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[Speaker 2] What's up? Welcome to Black Healing Remix, the podcast season two. I am your host and my name is Yolo Akili Robinson.

Now, for folks who joined us for season one, you might be wondering, where is Natalie? Well, don't worry. In season two, we are doing things a little bit differently.

You see, season two features a collection of powerful conversations Natalie and I have held, both individually and collectively, throughout the year with healers, advocates, artists, therapists, and activists. This episode comes from a conversation I got the opportunity to have with Emmy and Peabody award-winning author Antonia Hilty, whose groundbreaking book, Madness, Race and Insanity in a Jim Crow Asylum, uncovers the deep-seated injustices of Crownsville State Hospital, originally known as the Hospital for the Negro and Sane of Maryland. Through the experiences of patients, doctors, nurses, and community members, Hilty uses Crownsville's history to expose the deep-seated racism, ableism, and misogyny inherent in psychiatry's roots in the United States, while also showing the defiance, resistance, and reimaginings of Black advocates and caretakers.

In our discussion, we delve into this profound and troubling legacy, and how Crownsville's history reflects the current reality of mental health care and prison systems today. Join us as we explore these critical narratives and remix Black healing. Y'all give a warm welcome to Antonia Hilty, and thank you so much for joining us.

[Speaker 1] Thank you for having me. I am so honored to be here.

[Speaker 2] So let's just launch into it. Tell us a little bit about, first, how did you get to Crownsville? So this book, for folks who are not familiar yet, who haven't had a chance to dive into, really explores the history of Crownsville Hospital, which is a hospital in Maryland, the only hospital for mental health patients in Maryland at that time.

Black mental health care patients are in Maryland at that time. And so I'm really curious if you could give us a little genesis of what led you to stumble upon? You talk about it in the book, but I'm curious if you could talk to a little bit about it.

[Speaker 1] Yeah. Well, you know, it's interesting. I often give people two options for origin stories, so I'll give you both.

The first is the simplified version of the story, which is that I was a freshman in college trying to figure out who I am and what I want to do, and that I stumbled into a class that was all about the history of psychiatry, almost by accident, just at the suggestion of a friend. And I very quickly became obsessed with it, but also a bit disturbed by it. We were learning about the creation of asylums, their development in Europe and the United States.

And we were learning about iconic surgeons, psychiatrists, the development of medications. And time and time again, I noticed that Black people were not present in these histories, in the stories, in the texts that were offered to me at a university that has one of the best history and science departments in the world. And so I knew something was wrong, and that's not just because I had a hunch something was wrong.

I come from a family with a long history of mental illnesses, of needing access to this kind of care. And so I knew Black patients had gone into these spaces. My great-grandfather was sent to a segregated ward of an asylum in Michigan.

I have loved ones living now who have needed this kind of care. And I also know that there are Black doctors and nurses who worked in these spaces. So it couldn't be that we had no role at all.

And so I went looking for it. And I found that almost every state had a version of Crownsville, a segregated Jim Crow-style institution. And that's because, you know, Jim Crow and apartheid at that time in this country seeped into everything.

I think people understand the water fountains. They understand schools and buses. But even just what kind of health care you can access and how they're going to treat you when you get to that institution was so determined by that system.

And so Crownsville really stood out to me and was so special because it was one of the few segregated institutions that had surviving records and a surviving campus. So I could physically get my hands on artifacts. I could read patient records and look at testimony and notes from doctors.

And then I could walk around the buildings and actually experience the institution for myself. The other story that I tell people about how I came to this work actually starts when I was 11, though. And it begins with me discovering that one of my father's closest friends, a cousin that he looked up to when he was much younger, had been killed by a police officer in the midst of a mental health episode in public in Mobile, Alabama.

And I think when I try to make sense of why I wrote this book and why I was so drawn into that class my freshman year, I think the story really starts there, if I'm being honest with you, because the realization of what happened to my father's cousin, the intersection of race, the mental health industry and space and policing and incarceration all in that one story in my family, and then the sort of aftermath, the trauma that my father and all the rest of my relatives experienced as a result of it.

It changed the culture of my family. I think it deeply impacted me and my six siblings. And I think it put me in a place where I was searching for understanding and searching for answers.

And so it was sort of all these things colliding at that moment that then brought me to Crownsville at just 19 years old.

[Speaker 2] As you were sharing, I'm thinking about not only your story, but also how it reflects, unfortunately, so many of our folk stories, right? And particularly when it comes to the intersection of folks who are navigating distress, essentially, and really being met with police violence and state violence, right? So really just holding that.

And thank you for sharing that and naming that. This is a part of your journey, right? It's not something that's divorced from your own experience as well, right?

When I think about the genesis of Crownsville, which was started off with being called Maryland's Hospital for the Negro and Sane, when that language was more commonly accepted in the common vernacular, the Negro or Sane language, right? I'm thinking about 1911. And I remember opening the book and being kind of shocked but not shocked, Tonya, to find that you shared that when the initial patients were sent to what would become Crownsville, which was then the Hospital for the Negro and Sane, they had to build the actual mental health facility.

Can you talk a little bit more about that?

[Speaker 1] Yeah. So as far as I can find in my research, which has been ongoing for more than a decade now, this is the only hospital, the only instance in which a group of patients in the United States were forced to build their own asylum before they could access mental health care. And I begin the book there for a few reasons.

I think it's really important for people to understand that while the hospital story begins in 1911, in a way it actually begins with emancipation and very public debates that began at the very moment Black people became free. And so what you see in the decades leading up to Crownsville's creation in 1911, so sort of from the late 1800s up to that point, are politicians, doctors, and business owners talking in the newspapers, in medical journals, in public with each other about what they describe as rising Negro insanity. They say they're noticing Black people struggling emotionally and mentally in corners all over the country and in Maryland as well.

And what's really interesting is a couple of Northern doctors try to raise the possibility that perhaps they are struggling because of the trauma of enslavement. And very quickly, a lot of Southern doctors kind of say, no, actually, we think their emotional and mental issues are a result of their inability to handle freedom.

[Speaker 2] Can I pause you there for a minute? Because that's a profound piece, right? I just want to pause for a minute just to make sure everybody hears that point.

That in this moment, we're talking about this post-enslavement era, Black folks are literally in distress. And the dominant kind of framing that the psychiatric and mental health institutions are shooting out into the world is that it is because they have too much freedom, essentially. And because their natural kind of role is to be subservient.

[Speaker 1] I try to emphasize this, especially when I speak to people. I think I'm probably on a call with people who recognize that the founding of this system has a lot of flaws. But I travel all over the country talking about this book.

And so I encounter people who know nothing about this history, who actually know very little about how terrible slavery was, who don't understand Reconstruction. And so I have to start from square one often. And what I try to tell people is, you know, these were not just casual racists making comments about Black people.

These were incredibly influential people whose names are still on buildings and roads in Maryland. In fact, if you went to go visit Crownsville now, because the buildings still stand, several of the buildings are named after people who were staunch segregationists. One of the roads surrounding Crownsville is named after someone who helped to develop the very first apartheid redlining law in Baltimore that was the blueprint used across the South to bar Black people from living in any neighborhood that was more than 50 percent white.

You know, these are the architects of our racial order. And they were influencing the foundations of psychiatry in America. And I emphasize that because this book is split up into five sections.

And of course, section one is all of this. It is how do we begin? And I argue essentially that in order to understand our current moment, why are the largest mental health care providers in the United States, Rikers Island, the Cook County Jail in Chicago and the L.A. County Jail system? Why, if you live in Louisiana, is the New Orleans jail system the largest mental health care provider in its region? If you're trying to understand that, you actually need to go all the way back to what I'm describing here, because these people, they trained fellow doctors. They created internship programs.

They interacted with Black patients with all of that mythology and pseudoscience in mind. And they set everything in motion. I mean, they created this system.

And we have to understand that and reckon with that to make sense of anything else.

[Speaker 2] Absolutely. Brilliantly said. And that's exactly why we want to have this conversation.

You know, and building on that piece about this being the foundations of psychiatry being deeply rooted in this like, segregationist, racist rhetoric, I'm thinking also about when I was reading about the early days of Crownsville, you kind of explored and talked about how the treatment that Black folks who were going to the mental asylum were receiving in the early days, particularly in Crownsville, was this kind of theoretical approach that giving them labor, right?

Like giving them labor and like, actually like, you're going to get, you're supposed to be going to this place to get treatment, but actually what you're getting is work. But the idea that work was going to like, you know, stabilize your mind or your distress, and even being still put to work in local farms and other places, people who had been sent to that space or went to that space for treatment. Can you talk a little bit more about that?

[Speaker 1] Oh, yeah. You know, I think it's worse than just they're subjected to work. What they're really subjected to is someone's sort of fantasy recreation of the antebellum social order.

[Speaker 2] I'm on that.

[Speaker 1] So because these people who I've just described are so convinced that Black people are fundamentally different from white people, they deserve a different type of care, they must be taken care of in a different institution, they must build their own institution from the ground up before they can go inside it and access any care. That doesn't stop the moment that the doors are in place and the wards are open. They then basically create a plantation.

They force the patients at Crownsville to run a highly modern, extremely productive farm. They rent them out to local private businesses, many of them openly bigoted. They use them in wartime efforts during World War I and World War II.

And then lawmakers in the state of Maryland purposefully underfund the institution so that the patients are sort of trapped in a labor cycle in which they have to work, they have to cook their own food, they have to run a farm, they have to take care of animals and go get their own eggs and milk every day, because without that, the institution and they would simply not survive. The thing I always try to emphasize to people, too, is anyone who's familiar with the sort of founding and creation of the therapeutic models in asylums in this period, they would be familiar with this idea of industrial therapy. So in Europe and in the United States, it was very common for asylums to say part of getting healthy is getting to work.

It's finding a vocational job program. It's becoming an apprentice to someone.

[Speaker 2] Which is such a curious thing in the context of capitalism. It's such a curious idea, right? I think the connection is like, yeah, it's capitalism.

Find a job. It's really interesting to think about. Go ahead.

I'm sorry.

[Speaker 1] No. Well, that's the really prevailing idea that in order for you to be healthy and get back home someday, you need to have a trade, have something you know how to do and like to do. And what you see in the majority white asylums is that people are able to develop a skill like carpentry and actually work under people they say have connections to their community.

They are able to essentially build apprentice style networks. So when they do leave and get discharged, they actually can go get jobs. But that's not what you see happen at Crownsville in those early decades.

They are essentially used as farmhands and slaves by people who make it very clear they have no desire to pay those patients, no relationship with the black communities of Maryland and aren't planning to hire them. And I think it's really important people know that for the first several decades of existence, the state wouldn't even allow black people to work there. So all black patients, but all white staff and black people have to fight for years to be seen as even qualified enough to get low level jobs as cooks and orderlies there.

And so, you know, it's just, it is, I think one of those things where you're not surprised, but when you look at the details of it, you are shocked.

[Speaker 2] Yeah, absolutely. And you do a really brilliant job in the book of helping us see how monumental shifts begin to happen in Crownsville when black staff begin to enter into space, right? A humanization of people who have been denigrated and dehumanized begins to happen as black people are coming into space and being like, wait.

[Speaker 1] Well, one of the themes of the book that I really hope people pick up on is this very thin line between who's insane and who's sane, who's well and who's unwell. And this idea that these categories are often weaponized against people of color, and they're not really objective categories at all. And so, you know, you, in the beginning of the book, you see the powerful white politicians and leaders make this argument that black people are sort of inherently incapable.

They are not well, they can't handle freedom, they are immature, they're criminals, all of these terrible things. And that's why Crownsville exists. And they refuse to let them have jobs there.

And I even at one point show you the transcript of a conversation between a white state leader and a black reporter as he tells her this, but essentially he doesn't believe black people are actually capable of taking care of their own. He says that to her on the phone. And what you find once integration finally happens is the black staff is in shock, not just because the institution is in complete disarray.

And as you mentioned, there's filth everywhere, overcrowding, inhumane conditions. They are shocked because they find that many of the white people they were told were superior to them, cannot read, are addicted to meth, working high on the job, neglecting basic parts of the job, like just keeping notes on what's happened with the patients that day, recording their names and their backstories, calling their family members to alert them that they're even at Crownsville. So black staff start doing very simple things, like asking some of the patients, who are you and where did you come from?

And discovering that some of them have been unjustly trapped at the institution for years, including a British man brought to Crownsville, they find in the fifties, simply because one of their white supervisors didn't believe there could be black people with British accents. And so they arrest this man or basically apprehend this man who was from London and had a British accent because they think he's making it up, that he's crazy.

[Speaker 2] And you also talk a lot about in the book about the ways in which Crownsville and the surrounding neighborhood was used as a threat to many black people.

[Speaker 1] You know, Crownsville basically takes on this larger than life sort of mythology in the minds of actually both white Marylanders and black Marylanders, although of course in different fashions. So in the black community, Crownsville becomes this very frightening place where people start to tell these stories. Oh, a night doctor will come to get you if you are a black boy out at night and you don't come home before 12 a.m. A night doctor can scoop you up off the street and take you to Crownsville and you'll never be seen again. I was told that all the time by some of the elders in their eighties and nineties in Maryland. And I thought, oh, it's almost sounds like a reference from Game of Thrones or something like that can't be real. Right.

But one of the first things I found in my research was while it wasn't actually called night doctor, what the elders were saying was actually functionally true. People were scooping up black men who had just had a little bit too much to drink, were hanging out on beaches, segregated beaches too late at night and bringing them to Crownsville and not alerting their families or going through the proper processes to actually commit someone to the place. You know, you would hear rumors about there being money exchanged for people to be brought to Crownsville.

And I heard that so frequently that even though I couldn't find records that proved these transactions happened, it was so common in the oral history in the black community. I mean, people who don't know each other saying they would give people money to bring black people here. They gave people money to bring black people here that I talk about in the book because, you know, the official story the institution tells about itself doesn't measure up with the story that the patients and the people most affected by it telling it.

And I wanted people to see that up close. In the white community, though, you're right, this fear kind of takes hold. The conditions are really bad.

I mean, at one point, the hospital goes for weeks without even having access to soap. So you can imagine the overcrowding, the just inhumanity that the patients and the staff are subjected to. But the community blames the patients, the black community for what's happening.

They're not the lawmakers and leaders who refuse to pay for their care. And so what you see are them, they start to advocate for carceral measures, more locks, build a wall, a refrain we're all now very familiar with.

[Speaker 2] And that was fascinating to me, too. Tony, when I was reading the book, I was like, wow, this is the same rhetoric that we're seeing in this era, like, you know, in this era that we're seeing currently. Right.

I was like, wait a second. When I saw that language around, like, you know, the idea there was there was even discourse around, like, you know, mental health and prisons even at that point. Right.

Like, you know, incarcerating people with mental illness. And you're like, whoa, here I'm seeing a cycle. Right.

And I think that's one thing that was fascinating about your book is it's like seeing this early, this different era in our history really reflect this current moment in so many different ways with all the shifts and waves. Just what was like mind blowing for me. I want to lift up also that, like, in your research, which I can't say enough how thoughtfully and well researched your book is, but you also talk about there are many well-known historical figures who cross paths with Crownsville.

You talk about Henrietta Lacks' daughter, Elsie, and Polly Murd's father. I would love to talk to people because I know people are familiar with Henrietta Lacks very often, but not Elsie and not her story in terms of how it intersects with Crownsville. I would love if you could share a little bit about that.

[Speaker 1] Yeah, definitely. Henrietta Lacks, at the very moment that she was being experimented on by doctors at Johns Hopkins, her cervical cancer cells taken from her without her consent and used to develop billions of dollars worth of drugs that her family has had to fight for decades to get a small piece of that pie. While that was happening to their mother, their sister, so Henrietta's daughter, is sent to Crownsville.

She's labeled an idiot when she's born. She's unable to speak, unable to communicate, and she has epilepsy. They send her to Crownsville.

The family doesn't have much money. They don't know where else to get her support, and that's where they're told Black people need to go. Elsie is sent to Crownsville, and at the same time that her mother is going through that kind of cancer treatment, Elsie is subjected to experimental procedures at Crownsville.

They drill into her brain, pump helium and all kinds of gases there to take images to try to better understand, they say, the brains of children with epilepsy. But according to the records and the Lacks family, they never asked, of course, Elsie herself, but certainly not the family, for informed consent. They took extremely graphic images of Elsie, and she died as a result of the experimental procedures they did on her and did not notify the family.

I thought it was really important to highlight Elsie's story, not just because I think it's important to center patients in research like this, both the patients who recover and who have amazing journeys, and I write about especially one of them who I've gotten to know really well, but also young children. I mean, Elsie was a child whose lives were taken at Crownsville too. And I also think it's important because so often when people talk about our history and our relationship to the medical field, they kind of point to these major scandals.

So they'll say Henrietta Lacks, they'll say the Tuskegee syphilis study, and they'll make a lot out of just that one incident. And I think those two stories deserve a lot of attention. I'm not taking anything from that.

But I call attention to Elsie because I want you to consider the fact that perhaps they weren't outliers. They were parts of patterns. It was a way of doing, of being in the medical field.

And if in one family, two people can experience that kind of medical experimentation in one state, in one period of time, you can extrapolate from there what was happening to many of us around the country. And I think that's really important to acknowledge.

[Speaker 2] Absolutely. Extremely important and heartbreaking and infuriating, quite frankly, to think about what our folks have endured. Hi, everyone.

I'm Khadijah, BEAM's Finance and Operations Manager. Today, I am super excited to share one of the many resources we offer at BEAM, HeartSpace. HeartSpace is a Black-led, culturally competent healing circle and peer support program.

It's designed to help participants connect, share, and learn mutual coping strategies and wellness skills. We meet each month in person in Atlanta and also Los Angeles, as well as virtually. Join us and discover more on our website at beam.community. You know, one thing that comes up a lot of times in our work, so Antoine, you know, our work is really, we believe in empowering all community members to understand not only their current mental health systems, but also have tools and skills to be able to resource themselves and each other. And constantly what comes up, I'll never forget, like, you know, traveling in the early days of BEAM, traveling to different cities and talking to people and hearing this fear that is really rooted in this history that you've unearthed around mental health asylums, like being, people saying things about, like, you know, somebody gonna come get you and they're gonna lock you up and you'll never get out, right? And the ways in which in the early days, pre this kind of mental health conversation we're having now, people disputed that.

Like, you know, they thought it was just like, you're just being extra. That's just like, you know, extreme. Black people have this unhealthy mental health stigma, not realizing this is rooted in actual ongoing trauma, right?

And historical trauma. And so I think it's so important when we think about, when we hear people say people are reticent about getting psychiatric care, understanding that there is this legacy of these stories, these histories that live in us and are present with us that like informed this. So it's not coming out of anywhere.

You know what I mean?

[Speaker 1] Yeah. And I'll add to what you just said there, that it's actually been really, in a way coming to that realization was actually very healing for me. And that's because I come from a family with a lot of fear and skepticism of the medical system.

A lot of the black men, especially in my family, really struggled to even just go to basic doctor's checkups. They really, you know, just have a fear of communicating with and trusting white doctors with surgeries, for example. And I used to, as a kid, be very confused by this.

I would say, oh, my dad is being just so conspiratorial or, oh, he's such an old head or whatever. And I would talk about him or my grandparents and say, oh, they told me that I shouldn't do therapy because they just don't understand what me and my siblings are going through. And I was angry, actually, a lot of the time at them.

I remember I was in high school and I went through a period of just really struggling to make friends. I was in a very white area. And I asked my parents if I could have a therapist because I had seen all these white kids who were able to do it.

And they said, no, we don't do that. That's not for people like us. And I was mad at them.

And now having seen what I know they were subjected to and my elders were subjected to, because as I mentioned, not only had my father lost a cousin who was killed for openly suffering in public, not only did his grandfather get sent to an institution where he was given substandard care in a segregated way. And so I could release the anger that I had had toward my father because I saw that actually he was making a logical decision. He had assessed that this wasn't safe for him.

And that was his way of trying to protect me. And so that actually really, even if it's tough to face that, it actually really, really helped me.

[Speaker 2] Yeah, that's absolutely powerful. And I want to implore us who are listening to think about that when we are talking to our community members and our loved ones and our families about engaging mental health, engaging psychiatry, and needing support. The hesitancy, the fear is rooted in real trauma, right?

And thinking about how does that change the way in which I approach the conversation? How does that change the ways in which I'm thinking about what their experiences have been? This book really does a good job of helping us understand contextually.

I want to talk a little bit more, move into a space and talk about The Resistance.

[Speaker 1] This is a book that is, it is a narrative history. And so it is not just, you know, archival records and fact after fact, after fact, you're actually going to meet families with deep, deep histories and roots at Crownsville and in Maryland. And that

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