Madness

Race and Insanity in a Jim Crow Asylum

By: Antonia Hylton

Narrated by: Antonia Hylton

In the tradition of The Immortal Life of Henrietta Lacks, this New York Times bestseller is a page-turning account of one of the nation’s last segregated asylums.

"A book that left me breathless." —Clint Smith, New York Times bestselling author of How The Word Is Passed

"Fascinating." —The New York Times

For centuries, Black patients have been absent from our history books. Madness transports readers through the ninety-three-year history of Crownsville Hospital, one of the last segregated asylums with surviving records and a campus that still stands to this day in Anne Arundel County, Maryland.

Antonia Hylton blends the intimate tales of patients and employees whose lives were shaped by Crownsville with a decade's worth of investigative research and archival documents. Madness chronicles the stories of Black families whose mental health suffered as they tried, and sometimes failed, to find safety and dignity. Hylton also grapples with her own family’s experiences with mental illness, and the secrecy and shame that it reproduced for generations.

As Crownsville Hospital grew from an antebellum-style work camp to a tiny city sitting on 1,500 acres, the institution became a microcosm of America’s evolving battles over slavery, racial integration, and civil rights. Hylton traces the legacy of slavery to the treatment of Black people’s bodies and minds in our current mental healthcare system. It is a captivating and heartbreaking meditation on how America decides who is sick or criminal, and who is worthy of our care or irredeemable.

USA Today Bestseller

National Indie Bestseller

Kirkus Reviews Best Nonfiction Books of the Year

ELLE Magazine's Best (and Most Anticipated) Nonfiction Books of 2024

Entertainment Weekly’s Best Books to Read 2024

An Amazon “Best Book of the Year”

Thank you!

Thank you for honoring those who were at Crownsville and telling their story! Thank you for inspiring us to do the right things in the future!

Jim Crow Era Assylum

Definitely a good story. The author does a good job of pulling everything together. The ability to meet with the families and staff and share their story is wonderful. I wish there were more details about specific people, but they just don’t exist.

Jim Crow Lives

This is the story of Crownsville State Hospital in Maryland, an institution for mentally ill Blacks that for most of its history was an underfunded and poorly administered dumping ground in the guise of a hospital. It housed not only psychiatric patients, but persons with other disabilities, criminals, and more generally Blacks who for whatever reason — legitimate or not — crossed paths with law enforcement. It is a horrific story of abuse, neglect, racial stereotyping, and general disregard for people who desperately needed support and expert care, but who were often brutalized by a system supposedly designed to benefit them. This institution existed until the early 21st century. Sadly, it’s just one example of similar institutions around the country. And, though to a much lesser degree, is an indictment of some systems and institutions (large and small) currently serving persons with disabilities, especially minorities, that continue to be underfunded, poorly staffed, and often incapable of providing expert care to their residents/patients.

Great read

This book was knowledgeable and very heavy. I’ve worked in the mental health field for almost 12 years and never heard about this. Please read if you’re in the field. It’s sad that parts of this book is still alive today.

madness was very informative

well researched, well told. unfortunate truth about our country and how it treats patients and mental health facilities, especially black patients probably to this day