Speaker 1: Hi, I'm Aaron Welsh and this is this Podcast Will
Speaker 1: Kill You. Welcome to another episode of the tp w
Speaker 1: k Y book Club, where I bring on authors of
Speaker 1: popular science and medicine books to ask them all about
Speaker 1: their latest work. This is truly one of my favorite
Speaker 1: things to do because I get to learn about so
Speaker 1: many fascinating topics like just this season alone, we've covered measles,
Speaker 1: the history of the pelvic exam, phase therapy, the aerobiome,
Speaker 1: and we've got more on deck for the rest of
Speaker 1: the season. If you want to read ahead or see
Speaker 1: what books we've covered in the past, head over to
Speaker 1: our website This Podcast will Kill You dot com, where
Speaker 1: you can find a link to our bookshop dot Org
Speaker 1: affiliate page under the extras tab. Once you're on bookshop,
Speaker 1: you'll be able to spot a bunch of different TPWKY booklists,
Speaker 1: including one for this book club. Throughout the rest of
Speaker 1: this season, I'll be posting upcoming books, so make sure
Speaker 1: you check in regularly. As always, we love hearing from
Speaker 1: you all about these book club episodes and our other episodes,
Speaker 1: so if you have topic suggestions, book suggestions, a first
Speaker 1: hand account to share any other thoughts, let us know
Speaker 1: the best way to get in touch is through the
Speaker 1: contact or through the submit your first hand account form
Speaker 1: on our website. Two last things before moving on to
Speaker 1: the Book of the Week, and that is to please rate, review,
Speaker 1: and subscribe. It really does help us out. And second,
Speaker 1: you can now find full video versions of most of
Speaker 1: our newest episodes on YouTube. Make sure you're subscribed to
Speaker 1: the exactly right Media YouTube channel so you never miss
Speaker 1: a new episode. Drop. It is twenty twenty five. We
Speaker 1: are a quarter of the way into the twenty first century,
Speaker 1: and we are still failing in many ways to deliver
Speaker 1: mental health care to those in need. Stigma, shame, dismissal, sexism,
Speaker 1: and racism are all embedded in the way we view
Speaker 1: and treat mental health issues, affecting who is deemed worthy
Speaker 1: of receiving care and what type of care they receive.
Speaker 1: And as the police have increasingly and inappropriately been called
Speaker 1: on to respond to mental health health crises, Black Americans
Speaker 1: and other people of color experiencing a crisis are disproportionately
Speaker 1: more likely to be harmed or killed by police, imprisoned,
Speaker 1: rather than given the help and mental health resources that
Speaker 1: white Americans are more likely to receive. The roots of
Speaker 1: these inequalities, which are ingrained in our current medical andcarceral systems,
Speaker 1: stretch back generations. To make lasting and effective changes in
Speaker 1: the way we approach mental health in this country, we
Speaker 1: need to turn to the past to understand its role
Speaker 1: in shaping are present in madness, race, and insanity. In
Speaker 1: a Jim Crow Asylum, author Antonia Hilton explores the story
Speaker 1: of Crownsville Hospital, a segregated asylum in ann Arundel County, Maryland,
Speaker 1: built in nineteen eleven by its first patients, twelve black men.
Speaker 1: Over the decades of its operation, during which it grew
Speaker 1: into a compound housing thousands of patients, Crownsville became, in anyways,
Speaker 1: a microcosm of the dynamics between race, mental illness, medicine,
Speaker 1: and the civil rights movement playing out across the United States.
Speaker 1: Expertly blending oral histories with archival materials, Hilton, who is
Speaker 1: an Emmy Award winning anchor and correspondent for MSNBC and
Speaker 1: NBC and New York Times bestselling author, presents a nuanced
Speaker 1: and moving examination of an overcrowded, understaffed Jim Crow institution
Speaker 1: that shaped the lives of those who lived or worked there.
Speaker 1: Hilton also reveals how the shift in focus from asylums
Speaker 1: to prisons in jails was reflected in Crownsville's operation. Madness
Speaker 1: is an urgent, necessary, and powerful work that sheds much
Speaker 1: needed light on the intersections between race, racism, and mental illness.
Speaker 1: I'm really excited to share this conversation with you all,
Speaker 1: so let's take a quick break and get started. Antonia,
Speaker 1: thank you so much for joining me today.
Speaker 2: Thank you for having me. I'm so excited to do this.
Speaker 1: In your book Madness, you tell the truly haunting and
Speaker 1: heartbreaking story of Crownsville Hospital, which is one of the
Speaker 1: last segregated asylums in the US. How did you first
Speaker 1: come across this story?
Speaker 2: Well, I first came across the story of Crownsville my
Speaker 2: freshman year of college, and it was there's sort of
Speaker 2: two origin stories I always tell people about how I
Speaker 2: came to this place. The simple one is it's my
Speaker 2: freshman year. I'm trying to figure out who I want
Speaker 2: to be and what I want to study, and I
Speaker 2: stumble into a class called Madness in Medicine that I
Speaker 2: didn't even know was something that could exist, A course
Speaker 2: all about the history of mental health care treatment in
Speaker 2: the Europe in the United States, and I learn all
Speaker 2: about the development of the asylum, the development of medications
Speaker 2: to treat mental health challenges, and as I grow deeper
Speaker 2: and deeper into the course, there's this thing gnawing at me,
Speaker 2: which is that I'm learning about the history of mental
Speaker 2: health care mostly from the perspective of European or white
Speaker 2: American people. And I knew something was wrong with that,
Speaker 2: not just from you know, basic instinct, but because I
Speaker 2: have family members who were very deeply impacted by the
Speaker 2: system themselves in the US history of mental health challenges
Speaker 2: in my family, and so I knew that there were
Speaker 2: black people, black patients, black providers who worked in these spaces,
Speaker 2: who contributed and tried, and I just went looking for
Speaker 2: a way to learn more about that at first. And
Speaker 2: so I go looking to find out about the asylums
Speaker 2: the institute US that worked with black patients, And what
Speaker 2: I found was a system of segregated asylums built in
Speaker 2: the decades after slavery came to an end in the US,
Speaker 2: and many of them closed down, were the subject of scandal, burned, files, destroyed.
Speaker 2: There's one asylum that a great grandfather of mine spent
Speaker 2: some time in that has been turned into a kind
Speaker 2: of Halloween theme park sort of experience. Yeah, I made
Speaker 2: the same face when I first found that out. Wow.
Speaker 2: And so in many cases I just kept hitting these
Speaker 2: like dead ends. Okay, not much here, there's just a
Speaker 2: paragraph about it here. And then I found Crownsville. And
Speaker 2: Crownsville is unique and not unique in a number of ways.
Speaker 2: Unique in that it is one of the only ones
Speaker 2: that were part of this network, a segregated asylum with
Speaker 2: existing records, living people and patients who had been at
Speaker 2: this place, and a campus that is still standing even
Speaker 2: to this day. In fact, it's in really the heart
Speaker 2: of Maryland, in an Arundel County, and the county and
Speaker 2: the state is engaged in a massive sort of rehabilitation
Speaker 2: and reimagining project as we speak. And so there was
Speaker 2: this opportunity to feel the place, to see it, to
Speaker 2: walk through it, to talk and sit with people who
Speaker 2: knew it intimately, and then to also petition the state
Speaker 2: of Maryland for access to its records. And that was
Speaker 2: unlike really any other opportunity. I'd say. There's one similar
Speaker 2: place in Virginia called Central state that there's similar opportunity there,
Speaker 2: but this was so rare, and so I just dove
Speaker 2: in and I became obsessed. The longer story, and perhaps
Speaker 2: the more true story, is that when I was eleven
Speaker 2: years old, I had a conversation with my father about,
Speaker 2: you know, cousins, and my cousins had just been visiting
Speaker 2: our house and I asked my dad, you know, I
Speaker 2: guess something must have clicked in my I had, Hey,
Speaker 2: why haven't I met any of your cousins? Do I
Speaker 2: know any of your cousins? You must have some And
Speaker 2: he said, well, you know, there's an uncle who you
Speaker 2: think is an uncle, but he's technically a cousin, but
Speaker 2: you call him uncle. And that's something that I know
Speaker 2: many people can relate to. And then he said, and
Speaker 2: then you know, some of my cousins have lost touch
Speaker 2: with them. One was incarcerated, and then one was killed
Speaker 2: by a police officer in the middle of a mental
Speaker 2: health episode, and we don't talk about him very much.
Speaker 2: And that was my first time ever learning that my
Speaker 2: dad had had a cousin named Maynard growing up, who
Speaker 2: he had loved and admired. He kind of wanted to
Speaker 2: be Maynard and in many ways, he actually did follow
Speaker 2: in that cousin's footsteps. My dad is a lawyer. Maynard
Speaker 2: was a lawyer when my dad was little, and he
Speaker 2: developed schizophrenia and was killed by a police officer during
Speaker 2: an interaction in public on the steps of a federal
Speaker 2: building in Mobile, Alabama in the seventies. And I was
Speaker 2: too young at the time to talk to my father
Speaker 2: about that. I didn't really know how to ask good questions.
Speaker 2: But then I became older and I asked a little
Speaker 2: bit more. I became a journalist, I became a pest,
Speaker 2: and I started to understand who Maynard was and just
Speaker 2: how much his death had transformed my family. And I
Speaker 2: think that in a way, for me, this story really
Speaker 2: goes back to my childhood, to the discovery that there
Speaker 2: had been all these stories in my family, these experiences
Speaker 2: people who had tried and failed to seek treatment in
Speaker 2: the system that set me on this path. Made me
Speaker 2: so curious in my bones to try to understand this
Speaker 2: that it set me up to be in a place
Speaker 2: where then when I am this young student, it all
Speaker 2: kind of clicked together. And so that's why I always
Speaker 2: tell both of those stories, because there's this sort of
Speaker 2: surface level story. But then there's like the what said
Speaker 2: times has felt for me like this, like familial mission
Speaker 2: I have been on almost like I don't know so
Speaker 2: much that I had a choice. It just sort of
Speaker 2: feels like all these things fell into place and they
Speaker 2: were right, and they were the thing I had to do,
Speaker 2: and that is what brought me to Crownsville and to
Speaker 2: this unbelievable story.
Speaker 1: I mean, there are so many elements to the story
Speaker 1: that you tell and in your book that it's not
Speaker 1: just the effects of Crownsville Echo today, it's that they,
Speaker 1: you know, have dictated, They have made the world that
Speaker 1: we have today in terms of mental health care. And
Speaker 1: I think it really helps sort of contextualize how today
Speaker 1: we are still failing in many respects to provide adequate
Speaker 1: mental health care. And I want to go through the
Speaker 1: full story, but I want to touch on something that
Speaker 1: you mentioned early on, which is the difficulty in obtaining
Speaker 1: source materials. And I'd love to hear more about your
Speaker 1: research method and your process for incorporating these different types
Speaker 1: of source materials together, like which elements do you pull from?
Speaker 1: What was that entire experience like for you.
Speaker 2: Oh boy, it was a lot it's short answers because
Speaker 2: I was so young. So keep in mind, you know,
Speaker 2: I begin this process as a literal teenager. I'm like
Speaker 2: nineteen years eighteen, nineteen years old. There's a lot I
Speaker 2: did not know about the world and how all of
Speaker 2: this worked. And so my first real task at working
Speaker 2: with I was really lucky to have Evelyn Hammonds at
Speaker 2: Harvard as my PSIS advisor. I had her help and
Speaker 2: some other people in the Harvard History of Science Department
Speaker 2: really guide me through this. I don't know that I
Speaker 2: would have gotten it done without them, but the process
Speaker 2: of going through Institutional Review Board Human Subjects Research Approval
Speaker 2: and getting the State of Maryland to give me permission
Speaker 2: to come to the state archives and access records that
Speaker 2: they typically refuse to share. In fact, it's a point
Speaker 2: of contention for many people in the black community in
Speaker 2: Maryland who have routinely asked for access to these records
Speaker 2: and been denied it. And so I think I didn't
Speaker 2: appreciate how hard it was going to be. I thought, Okay,
Speaker 2: there's some rules on this website. I'm going to follow
Speaker 2: all the rules. I'm going to take the tests they
Speaker 2: tell me to take, and then they're going to let
Speaker 2: me go. But you know, there were some politics that
Speaker 2: got into the way and some people that dragged their feet,
Speaker 2: and so it was helpful to have the backing of
Speaker 2: that institution to come in and sort of apply some
Speaker 2: pressure to make sure that I could get in there
Speaker 2: and get my work done. And so that was to me.
Speaker 2: I thought, like, Holy Grail, I'm going to go into
Speaker 2: the state archives and everything will be there. I will
Speaker 2: know everything about this place as soon as I can
Speaker 2: get my hands on these primary source documents. And then
Speaker 2: I finally do, and it is incredible. Let me not
Speaker 2: downplay what's in there. I mean, there were monthly reports.
Speaker 2: There were writings and letters that superintendents who ran the
Speaker 2: institution had written to themselves or privately to other state leaders.
Speaker 2: There were certain patient records, but whole lot of patient
Speaker 2: records missing. And I very quickly realized this wasn't the
Speaker 2: hoil that I thought it was going to be. That
Speaker 2: most of what happens when an institution of that nature
Speaker 2: closes down and people preserve what remains is the sort
Speaker 2: of clinical perspective and the leadership perspective is preserved, but
Speaker 2: the patient story that is not respected that's not maintained,
Speaker 2: that's not preserved as as well. And in fact, as
Speaker 2: I later learned in my journey, I didn't know this
Speaker 2: at the time. Employees of the institution alleged that there
Speaker 2: was a systematic effort to destroy a lot of the
Speaker 2: patient stories because there was a fear from the state
Speaker 2: in their view that perhaps lawsuits could come from that,
Speaker 2: that it would be more trouble than it was worth.
Speaker 2: And so I realized, even as a very young person
Speaker 2: sitting there in the Maryland State Archives, oh wow, I'm
Speaker 2: going to need to launch like a big oral history project.
Speaker 2: I need to go talk to people. I need to
Speaker 2: meet people. I'm going to need to make up for
Speaker 2: the voices that are missing in this place and find
Speaker 2: them elsewhere. And that it took a long time because
Speaker 2: humans are human and you have to build trusts with people.
Speaker 2: You have to call them, write them snail mail. I
Speaker 2: mean a lot of the former employees they were at
Speaker 2: the time and they still are quite elderly, and so
Speaker 2: I couldn't text them and DM them on Instagram or something.
Speaker 2: I had to really do some like shoe leather reporting work.
Speaker 2: And in some cases there were some people I was
Speaker 2: able to meet very quickly Pauler's for example, Paulers worked
Speaker 2: at the institution for forty years, social worker who dedicated
Speaker 2: his life to children at Crownsville. He was very quickly
Speaker 2: willing to speak, but so many people had been affected.
Speaker 2: I'd been traumatized in some cases by what they experienced
Speaker 2: at Crownsville, and so it took a while to build
Speaker 2: their trust. There are people in this book who took three, five,
Speaker 2: seven years to decide to talk to me, and I
Speaker 2: had to be really patient with that and respect that
Speaker 2: there were people who didn't want to talk on the phone,
Speaker 2: but they were willing to talk if I came and
Speaker 2: knocked on the door and I sat on their porch.
Speaker 2: And so the level of investment and patience that comes
Speaker 2: with that, I really I grew into it in a way.
Speaker 2: I started out as this young person who was just
Speaker 2: calling people up, and I should be grateful that anyone
Speaker 2: answered to a nineteen year old's phone calls. First of all,
Speaker 2: let me say that. But then I became an adult
Speaker 2: and a professional journalist, and I got the resources to
Speaker 2: be able to do the sort of real like sitting
Speaker 2: in the community and being present work, and that is
Speaker 2: what transformed everything. I think those stories, those memories, they
Speaker 2: are the richest part of this book. You know, the records,
Speaker 2: they are fascinating, They are valuable. I worked with so
Speaker 2: many of them in the story. But it's so helpful
Speaker 2: to have the sort of sites, smells, sounds, and stories
Speaker 2: from people who were so personally impacted by all this,
Speaker 2: whether they were the patients or they were the providers,
Speaker 2: and in many cases they really fill in critical gaps
Speaker 2: or you know, the records in some cases actually confirmed
Speaker 2: some of the stories that were found out in the community.
Speaker 2: And with an institution like Crownsville, it's huge for anyone
Speaker 2: listening who lives in the Maryland area, like it is
Speaker 2: worth driving by and seeing this place because you'll get
Speaker 2: a sense of just the immensity the number of people
Speaker 2: who were touched by this place over the almost one
Speaker 2: hundred years that it was in operation. And what comes
Speaker 2: with that is there's amount of community rumor and storytelling
Speaker 2: and all of that that you have to wade through.
Speaker 2: And having the community and having the trust in the community,
Speaker 2: and then having the records and bringing those complimentary pieces together,
Speaker 2: it allowed me to find a way to tell a
Speaker 2: story that had either been both sort of simultaneously pushed
Speaker 2: under the rug but also sort of festered as a
Speaker 2: mythological thing for a really long time. And it was
Speaker 2: the ability to do both of those things that helped
Speaker 2: me find the truth, the core of what happened there.
Speaker 2: And I see the record, the sort of painstaking archival
Speaker 2: and research process as being just as important as the
Speaker 2: oral history endeavor to.
Speaker 1: Let's take a quick break and when we get back,
Speaker 1: there's still so much to discuss. Welcome back everyone. I've
Speaker 1: been chatting with Antonia Hilton about her book Madness, Race
Speaker 1: and Insanity in a Jim Crow Asylum. Let's get back
Speaker 1: into things. What emerges is this really rich, sweeping perspective
Speaker 1: like the storytelling of asylums and the representation of asylums
Speaker 1: that happens often in popular media like movies, is very
Speaker 1: one sided, one dimensional, or just one perspective. And that's
Speaker 1: one of the things I really appreciated about your book.
Speaker 1: And I would love to turn to the beginning. Why
Speaker 1: was this institution and other institutions like it? Why was
Speaker 1: it built and how did its surrounding context both the
Speaker 1: time period in which it was established and the location
Speaker 1: that it was established in how did that shape what
Speaker 1: it would become.
Speaker 2: The context is everything Crownsville is created. It is founded
Speaker 2: in nineteen eleven, and this is a fascinating time in
Speaker 2: the United States. Were a couple decades after the end
Speaker 2: of slavery, and there have been these immense contradictions in
Speaker 2: American society. I mean, black people have in some cases,
Speaker 2: they've become lawmakers, they've started incredibly successful towns and communities
Speaker 2: in places like Tulsa, Oklahoma, and they're gaining ground. But
Speaker 2: then there is a massive backlash and backsliding that starts
Speaker 2: to steal some of that ground back. And there's an
Speaker 2: effort and a lot of that effort actually begin in Maryland.
Speaker 2: A lot of people don't know this. You know, Maryland
Speaker 2: passed one of the first segregation ordinances in the entire country,
Speaker 2: if not I think the very first segregation ordinance in fact.
Speaker 2: So there is this effort to try to put black
Speaker 2: people back in their place. But there also is for
Speaker 2: the black people who you know, haven't found the Tulsas,
Speaker 2: who haven't maybe found their footing yet. There's this sort
Speaker 2: of incessant writing going on in white intellectual circles. So doctors, lawyers,
Speaker 2: politicians who are really obsessed with what they describe as
Speaker 2: this problem of Negro insanity, Negro alcoholism, Negro waywardness. They
Speaker 2: are observing that there are all these black people who
Speaker 2: seem to be traumatized and struggling and unable to adjust
Speaker 2: to life post enslavement. And you know, looking back on
Speaker 2: it for us now, that perhaps doesn't seem so surprising
Speaker 2: that people found that experience, you know, hundreds of years
Speaker 2: of enslavement to be traumatizing for their families. But at
Speaker 2: that time, you would think think they thought that everyone
Speaker 2: would get over it in a year or two. That
Speaker 2: just simply hadn't been the case. So they're writing in
Speaker 2: these letters to each other or they're publishing in medical
Speaker 2: journals these observations that were incredibly dehumanizing. On the other hand,
Speaker 2: then they're expressing pity and saying, well, we need to
Speaker 2: do something about it. We got to do something about it.
Speaker 2: But what they decide to do is create a place
Speaker 2: to treat them. But they must be separate from white
Speaker 2: people because these antebellum attitudes that black people are inherently different,
Speaker 2: they seeped into everything. I mean, I think people understand, okay,
Speaker 2: separate Water Fountain, separate schools, but they forget I mean,
Speaker 2: it went into healthcare treatment. It meant into basic conceptions
Speaker 2: of how the mind in different people would work. And
Speaker 2: so they make the decision that there need to be
Speaker 2: these separate places for treatment, and Maryland takes it one
Speaker 2: step farther. They decide that they're going to create this asylum,
Speaker 2: but they don't really want to pay for it, and
Speaker 2: they're going to ask, not ask, They're going to force
Speaker 2: these patients to build it for themselves. So it begins
Speaker 2: with twelve black men who are brought from almshouses, poorhouses
Speaker 2: around the state, brought into a forest and if you
Speaker 2: know the Maryland area, it's sort of the modern Bacon
Speaker 2: Ridge natural area, and there's nothing there, nothing, not a
Speaker 2: place to sleep, no cabins, and they are told they
Speaker 2: have to get to work, build yourself an asylum, move railways,
Speaker 2: move tracks, construct roads, clear ground. I mean really monumental labor.
Speaker 2: They're working side by side with contractors hired by the state,
Speaker 2: but the patients did an immense amount of the backbreaking,
Speaker 2: really physical labor. And weeks go by as they're doing this,
Speaker 2: and they bring new patients in and new men in
Speaker 2: and actually also boys. There are state records describing you know,
Speaker 2: putting boys who are about ten to twelve years old
Speaker 2: who are disabled, physically disabled to work and being proud
Speaker 2: that they were able to get them to carry you know,
Speaker 2: pails of water or other items around and get them
Speaker 2: to contribute to this effort. And the sort of tone
Speaker 2: is always that they should be grateful that they're given
Speaker 2: this work, that it must make them feel better, you know,
Speaker 2: and that once this project is done, they'll march into
Speaker 2: the rooms that they just built and they'll become its
Speaker 2: first patients. So that is how Crownsville begins, and that
Speaker 2: is the racial and political context at the time.
Speaker 1: How was mental health like was mental health a concept?
Speaker 1: How was mental health different than mental illness? And what
Speaker 1: were the prevailing ideas around treatments or therapies and you know,
Speaker 1: what options were available to for instance, a black person
Speaker 1: in nineteen eleven in Maryland that if they were experiencing
Speaker 1: a crisis, where could they go? Could they go anywhere?
Speaker 2: I really appreciate this question. Actually, you might be the
Speaker 2: first interviewer to ask me that in that way, because
Speaker 2: I think it gives me the chance to make an
Speaker 2: important point which is that I think often, you know,
Speaker 2: in twenty twenty five, we look back at a time
Speaker 2: like nineteen eleven and we think, well, people just didn't
Speaker 2: know anything, like it was all pretty horrible. And look,
Speaker 2: a lot of the mental health care treatment, the majority
Speaker 2: of what was available was terrible for everybody. I mean,
Speaker 2: if you actually talk to psychiatrists and biochemists and to
Speaker 2: therapists and people who work in the space today, they'll
Speaker 2: still tell you that we may be in the dark
Speaker 2: ages of understanding how the mind works at this current moment.
Speaker 2: So certainly nobody's going to argue that what was available
Speaker 2: in nineteen eleven was incredible. And you know that there
Speaker 2: were quick fixes all around, No, not for anyone, But
Speaker 2: there were ways in which leaders made very deliberate decisions
Speaker 2: to give people of color the absolute worst of what
Speaker 2: was available. You know. For example, they knew that tuberculosis
Speaker 2: was an incredibly dangerous disease that impacted people's physical and
Speaker 2: mental health, but they were careful to create separate, quarantined
Speaker 2: wards for that. At all white institutions, they refused to
Speaker 2: do that. However, at Crownsville, they knew that this disease
Speaker 2: would kill or physically and permanently disable all kinds of
Speaker 2: people in these in Crownsville, but they allowed it to
Speaker 2: fester anyway. That was a price, a sort of just
Speaker 2: a reality they were willing to accept, despite writing and
Speaker 2: openly knowing that to do the opposite was the right
Speaker 2: thing for another set of patients. And the other interesting
Speaker 2: thing I should say too, is a lot of these
Speaker 2: therapies are complicated to talk about because they may sound
Speaker 2: horrible at first, but there are clinical arguments that have
Speaker 2: been made for them. For example, electro shock. A lot
Speaker 2: of people horrified by the concept of electroshock, but there
Speaker 2: are still people doing electro shock to this day, and
Speaker 2: there are patients that will tell you that they love it,
Speaker 2: and so you know, while at Crownsville there are a
Speaker 2: lot of stories of abuse of patients through electroshock, there
Speaker 2: are stories of clinicians believing that it was a valuable
Speaker 2: tool that helped them gain insight and make treatment breakthroughs
Speaker 2: with patients at places like Crownsville too. Hydro Therapy is
Speaker 2: another example. Hydro Therapy is a tool that for some
Speaker 2: patients could be incredibly relaxing. It was the experience of
Speaker 2: being submerged up in water in a tub sort of
Speaker 2: up to right under your chin, and you would be
Speaker 2: either an incredibly hot or incredibly cold water for a
Speaker 2: period of time. That period of time could be a
Speaker 2: couple hours, it could be up to three days. At Crownsville, now,
Speaker 2: spending a couple hours in a very warm tub for
Speaker 2: some patients was apparently in some cases very relaxing. Spending
Speaker 2: three days in a very hot or a cold tub,
Speaker 2: some would call that torture. And so every single one
Speaker 2: of the sort of modalities available, you can pause, or
Speaker 2: you can do the reading and see a completely different
Speaker 2: way of looking at its application and the potential for harm.
Speaker 2: And so there's sort of the baseline story of what
Speaker 2: was available and how difficult and how dark the treatment
Speaker 2: of the mind was at that time. But then there's
Speaker 2: also just sort of the need to understand that as
Speaker 2: you look at the different kinds of facilities that always
Speaker 2: what you saw was the same pattern repeated, not just
Speaker 2: in Maryland, but certainly that's the place that I studied,
Speaker 2: that the black patients were going to get the worst
Speaker 2: of what was out there, and we're going to have
Speaker 2: the fewest sort of clinicians and aids available to support them.
Speaker 2: I write at one point about records that I found
Speaker 2: that showed that as the state rehabilitated a bunch of
Speaker 2: the different asylums in the state, that they sort of
Speaker 2: consciously made the decision to build less therapy spas at Crownsville.
Speaker 2: So sort of this idea that there was going to
Speaker 2: be room for patients to even just have space to talk,
Speaker 2: to reflect, to work with and be in conversation with
Speaker 2: a provider. You see the way in which sort of
Speaker 2: attitudes are reflected in expenditures and structural decision making. I
Speaker 2: know people don't love talking about structural racism anymore, but
Speaker 2: you see a lot of it, very obviously in the
Speaker 2: story of Crownsville. And so it's complicated because there are
Speaker 2: these moments in this story where people are able to
Speaker 2: do genuinely great work with patients at Crownsville, especially after
Speaker 2: integration and more members of the community are able to
Speaker 2: get the chance to take care of people who look
Speaker 2: like and who know them. But there are also there's
Speaker 2: also the element of horror. There's also an absolute reality
Speaker 2: of abuse, and all of those things existed and coexisted
Speaker 2: and could happen on any given day at the very
Speaker 2: same time.
Speaker 1: Let's take a quick break here. We'll be back before
Speaker 1: you know it. Welcome back everyone, I'm here chatting with
Speaker 1: the wonderful Antonia Hilton about her book Madness. Let's get
Speaker 1: into some more questions. The way that this plays out
Speaker 1: is such a nuanced way, where you have these prevailing
Speaker 1: notions about how the mind works, how mental illness works,
Speaker 1: and then also you have this racism that's baked into
Speaker 1: so much of the way that that is informing that
Speaker 1: a lot of the physicians, for instance, who are providing
Speaker 1: the treatment and so on, and then and of course
Speaker 1: funding and all of that. And initially it seems like
Speaker 1: for at least a period of time, Crownsville's predominant role
Speaker 1: was not too necessarily, or maybe it was in combination
Speaker 1: to provide care for those with mental illness, but also
Speaker 1: to exploit those individuals for their free labor. How did
Speaker 1: this factor into how long someone was held at Crownsville
Speaker 1: or was lived at Crownsville, And when did awareness of
Speaker 1: this sort of mistreatment or these instances of mistreatment seep
Speaker 1: into the surrounding communities.
Speaker 2: The question of exploitation is a really important one because
Speaker 2: it is there from the very beginning, I mean, the
Speaker 2: story of its creation. It's almost like when I tell
Speaker 2: people the story, it almost sounds like biblical or mythological
Speaker 2: to them that these twelve men are in the woods
Speaker 2: and they hear the news that they have to build
Speaker 2: themselves a hospital. So the exploitation begins before the hospital
Speaker 2: has any sort of physicality to it, and then when
Speaker 2: the hospital opens and its operations start, that is really
Speaker 2: just the beginning of very long workdays for the majority
Speaker 2: of the patients there. Unless you were essentially completely physically disabled,
Speaker 2: you were expected to offset the cost of your own
Speaker 2: care for many decades, the first essentially three four decades
Speaker 2: at Crownsville. There is this massive pressure on patient labor
Speaker 2: there in areas that were unusual to so in the
Speaker 2: twentieth century, there was a very common concept actually even
Speaker 2: before that, of this idea that having vocational training for patients,
Speaker 2: for people struggling with their mental health would be good
Speaker 2: for them. It would mean that when they get out
Speaker 2: they get great jobs or they have an apprenticeship, they
Speaker 2: have opportunity, or at least they can be helpful to
Speaker 2: their families if they're staying at home, and so Lots
Speaker 2: of asylums had jobs, programs or chores that patients needed
Speaker 2: to do, and Crownsville was no different in that respect.
Speaker 2: But the hospital had an entirely other layer of labor expectations.
Speaker 2: Unlike anything seen in Maryland or really most of the
Speaker 2: institutions I've ever studied, Crownsville expected patient to run a
Speaker 2: highly modern and productive farm with modern irrigation practices. They
Speaker 2: farmed tobacco, they worked with cattle. Women were expected to
Speaker 2: basically constantly be working with food and produce, or in
Speaker 2: the kitchen or in the laundry. And it was to
Speaker 2: such a powerful extent that this is remarked upon consistently
Speaker 2: in state records, really as a point of pride that
Speaker 2: we're able to keep the cost down at this place
Speaker 2: because we made the patients run the place themselves. They
Speaker 2: were proud of how much they were able to get
Speaker 2: them to do it. And then even they take it
Speaker 2: again another step too far. They are extracting from creative patients.
Speaker 2: So people who create rugs or did basket weaving, they
Speaker 2: start to sell their goods, and none of that money
Speaker 2: comes back to the patient themselves. It's used again to
Speaker 2: offset the costs of their care. They send items that
Speaker 2: patients at Crowns will made out to competition, and the
Speaker 2: superintendents would display and brag about them as if they
Speaker 2: were almost theirs. And so there is this sort of
Speaker 2: constant air of exploitation there, and it doesn't start to
Speaker 2: shift until really, I mean, I guess it depends on
Speaker 2: your idea of what a shift looks like, if it's
Speaker 2: the rumor mill, if it's awareness in the community. The
Speaker 2: black community became aware of a lot of this very
Speaker 2: early on. There were a number of patient murders. I
Speaker 2: write about one, the father of civil rights icon Polly Murray,
Speaker 2: her father William Murray, murdered by an allegedly pretty openly
Speaker 2: racist guard at the hospital. Stories like that they spread
Speaker 2: among black community members of Annapolis and Baltimore. They didn't
Speaker 2: necessarily get the attention they perhaps deserved in the papers
Speaker 2: like the Washington Post or Baltimore's Sun, but they certainly
Speaker 2: were known about. But real action begins, say in the forties,
Speaker 2: when there are these sort of budding civil rights movements.
Speaker 2: There are lawyers and growing budding associations like the NAACP
Speaker 2: that are starting to sort of demand access, demand meetings
Speaker 2: with state leaders and the superintendents of Crownsville and get
Speaker 2: in there and actually start taking testimony from patients. And then,
Speaker 2: to give a little credit to my field, there are
Speaker 2: reporters who start asking questions. At all the major papers,
Speaker 2: there is a series of expose as, but there's also
Speaker 2: some incredible work done. I have to shout out the
Speaker 2: Afro American newspapers because those reporters consistently published diary entries
Speaker 2: of patients on the first pages, unlike anything any of
Speaker 2: the other papers were doing. And they allowed patients to
Speaker 2: tell their own stories and their own voices, and weren't
Speaker 2: always taking the word of say the police or the
Speaker 2: superintendent above theirs. And so there's a lot of richness
Speaker 2: there in the record that you can find by looking
Speaker 2: at some of the alternative or minority media at that time.
Speaker 2: And so that's when the sort of consciousness that guests
Speaker 2: starts to shift is in that period in the forties,
Speaker 2: and in a way it's no surprise America is engaged
Speaker 2: in a horrendous world war. The hospital is starting to
Speaker 2: receive and welcome in Jewish men and women who are
Speaker 2: fleeing the Nazis and who are coming to restart their
Speaker 2: lives in the United States, they come to work at
Speaker 2: places like Crownswell, and they too are outraged by what
Speaker 2: they see there because they've seen this, They just escaped
Speaker 2: a system of extinction, and now they come to this
Speaker 2: place and they see the patient labor and the exploitation
Speaker 2: for what it is. And so you have all these
Speaker 2: factors that are coming together in that period that are
Speaker 2: leading to these new coalitions that are getting ready to
Speaker 2: transform this place.
Speaker 1: This broader shift not just within the recognition of Crownsville,
Speaker 1: but this shift in the mid twentieth century that you
Speaker 1: describe in the way that the general public and medicine
Speaker 1: begins to see mental health and psychiatric hospitals these views.
Speaker 1: Of course, the shifts and these views are not consistent
Speaker 1: across the race of the patients, right, And you point
Speaker 1: out the differences in this framing where white patients are
Speaker 1: said to well, well, we need to rehabilitate, but black
Speaker 1: patients it said, oh, well we need to manage. How
Speaker 1: did this play out at Crownsville.
Speaker 2: This is again actually where some of the most valuable
Speaker 2: records were the work of reporters, because they would talk
Speaker 2: to community members and kind of publish their unvarnished thoughts
Speaker 2: about what should be done about places like Crownsville or
Speaker 2: similar peer white institutions like spring Grove or Springfield in
Speaker 2: the state. What I found was that just as you mentioned,
Speaker 2: there's this movement after there are scandals in the asylums
Speaker 2: and reporters are starting to get the story out there,
Speaker 2: lawyers are starting to make demands. There's this growing movement
Speaker 2: in the United States that begins in the forties and
Speaker 2: really extends for decades onward to rein best in community care,
Speaker 2: to bring people home, to have more empathy for the patient,
Speaker 2: to be willing to hear their side of the story,
Speaker 2: and to share their narratives in the paper, in media
Speaker 2: and movies. Really there was a sort of explosion. But
Speaker 2: then what I found is that when it came to
Speaker 2: black patients, the communal response was very different. There was
Speaker 2: a fear about release, there was a fear about what
Speaker 2: it would mean to welcome them back into the community,
Speaker 2: and that often reporters in my field then they made
Speaker 2: a lot of mistakes. They over exaggerated and sort of
Speaker 2: misreported the extent of for example, escapes or riots at
Speaker 2: a place like Crownsville, as compared to what was happening
Speaker 2: at pure white institutions. And I found records of even
Speaker 2: superintendents who know none of the patients, would have described
Speaker 2: as their ally. They would acknowledge that the crowns will
Speaker 2: the amount of violence or escapes at that site were
Speaker 2: being sort of unfairly highlight or featured in the papers,
Speaker 2: even when pretty much equivalent events were happening elsewhere. I
Speaker 2: spent some time going through just some of the language
Speaker 2: the adjectives used by reporters at the time, too, that
Speaker 2: when they would talk about a white patient who escaped,
Speaker 2: they would often describe sort of the person's melancholy, how
Speaker 2: fearful they were. I remember, I don't think I included
Speaker 2: in the book, but I remember reading one paper describing
Speaker 2: a white male patient escaping one institution, and the paper
Speaker 2: was kind of making jokes about the red fluffy slippers
Speaker 2: that he escaped into the woods wearing. Whereas and I
Speaker 2: do include these in the book. I write about some
Speaker 2: of the young black male patients who are written about
Speaker 2: as though they are any minute now going to come
Speaker 2: into the suburbs surrounding the institution and rob rape and
Speaker 2: terrify people. And there are descriptions of people saying, you know,
Speaker 2: after they've heard about an escape, that guns are going
Speaker 2: out onto porches tonight, and people are sort of fantasizing
Speaker 2: about this fear of their wives being left home alone.
Speaker 2: And there's this sort of juxtaposition always between sort of
Speaker 2: white domestic life and the threat of the people inside
Speaker 2: Crownsville again, even though at the same time, the same
Speaker 2: number of patient escapes are pretty routinely happening at pure
Speaker 2: white places as well, And so there is a perception
Speaker 2: that follows then, of course, and what follows from the conversation,
Speaker 2: the cultural conversation, the perception is political action. People start
Speaker 2: advocating to build a wall around Crownsville anyone, I don't know.
Speaker 2: Maybe they advocate for morelock and key policies. They want
Speaker 2: to bar patients from being able to visit communities. There's
Speaker 2: this massive carceral push to keep them behind bars at
Speaker 2: all costs, even as clinicians keep saying, we know from
Speaker 2: the evidence from the work we're doing with these patients
Speaker 2: that what they need is actually more community support. We
Speaker 2: need to be able to hire more people they need therapists.
Speaker 2: There are patients every week getting zero time with therapists
Speaker 2: or psychiatrists at the hospital. Basically they're just like sleeping
Speaker 2: there and working there all day long. They're not actually
Speaker 2: getting the treatment and rehabilitation that this place was supposed
Speaker 2: to provide. And so there's the people who sort of
Speaker 2: know the people in the place begging for one thing,
Speaker 2: but the community, because of what they've grown to fear
Speaker 2: and believe, pushing for the exact opposite. And in many cases,
Speaker 2: the community and the sort of people filled with this
Speaker 2: false perception they went out and one of the tragedies
Speaker 2: of Crownswel, and I often use Crownswel to help people
Speaker 2: understand concepts around structural racism and sort of the ways
Speaker 2: in which our past informs always our present moment is
Speaker 2: that because of what happened in Crownzell's founding, that the
Speaker 2: state always wanted to spend less money on it. They
Speaker 2: never invested in its building completely, they never invested in employees,
Speaker 2: they never invested in making sure there were good doctors
Speaker 2: and clinicians there. They didn't want to build the proper
Speaker 2: amount of therapy space. They barely had food and soap
Speaker 2: available during World War Two, when patients there were literally
Speaker 2: suffering and dying. Even when this sort of civil rights
Speaker 2: movement gets some wins, there's integration and there are changes coming,
Speaker 2: and there's sort of new standards and rules by which
Speaker 2: all these places have to operate. Crownsville is operating at
Speaker 2: a deficit. They're never given back the money they were
Speaker 2: never provided, and so all these new sort of institutional
Speaker 2: and legal and healthcare care related laws and regulations come
Speaker 2: into place. There are these high expectations of the place
Speaker 2: after integration, like Okay, let's see what you all can do.
Speaker 2: But they don't have money. They're operating with an institution
Speaker 2: never built with what it needed to properly survive, and
Speaker 2: so they end up kind of stuck in this heads
Speaker 2: you lose tails, you lose situation, and it's heartbreaking for
Speaker 2: the institution and it haunts it from the period we're
Speaker 2: talking about all the way until it's closure in two
Speaker 2: thousand and four.
Speaker 1: This period of time too is as I find this
Speaker 1: so interesting, this shift in the framing of how we're
Speaker 1: viewing mental illness and then also sort of the weaponization
Speaker 1: of diagnosis that still happens today, where you get these
Speaker 1: shifts in or these changes in the way that certain
Speaker 1: conditions are labeled or you know, for instance, schizophrenia is
Speaker 1: one that you discuss in your book. And of course
Speaker 1: there's another book, the Protest Psychosis, that goes into this
Speaker 1: as well, where it starts out as this sort of
Speaker 1: this diagnosis of mothers, homemakers who are burnt out, and
Speaker 1: then it transforms into this opportunity to pathologize young black
Speaker 1: men in particular, especially during this period of time. What
Speaker 1: was happening at Crownsville as far as that goes, or like,
Speaker 1: was that bleeding into there as well?
Speaker 2: Oh? Absolutely. And I have to give a shout out
Speaker 2: to Jonathan Metzl, the author of The Protest Psychosis. He
Speaker 2: was so helpful to me when I was an undergraduate
Speaker 2: trying to learn how to do all of this stuff,
Speaker 2: and we have been so supportive of each other's work since,
Speaker 2: and so I cite him a lot in the book,
Speaker 2: and that's no mistake, Like I couldn't have done a
Speaker 2: lot of this work without his help and his feedback
Speaker 2: at many points. Crowns Will absolutely reflects that story. You
Speaker 2: see it in the records, but you also see it
Speaker 2: in really and what I found most interesting was the
Speaker 2: recollections and the testimony of the people who were there.
Speaker 2: There's this really just fascinating transition coming out of really
Speaker 2: the civil rights movement where you start to see all
Speaker 2: of these clinical changes that they're starting to change that
Speaker 2: labeling as you just spelled out. So schizophrenia is becoming
Speaker 2: more of something that is about paranoia and aggression and
Speaker 2: all of these assumptions around black men and masculinity, and
Speaker 2: it's shifting from being sort of pictured or illustrated as
Speaker 2: a disease mostly of I guess, being withdrawn into yourself,
Speaker 2: and so it's sort of seen as this explosive thing.
Speaker 2: I even show in the book some examples of psychiatric
Speaker 2: ads and ways in which the conversation and the depiction
Speaker 2: of who suffers from schizophrenia shifts at the same moment
Speaker 2: that these movements these protests are happening. There's one psychiatric
Speaker 2: ad that I'll never forget that depicts a black man
Speaker 2: like hanging from fiery bars and looks like he's in
Speaker 2: the middle of a protest that's burning some kind of
Speaker 2: city to the ground. And he is the image that
Speaker 2: is accompanying a medication to treat schizophrenia and other diseases.
Speaker 2: And so you see that and if you're a person
Speaker 2: of that time. That is absolutely when you're talking about
Speaker 2: a time in which there were massive protests. I mean
Speaker 2: Martin Luther King murdered and that impacted Crownsville. People there
Speaker 2: process that in real time, staff members, patient, family members,
Speaker 2: they attended the march on Washington. I mean, all of
Speaker 2: this is interrelated. It's all part of the cultural context
Speaker 2: to the story. So you see it from the clinical perspective,
Speaker 2: but also I enjoyed hearing the memories of people who
Speaker 2: could describe it for you less as this sort of
Speaker 2: academic pattern and more is just the real thing that
Speaker 2: they saw every day at work. I spent a lot
Speaker 2: of time with this psychiatrist who actually still lives and
Speaker 2: works in ann Arundel County, Maryland to this day, named
Speaker 2: doctor Brian Simms. He was one of the first black psychiatrists.
Speaker 2: He really helped pioneer trauma informed care at Crownsville. And
Speaker 2: this is in the latter part of the book, and
Speaker 2: he writes about seeing police bringing a boy who's about
Speaker 2: six years old to the hospital in a karate uniform.
Speaker 2: He's misbehaved in karate class and he's brought there. He
Speaker 2: and many other described to me seeing patients you chained
Speaker 2: to polls while they waited to find out where they
Speaker 2: were going to be sent. Within the institution, the sort
Speaker 2: of constant flow of court committed patients who judges sort
Speaker 2: of decided were one week maybe they would go to
Speaker 2: the jail, the next week they were fit for Crownsville,
Speaker 2: And how doctors like him had to get on the
Speaker 2: phone and battle it out with judges and try to
Speaker 2: explain to them what was and wasn't appropriate, what was
Speaker 2: a clinical necessity and what wasn't, and that it was
Speaker 2: an exhausting, sort of unpaid part of their labor, and
Speaker 2: that they saw a lot of it as incredibly racialized,
Speaker 2: that kind of the second they saw a black person
Speaker 2: with pain and confusion and who had perherhaps committed a
Speaker 2: low level crime, that to them there was this sort
Speaker 2: of fear of derangement and a desire to have them
Speaker 2: stuck at a place like Crownsville. And that was really
Speaker 2: heartbreaking for the people who worked there. And the way
Speaker 2: that they tell those stories, they capture it so much
Speaker 2: better I think than a journalist or an acade even can,
Speaker 2: And so I tried my best to retell those stories
Speaker 2: in their voices, but you absolutely see it play out.
Speaker 2: And the doubly heartbreaking part is that those same doctors
Speaker 2: then respond by trying to create sort of a community
Speaker 2: based solution. So, Okay, we're going to create a program
Speaker 2: where we ourselves drive to visit our patients out in
Speaker 2: the community. We're going to make sure they stay on
Speaker 2: their medications. We're going to make sure they don't go
Speaker 2: back to court that they because a lot of patients
Speaker 2: they end up on what's essentially sort of the mental
Speaker 2: health equivalent of like probation, where any missed appointment could
Speaker 2: send you back to the hospital. And so these doctors
Speaker 2: are committed to trying to get people out of that cycle,
Speaker 2: because I mean, who among us hasn't missed a doctor's
Speaker 2: appointment to be told for five years that you can
Speaker 2: never miss an appointment and put people at a meense risk.
Speaker 2: So they sort of put a lot aside in their
Speaker 2: day to day jobs and drove out there into Baltimore,
Speaker 2: into all these other neighborhoods to make sure their patients
Speaker 2: made it anyway, and after seeing immense success, seeing the
Speaker 2: recidivism drop precipitously, they're told by the state that this
Speaker 2: isn't a good use of their time, and that the
Speaker 2: program needs to disband. And so you saw that lack
Speaker 2: of compassion and the way in which the attitudes you
Speaker 2: have about a certain community create a kind of permission
Speaker 2: structure and a sort of attitude from the top down
Speaker 2: where anything that would actually solve the problem you claim
Speaker 2: to be so alarmed about isn't worth spending money on.
Speaker 2: But the one thing consistently we're willing to do is
Speaker 2: behind bars, behind bars, behind bars. And it is absolutely
Speaker 2: a part of the Crownsville story, and it's something that's
Speaker 2: stuck with so many of the people who worked there
Speaker 2: for decades onward.
Speaker 1: Crownsville acted as almost like a place of dual purpose,
Speaker 1: where you have it as a psychiatric facility on one hand,
Speaker 1: but then this unofficial detention site on the other. And
Speaker 1: this also, as you describe in your books or plays
Speaker 1: out on the national scale, where you have this decline
Speaker 1: in psychiatric hospitals, just as you see this expansion of
Speaker 1: the prison system in the US. Can you tell me
Speaker 1: a little bit more about that.
Speaker 2: Yeah, what I'm arguing in that section of the story
Speaker 2: is really that it's not such a simplistic story where
Speaker 2: the asylum disappears and everyone goes to prisons. But that
Speaker 2: you have to see these institutions as being in conversation
Speaker 2: with each other and as sharing DNA, being part of
Speaker 2: the same genealogical timeline, and that it isn't a coincidence
Speaker 2: that at the moment that we are starting to disband
Speaker 2: this massive institution that at one point was the dominant
Speaker 2: institution in the United States and the mid twentieth century,
Speaker 2: the asylum was much more prevalent and powerful. There were
Speaker 2: more people there than there were in our prison system,
Speaker 2: and so you see the decline of that place and
Speaker 2: this explosion in the other And Crownswell is a fascinating
Speaker 2: window into that because again it's you can see how
Speaker 2: it worked in real time and in day to day
Speaker 2: human interactions. I write at one point about a report
Speaker 2: that breaks down what was essentially going on inside of
Speaker 2: peer white institutions and Crownsville, which at that point had
Speaker 2: been desegregated but was still majority black, as they were
Speaker 2: trying to transition patients out of the institution back to
Speaker 2: the community. Sort of a simple government study trying to
Speaker 2: look at what was available to those people in those
Speaker 2: different groups as that process unfolded. What they found was
Speaker 2: that at a peer white institution, there were vocational trainers available,
Speaker 2: There were counselors and teachers and family members present at
Speaker 2: these hearings, essentially where someone would get approved to go
Speaker 2: home or not go home, and they would be connected
Speaker 2: with opportunities and resources afterward. The report found that at
Speaker 2: Crownsville there were juvenile probation officers present, there were often
Speaker 2: no educators, nobody hiring out in the community, no vocational support,
Speaker 2: and so there was much more common that there would
Speaker 2: be someone who had a tie to the prison and
Speaker 2: jail industrial system, and a lot less likely that there
Speaker 2: would be somebody who was about to connect that person
Speaker 2: with a bright future, a job opportunity, and an appointment
Speaker 2: to make sure that they stayed on their care schedule.
Speaker 2: And so even then, as this is happening in real time,
Speaker 2: there is a knowledge that it's not happening the same
Speaker 2: for everyone. This whole idea that we had become so
Speaker 2: empathetic and interested in supporting patients and bringing them home
Speaker 2: was not applied evenly to all populations, and so it's
Speaker 2: no surprise then that our prisons and jails are full
Speaker 2: of black people, many of whom clinicians CEOs will tell
Speaker 2: you they think actually need mental health care, treatment and
Speaker 2: support and are likely regressing in a car soral setting
Speaker 2: like that. And it's the kind of maddening moment we're
Speaker 2: living in right now. I mean, I think about it
Speaker 2: a lot, in particular as we look at what's unfolding
Speaker 2: in Washington, d C. And we see this big push
Speaker 2: to just get the homeless out of there, just push
Speaker 2: them out, like the President basically saying that he doesn't
Speaker 2: care where they end up and where they go, but
Speaker 2: they can't be here. And the idea that well, okay,
Speaker 2: you either find yourself a shelter or something you're gonna do,
Speaker 2: or you're gonna end up in jail. That attitude, it
Speaker 2: came from somewhere, and we saw all these shifts, and
Speaker 2: in many ways I describe basically the black patient as
Speaker 2: sort of the lynchpin that held these negotiations together, through
Speaker 2: which you can see how so many of these decisions
Speaker 2: and disparate actions were taken. And that's really one of
Speaker 2: the key lessons from Crownswell. I think, you know, people
Speaker 2: they often ask me like how hard it must have
Speaker 2: been for me? To write this story and how dark
Speaker 2: some parts of it are, and I of course agree,
Speaker 2: and I needed to take a lot of breaks while
Speaker 2: I did this work, absolutely, But the piece of it
Speaker 2: for me that's actually incredibly hopeful, not just the amazing
Speaker 2: people that you meet along the way in this book,
Speaker 2: but also my belief that if you see where we
Speaker 2: went wrong and you see how some of these systems
Speaker 2: were set up, that now, in our current moments, so
Speaker 2: many Americans of every background want a better mental health
Speaker 2: care system, that this is a story that can provide
Speaker 2: us a window like, oh, hey, this was a poor decision,
Speaker 2: this wasn't necessary. Perhaps we should listen more to what
Speaker 2: advocates and doctors are trying to tell us in this moment.
Speaker 2: And I think that this when you look at Crowns Well,
Speaker 2: through all these different eras, you can see windows of
Speaker 2: opportunity and for change. And that to me is actually
Speaker 2: a piece that, as strange as it may sound to others,
Speaker 2: actually gives me hope.
Speaker 1: I can I can appreciate that we just it's having
Speaker 1: the will to implement these changes. And to another question
Speaker 1: here or lessons from the past, Yeah, right, that's separate. Well, Antonia,
Speaker 1: this has been. I mean, such an enlightening and important conversation.
Speaker 1: I am so happy to talk with you today and
Speaker 1: I really appreciate you taking the time to chat.
Speaker 2: Thank you so great to join you.
Speaker 1: A big thank you again to Antonia Hilton for taking
Speaker 1: the time to chat with me. If you enjoyed today's
Speaker 1: episode and would like to learn more, check out our
Speaker 1: website this podcast will kill You dot com. We're all
Speaker 1: post a link to where you can find and Madness,
Speaker 1: Race and Insanity in a Jim Crow Asylum. The paperbook
Speaker 1: is now out, by the way, as well as a
Speaker 1: link to Antonia's website where you can find her other
Speaker 1: incredible work, including the podcast South Lake and Grapevine and
Speaker 1: Don't Forget. You can check out our website for all
Speaker 1: sorts of other cool things, including but not limited to, transcripts,
Speaker 1: Quarantini and Placeibrida, recipes, show notes and references for all
Speaker 1: of our episodes, links to merch our bookshop, dot Org,
Speaker 1: affiliate account, our Goodreads list, a first hand account, form,
Speaker 1: and music by Bloodmobile. Speaking of which, thank you to
Speaker 1: Bloodmobile for providing the music for this episode and all
Speaker 1: of our episodes. Thank you to Leana Squalacci and Tom
Speaker 1: Bryfogel for our audio mixing, and thanks to you listeners
Speaker 1: for listening. I hope you liked this episode and our
Speaker 1: loving being part of the TPWKY book Club. A special
Speaker 1: thank you, as always to our fantastic patrons. We appreciate
Speaker 1: your support so very much. Much well, until next time,
Speaker 1: keep washing those hands, um.
Speaker 3: Um um
Speaker 1: Y