Asylum for Jim Crow: state mental hospitals for African Americans in the Upper South Atlantic region 1865-1965
Date
2025
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Publisher
University of Delaware
Abstract
Asylum for Jim Crow” is an institutional and social history that explores the creation, function, and demise of state-funded mental hospitals for African Americans in the Upper South Atlantic region from 1865 to 1965. While most Southern state hospitals segregated races within existing infrastructure, the concept of racially exclusive psychiatric facilities originated in 1848 as a commitment to the then guiding principles of moral therapy. Born in the age of slavery, this antebellum concept was not implemented until 1869, beginning with Central State Hospital in Virginia, and further duplicated in the surrounding states of North Carolina (Goldsboro State Hospital in 1880), Maryland (Crownsville State Hospital in 1911), and West Virginia (Lakin State Hospital in 1926). ☐ Besides understanding the origin of these four hospitals, this project documents the disparities in implementing “separate but equal” psychiatric care. The primary objective of these establishments was less about providing adequate treatment to Blacks as it was to improve conditions and results within white-only asylums and to guarantee social distance from a race of people increasingly associated with overt criminality and sexuality. Racial bias–in medical beliefs, in employment opportunities, and in funding allocations–ensured Blacks received compromised care. African American patients dealt with misdiagnosis, discomfort, forced unpaid labor, unnecessary extended stays, abuse and violence, experimentation, disease, and death at a disproportionate rate during the life span of these institutions. These men, women, and children found themselves admitted to an environment that, on many levels, replicated a slave plantation. ☐ Yet, this work is not an entirely damaged-centered narrative. Research reveals that African Americans were active participants in this segregated mental health care system. For all its faults, the segregated mental hospital served a necessary function for the Black community. In a period of abject discrimination, African Americans in this region had virtually no other option for the care of individuals with mental illness, developmental and intellectual disabilities, epilepsy, senility, and a host of physical ailments. While acknowledging many patients came to these facilities involuntarily and often for illegitimate reasons, this dissertation asserts a fair proportion of individuals were admitted by other African Americans, who in their own interpretation of what warranted hospitalization, initiated their right to use these tax-supported hospitals for their intended therapeutic purpose. ☐ This dissertation chronicles the patient experience in these facilities, but also examines acts of Black empowerment including involvement in the commitment process and soliciting police intervention, in seeking leadership positions in management and boards, in the day-to-day hospital operations as employees and volunteers, and in advocating for increased funding and improved services. Prior to World War II, African Americans protested when states threatened to move or close these facilities. But it was their activism during the Civil Rights Movement that ultimately led to the termination of race as the determining factor in hospital placement and hiring practices. With integration, African Americans finally saw the degree upon which their calls for parity within these public mental hospitals had been ignored and understood the detrimental impact segregation had on the well-being of confined patients.
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Keywords
Maryland, North Carolina, Medical history, Segregation, West Virginia, Asylum