Madness in the City of Magnificent Intentions : A History of Race and Mental Illness in the Nation's Capital

"From the mid-nineteenth to the late twentieth centuries, Saint Elizabeths Hospital was one of the United States' most important institutions for the care and treatment of the mentally ill. Founded in 1855 to treat insane soldiers and sailors as well as civilian residents in the nation's capital, the institution became one of the country's preeminent research and teaching psychiatric hospitals. From the beginning of its operation, Saint Elizabeths admitted black patients, making it one of the few American asylums to do so. This book is a history of the hospital and its relationship to Washington, DC's African American community. It charts the history of Saint Elizabeths from its founding to the late-1980s, when the hospital's mission and capabilities changed as a result of deinstitutionalization, and its transfer from the federal government to the District of Columbia. Drawing on a wide variety of sources, including patient case files, the book demonstrates how race was central to virtually every aspect of the hospital's existence, from the ways in which psychiatrists understood mental illness and employed therapies to treat it to the ways that black patients experienced their institutionalization. The book argues that assumptions about the existence of distinctive black and white psyches shaped the therapeutic and diagnostic regimes in the hospital and left a legacy of poor treatment of African American patients, even after psychiatrists had begun to reject racialist conceptions of the psyche. Yet black patients and their communities asserted their own agency and exhibited a "rights consciousness" in large and small ways, from agitating for more equal treatment to attempting to manage the therapeutic experience." --From publisher's description "This book is a history of the federal mental institution Saint Elizabeths Hospital and its relationship to Washington, DC's African American community. Founded in 1855 to treat insane military personnel and the District's civilian residents, the institution became one of the nation's preeminent research and teaching psychiatric hospitals. From the beginning of its operation, Saint Elizabeths admitted black patients, making it one of the few American asylums to do so. The book charts the history of Saint Elizabeths from its founding to the late 1980s, when the hospital's mission and capabilities changed as a result of deinstitutionalization and its transfer from the federal government to the District. The book makes two main arguments. First, ideas of racial difference figured prominently in how hospital officials understood the mission of the institution and subsequently designed and operated it, in how hospital officials understood mental disease and developed therapies to address it, and in how patients experienced their confinement. This history reveals the ways the American psychiatric profession engaged in an unarticulated project that conceptualized the white psyche as the norm. Second, this book argues that African Americans--both patients and nonpatients--were not powerless people acted on by large institutional forces. Black Washingtonians were active agents in their interactions with the hospital, from more overtly political and collective endeavors, such as calling for investigations of the mistreatment of black patients and advocating for the hospital's integration, to the more individualized and quotidian attempts to manage their own or their loved one's therapeutic experience." -- Oxford Scholarship Online Dedication 6 Content 8 Acknowledgments 10 Introduction 16 1. “Humanity Requires All the Relief Which Can Be Afforded”: The Birth of the Federal Asylum 28 2. The Paradox of Enlightened Care: Saint Elizabeths in the Era of Moral Treatment, 1855–1877 54 3. “From Slave to Citizen”: Race, Insanity, and Institutionalization in Post-Reconstruction Washington, DC, 1877–1900 86 4. Care and the Color Line: Race, Rights, and the Therapeutic Experience, 1877–1900 110 5. “Mechanisms of the Negro Mind”: Race and Dynamic Psychiatry at Saint Elizabeths, 1903–1937 140 6. “He Is Psychotic and Always Will Be”: Racial Ambivalence and the Limits of Therapeutic Optimism, 1903–1937 168 7. Mental Hygiene and the Limits of Reform: Saint Elizabeths in the Community, 1903–1937 205 8. “An Example for the Rest of the Nation”: Challenging Racial Injustice at Saint Elizabeths, 1910–1955 232 9. Whither the Negro Psyche: Integration and Its Aftermath, 1945–1970 262 10. From Model to Emblem: Community Mental Health and Deinstitutionalization, 1963–1987 292 Conclusion 324 Notes 330 Selected Bibliography 384 Index 392 Summers documents the history of Saint Elizabeths Hospital, a federal mental institution in Washington, DC, in relation to that city's African American community. He sheds light on the intersections of the historical process of racialization, medical and cultural understandings of insanity, the exercise of institutional power, and individual and collective agency. -- Provided by publisher In this work, Summers documents the history of Saint Elizabeths Hospital, a federal mental institution in Washington, DC, in relation to that city's African American community. He sheds light on the intersections of the historical process of racialization, medical and cultural understandings of insanity, the exercise of institutional power, and individual and collective agency