A New York Times 100 Notable Books of 2024 • A New Yorker Best Book of 2024
New York Times Bestseller • USA Today Bestseller
Kirkus Reviews Best Nonfiction Books of the Year • Amazon Editor’s Pick for Best Books

In the tradition of The Immortal Life of Henrietta Lacks, a page-turning ninety-three-year history of Crownsville Hospital, one of the nation’s last segregated asylums, that the New York Times described as "fascinating…meticulous research" and bestselling author Clint Smith endorsed it as "a book that left me breathless."

On a cold day in March of 1911, officials marched twelve Black men into the heart of a forest in Maryland. Under the supervision of a doctor, the men were forced to clear the land, pour cement, lay bricks, and harvest tobacco. When construction finished, they became the first twelve patients of the state’s Hospital for the Negro Insane. For centuries, Black patients have been absent from our history books. Madness transports readers behind the brick walls of a Jim Crow asylum.

In Madness, Peabody and Emmy award-winning journalist Antonia Hylton tells the ninety-three-year history of Crownsville Hospital, one of the last segregated asylums with surviving records and a campus that still stands to this day in Anne Arundel County, Maryland. She blends the intimate tales of patients and employees whose lives were shaped by Crownsville with a decade-worth of investigative research and archival documents. Madness chronicles the stories of Black families whose mental health suffered as they tried, and sometimes failed, to find safety and dignity. Hylton also grapples with her own family’s experiences with mental illness, and the secrecy and shame that it reproduced for generations.

As Crownsville Hospital grew from an antebellum-style work camp to a tiny city sitting on 1,500 acres, the institution became a microcosm of America’s evolving battles over slavery, racial integration, and civil rights. During its peak years, the hospital’s wards were overflowing with almost 2,700 patients. By the end of the 20th-century, the asylum faded from view as prisons and jails became America’s new focus.

In Madness, Hylton traces the legacy of slavery to the treatment of Black people’s bodies and minds in our current mental healthcare system. It is a captivating and heartbreaking meditation on how America decides who is sick or criminal, and who is worthy of our care or irredeemable.