazing author and researcher who I spoke with for the book.
And we kind of connected our research. And that's because these sort of systems, they build on each other. When you view black people as a labor source, as being physically different, as deserving a certain level of brutalization, that that's their natural state, and then you see them be justifiably angry, protest in the street, make demands and require change.
Instead of seeing that for what it is, you cast it into the sort of preconceived notions and hierarchies and power structure that you've already constructed for yourself. So the fact that we later have patients talked about in this aggressive manner, right? And they're calling people schizophrenic who are really just fighting for their rights. That's connected to what was going on in 1911. And there's one scene in the book, there's a chapter called the curious case of the
which looks at three civil rights protesters who go into a restaurant in Maryland and are told that they will not be served because it's whites only. And because they sit in their chairs and they don't even, they don't turn anything over, nothing violent happens, they just refuse to leave the restaurant. They eventually are committed to Crownsville and labeled as insane. And eventually they're freed.
And even the head of the hospital at the time writes to the papers and tells state leaders, these people are not insane. You need to, like, this is ridiculous. He doesn't wanna be part of the show.
I think that story tells you everything about the way in which people have pathologized Black people's suffering and demands for freedom in this country.
Jermaine (33:24)
Absolutely. And how long were they in there? I'm curious before they were left free.
antonia (33:29)
They were in there for about a week and they were there for days. And they were on a hunger strike for much of that. And the employees at the time stepped up and really allowed them to, you know, have visitors and kind of have free reign of the space because they recognized immediately, oh, these aren't patients. These aren't people who have a diagnosis. There's nothing for us to do here.
You know, our hands are tied because the state has committed them here, but we're not going to, to the extent that we can, we're not going to take part in all of this. And so there's a real resistance too from the staff.
Jermaine (34:06)
Yeah, I thought-
Yeah, and I think that's an important part of the story because you're zooming in, you're zooming out. I mean, you're seeing these instances where sometimes people do try to push back, but you have these larger systems at play that, even if there's one individual person or maybe even a small group of people who wanna push back, these systems, it's so embedded, right? These ideas of racism and ideas about how black people are mentally.
you know, unfit or incapable or inferior, they're so ingrained. I mean, these things take decades and decades to kind of reverse course on that again, which we're seeing still today. And I wanted to ask you as well about the bigotry and the segregation of the Jim Crow era specifically, and just based on your findings, you know, what was the mental health care system like for black people at that time and how?
antonia (34:43)
Yeah.
Jermaine (35:04)
have you seen a shift beyond that? Because you're connecting to people past and present, past and present, and I kinda wanna know, starting with that Jim Crow era, what was it like then versus now? How far have we really come from then to now?
antonia (35:12)
Yeah.
That's a big question that I grapple with at the end of madness. How far have we really come? It's an important one. In the first half of the 20th century, there really wasn't much in the way of treatment for black people who were suffering at all. There were these segregated wards or segregated hospitals where black people could be committed, either by family members or by police officers.
Or in some cases, you know, people would accuse a Black person who was say, you know, loitering or outside or who had gotten drunk of being mentally ill. And they could be forcibly committed without their family's knowledge even. And so there were a lot of Black people lost to these asylums. And what you see in the record repeatedly is that these asylums are really like warehouses. So Black patients would be brought there, sent to these.
overflowing wards and I mean like a ward that's built for a couple dozen people having hundreds of people on it. There's no sleeping space. People are sleeping head to feet in twin beds. Some people are sleeping on open porches. Some people are sleeping in sewage and fecal matter on the floor. I mean really, really gruesome stuff.
Some of the very first black employees who arrived at Crownsville, I interviewed them and they just, one common theme that comes up even when you interview employees who don't know each other, who never worked together, is that when they arrived in the asylum as some of the first black employees, that the smell, when they would walk in, before they could even see the horror, they could smell the horror. They could just smell human suffering. And they could smell.
that the white people who were running these hospitals were refusing to clean because they didn't want to clean for black people. And so that's what they consistently told me in their oral history interviews. And so if you were not sent to one of these places, the other thing that we see is that often there was this sort of abusive labor system that would drag black people who were say developmentally delayed or who had...
other emotional challenges or who were just labeled as different in their community, they would sometimes be sent to go work for a white family as an indentured servant. That was very common on the eastern shore in Maryland, and that's a part of Maryland that has a long history of KKK activity, of cross-burnings, that kind of thing. And a lot of Black families there speak about the history of their loved ones or family members having who were...
you know, different in some way, having been sent to do labor for other white families there. And then the other place was the jail. The criminal justice system really was the other place you could go.
Jermaine (38:12)
Did you find examples of...
Did you find examples of people who tried to fight to get their family members out or was it just kind of more of this accepted, like this is kind of what the system is, right? And if they take one of your loved ones away, this is just kind of what we're dealing with. I'm sure at some point there had to be a lot more pushback for things to get changed that didn't just change on their own.
antonia (38:25)
Yes.
a lot of pushback. You know, a lot of black families were fighting and trying to figure out. In some cases, they didn't even know their loved ones were sent to Crownsville. So I spoke to nurses who would come on and talk to a patient and discover that patient had a sibling living in Baltimore or somewhere not that far away in Maryland, but that none of the staff had been ever willing to call that family member and see if they'd come pick them up. And so I spoke to one woman
She had a patient stuck at Crownsville for 27 years, 27 years, who said that none of the staff listened to them. And so when she finally made a phone call on that patient's behalf, immediately their family came and picked them up. They thought they were dead. And so it's not so much that Black people didn't care about their loved ones and just let them disappear, it was that often no one answered the phone when they called. No one believed them when they tried to report things.
This shift as the community starts to learn more through reporting and letters that are coming out of the hospital and patients who are trying to speak up and a couple of doctors and investigators who get the opportunity to go inside, as they find out more, they start to demand more. And integration, which starts to happen in the 50s and 60s, does really transform the hospital because once black nurses and doctors arrive, they start to change the practices to take much better care.
they in many cases grew up with the patients that they served. So think about that for a minute. I mean, now we have a system where if you go to get inpatient treatment for a mental health challenge, you are very unlikely to know the people who work there because there aren't enough of them. There aren't enough resources to go around. Sometimes people are traveling to other states and regions of the country to get mental health care because that's how hard it is to find good mental health care in the U S
So you're not likely to be treated by your own community and people who already love and know you. But that wasn't actually the case here at Crownsville once black people were able to get jobs. They were treating people who rode the bus with them to school. They were treating their own cousins. They were treating people they knew from church. And so there's this moment where there's this shift, right? And you get a glimpse of a different way the system could be. So you have this community taking care of itself for a moment at the hospital.
And that's a really fascinating sort of juncture and part of the history that I explore through the eyes of the black nurses and doctors, what it was like to be put into this system, into this hospital that treated your people so badly, but now was giving you an opportunity to have a job. And now you're kind of in the middle of this power structure where there's still white administrators and leaders who have these racist views of your patients, but now you have a bit of power in the middle.
And then your patients are sort of at the bottom of that totem pole. And, and what that, that power structure and struggle did to them is a big part of madness, sort of exploring the relationship between black provider and black patient. And I would say it arguably to go to your other question of like, does this idea of, well, does the system we have now, is it better? Well, now if you're a black patient looking for a black doctor or therapist, it's next to impossible to find one.
They have long, long waiting lists. You better hope you have some money to pay out of pocket because some of them can't take insurance because a lot of insurance providers are almost impossible to work with on mental health care. So whether our system is better than what we had then, I think that's an open question. And I think that period where you're seeing black doctors take care of their own community is a really fascinating one because it's like this.
moment, this brief time where you can see an option, a way things could have gone or been built up, and then it's quickly dismantled.
Jermaine (42:34)
Yeah, and I think it speaks to that across institutions, right, whether you're talking about education, whether you're talking about law enforcement, whether you're talking about medicine, it kind of speaks to that idea of how much can you change the system from within versus how much of it would need to kind of be dismantled and built anew, right? So this is the conflict that I talked to so many teachers who, you know, are within the public school systems and they have that kind of inner turmoil and conflict where they're like.
Am I really making a change within the system? I might be helping one student, but I might be helping a classroom even in some instances, but they're moving along within the system that has the same outcomes year after year after year, decade after decade, same with the medical field. So I can only imagine, especially back then, the conflict that someone might have gone through to say, hey, yeah, I need to get in there, right? I can maybe act as a buffer between these administrators who are enacting all these atrocities on the people here.
antonia (43:15)
Yeah.
Jermaine (43:31)
But then that conflict of, well, I'm in here now, I really wanna change this, but there's my hands are tied, right? And so I think that's a recurring theme throughout so many parts of black history. And I'm glad you brought that up in your book.
antonia (43:45)
Yeah, it's a question I talked about this a lot with some of the elders who came to Crownsville, who are some of the last, you know, living people who saw some of the early stages of the hospital. And one of the things that comes up a lot in those interviews is this idea of, can you be a good person and work at a place where something like this has happened? Is it worth it doing good bit by bit?
when you know there's still a lot of bad going on. And do you stay and fight for the people you can fight for? Or if because the bigger picture is bleak, do you need to leave? Those were the kinds of questions that black people, and actually not just black, I mean, I even spoke to white staff members who were also trying to be dedicated to their patients and do everything they could for them. And they were wrestling with these things actively every year on the job.
Jermaine (44:43)
I think there's hope is as long as people are willing to wrestle with that question, right? And you have people who aren't giving up who are trying to move things better in a more positive way. I think that's important. And yet it's interesting that so many people have wrestled with this. And it makes me wonder too, because I mean, you've told so many stories here and there's so many stories in the book. What story for you hit you the hardest emotionally? Like what's one story that kind of really sticks out of you? All the people you've talked to, you've got this decade in.
you're exploring, not only talking to people, but researching stories on paper, like which one really hit you in the heart.
antonia (45:21)
Oh, it's hard to choose just one. I think one of the most important, you know, characters in the book, it's sort of a weird used word to use because this is a real person who's very much still alive. Her name is Sonia King. She is a former patient at
her arrival at the hospital in the 70s. She's just 20 years old, a black girl in college at Lincoln University in HBCU. And she suffers a mental breakdown after both being sort of excluded socially in school and then also being raped by a man who she knows in her neighborhood. And she has a psychotic break afterwards and is brought to the asylum. And...
At first, she's really horrified by the asylum. She doesn't like the medication that they are forcing her to take. She's afraid living on a kind of an open dorm floor with a bunch of other patients who have all kinds of challenges. And she's, you know, not, not used to all that as really nobody would be. But then it turns out that one of her best childhood friends is working at the hospital as a nurse and her family finds out and they call the friend and her name is Faye Bell.
and Fay Belt is working in a different part of the hospital, but she adds additional hours to her shifts every day, unpaid, just to come over to the part of the hospital where her friend is. And she puts in the extra work five days a week to help her friend recover. She goes on walks with her every day. She helps her talk through her trauma and work through what happened and try to lift some of the shame she's feeling after being assaulted off of her shoulders.
And you see these two friends, them walking this campus, the grounds going out into the woods every day to process this pain that they're feeling. And you know, Faye is holding onto Sonia and letting Sonia cry on her shoulder every afternoon and doing that just going above and beyond her job. And Sonia is able to make a recovery in a matter of months and then is able to make a slow recovery back into school, back into her routine.
And then when she graduates from college, she ends up pursuing a career in which she helps other people with mental and behavioral challenges and tries to help them avoid, you know, stooping and falling as low as she did at one point. And so to me, that story was just so breathtaking when I first uncovered it. As I got to know Sonja, I was so taken by her strength, her vulnerability, and what it takes to talk about
having been institutionalized. I think a lot of people are very, when they've had those experiences, they're afraid to share them. And I know this because I've reached, not only do I have members of my family who've gone through it, but I have, you know, reached out to many patients at Crownsville who weren't able to talk for a number of reasons and who were still working through the memories or the feelings they had about spending time there. But Sonia wanted the readers to know.
that you could release your shame. She wanted readers to know that when you suffer mentally or you go through a really hard period of your life, it's just a part of your story. It's not the whole story. And I felt like I learned so much from her. She blew my mind. Just this person who had so much strength and no embarrassment, no shame, and who could talk about her entire life and everything she'd been through with so much clarity and grace and kindness for herself.
I felt like, wow, that's something I aspire to be. Like someone who is so proud of myself, who's so happy and understanding of every version of myself, right? I think a lot of us struggle with that. And she had made this unbelievable recovery and she credited Fay Belt, this one nurse, as well as some other nurses, these black women who had basically wrapped their arms around her and said, oh no, we know you, we grew up with you.
and we're not gonna let you stay at this hospital for long. We're gonna save you, we're gonna get you out of here. You're gonna get your life back on track. And they did it. And for me, that's one of these sections of the book that fills you back up with hope. You, of course, you know all the horrible things that have happened there, but you also see all the potential in people. You see how much community can transform recovery. And so to me, I think that's, whenever I reread that chapter, whenever I had to edit that chapter, I just felt like...
I sometimes I would cry happy tears and other parts of the book would make me cry not so happy tears, but I really do love that section.
Jermaine (50:15)
Yeah.
Wow, that's a powerful story. It's a powerful story. And I want to know then, you know, your book, such important work, sheds light on neglected aspects of black history, American history, moving forward for you, like deep down, what changes or conversations do you really hope that your book will spark in terms of how we as a collective society understand and address the legacy of.
of the events that happened at Crownsville and that you talk about in your book, Madness.
antonia (50:52)
You know, I would love if my book helps other families have the kinds of conversations that my family has been able to have in recent years. Doing this reporting helped me make phone calls, reach out to people, and it gave me kind of a way in to talk about family history and heartbreak in a different way. And this book has helped me talk to some of the
the older folks in my family who maybe like five, 10 years ago would have told you they don't believe in therapy, they don't want to talk about mental health. Now they want to talk about it. And I think that that's such a beautiful thing. And so if my book gives other people, other families a way to talk, if it inspires someone to reach out and get help or raise their hand or lean on a friend.
That to me, that's winning. And so that's aspiration number one. I also hope that it maybe inspires people, whether that's politicians or leaders or organizers or journalists like myself, who all play a role in these things, to imagine a better system. I think no matter who you are, what background you are from, what corner of the country you live in.
this system is not working. We see that in our reporting, we see that from all kinds of families, whether it's you have a loved one suffering with substance abuse, whether you've experienced depression and anxiety, or maybe you have a challenging diagnosis like schizophrenia, the system isn't working for most people. And what can we do to build something better that we deserve, that serves us? And maybe...
some of the stories, some of the findings in madness will help people see a different way the system could be, help people imagine some solutions. That would be a dream of mine. Just to give people the tools to talk, both on that interpersonal and familial level, but also on that national, okay, what are we going to do now at that level too?
Jermaine (53:15)
Yeah, opening up conversations, dialogue, in the macro, and in the micro and the macro on the smaller scale and the larger scale. I think that's very important. And I want to thank you, Antonia, for joining me. And I really, truly believe that you are moving forward in the tradition of one of my personal heroes of history, and that is Ida B. Wells Barnett. And she has this quote where she said, the way to right wrongs is to turn the light of truth.
antonia (53:21)
Yeah.
Jermaine (53:44)
on them. And so I think that your work has the embodiment of this ethos with this commitment to courage and integrity, speaking truth to power. I think like Aida, you are really going in on these, these dark spots in our society and having this unflinching light that you're shining on these inequities and really trying to get to the core of our collective humanity. And so I think
You know, this book offers so much clarity, so much depth, and to Crownsville Hospital. I hope everybody reads madness, gets the book. And I want to thank you for sharing your invaluable insights here on the Humanity Archive podcast. Thank you so much, Antonia. Appreciate it.
antonia (54:25)
Thank you for having me and for that compliment which is the highest compliment one could ever receive to be compared to her i think i could retire now so thank you this is been this is lovely.
Jermaine (54:39)
I truly believe it. Thank you so much for coming on the show.