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Administrations of Lunacy: A Story of Racism and Psychiatry at the Milledgeville Asylum
A scathing and original look at the racist origins of psychiatry, through the story of the largest mental institution in the world
Today, 90 percent of psychiatric beds are located in jails and prisons across the United States, institutions that confine disproportionate numbers of African Americans. After more than a decade of research, the celebrated scholar and activist Mab Segrest locates the deep historical roots of this startling fact, turning her sights on a long-forgotten cauldron of racial ideology: the state mental asylum system in which psychiatry was born and whose influences extend into our troubled present.
In December 1841, the Georgia State Lunatic, Idiot, and Epileptic Asylum was founded. A hundred years later, it had become the largest insane asylum in the world with over ten thousand patients. Administrations of Lunacy tells the story of this iconic and infamous southern institution, a history that was all but erased from popular memory and within the psychiatric profession.
Through riveting accounts of historical characters, Segrest reveals how modern psychiatric practice was forged in the traumas of slavery, the Civil War, Reconstruction, and Jim Crow. Deftly connecting this history to the modern era, Segrest then shows how a single asylum helped set the stage for the eugenics theories of the twentieth century and the persistent racial ideologies of our own times. She also traces the connections to today’s dissident psychiatric practices that offer sanity and create justice.
A landmark of scholarship, Administrations of Lunacy restores a vital thread between past and present, revealing the tangled racial roots of psychiatry in America.
Today, 90 percent of psychiatric beds are located in jails and prisons across the United States, institutions that confine disproportionate numbers of African Americans. After more than a decade of research, the celebrated scholar and activist Mab Segrest locates the deep historical roots of this startling fact, turning her sights on a long-forgotten cauldron of racial ideology: the state mental asylum system in which psychiatry was born and whose influences extend into our troubled present.
In December 1841, the Georgia State Lunatic, Idiot, and Epileptic Asylum was founded. A hundred years later, it had become the largest insane asylum in the world with over ten thousand patients. Administrations of Lunacy tells the story of this iconic and infamous southern institution, a history that was all but erased from popular memory and within the psychiatric profession.
Through riveting accounts of historical characters, Segrest reveals how modern psychiatric practice was forged in the traumas of slavery, the Civil War, Reconstruction, and Jim Crow. Deftly connecting this history to the modern era, Segrest then shows how a single asylum helped set the stage for the eugenics theories of the twentieth century and the persistent racial ideologies of our own times. She also traces the connections to today’s dissident psychiatric practices that offer sanity and create justice.
A landmark of scholarship, Administrations of Lunacy restores a vital thread between past and present, revealing the tangled racial roots of psychiatry in America.
384 pages, Kindle Edition
First published April 14, 2020
49 people are currently reading
3555 people want to read
About the author
Mab Segrest
12 books70 followersMabelle ("Mab) Massey Segrest is an American feminist, lesbian, writer, and activist.
Born in Alabama, Segrest received her Ph.D. in Modern British Literature from Duke University in 1979 and was appointed the Fuller-Matthai Professor of Gender & Women's Studies at Connecticut College in 2004.
Segrest is often recognized for her efforts combatting sexism, racism, homophobia, classism, and other forms of oppression. She is credited by some as being one of the main forces that drove the Ku Klux Klan from North Carolina in the late 1980s.
Born in Alabama, Segrest received her Ph.D. in Modern British Literature from Duke University in 1979 and was appointed the Fuller-Matthai Professor of Gender & Women's Studies at Connecticut College in 2004.
Segrest is often recognized for her efforts combatting sexism, racism, homophobia, classism, and other forms of oppression. She is credited by some as being one of the main forces that drove the Ku Klux Klan from North Carolina in the late 1980s.
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Displaying 1 - 30 of 43 reviews
August 18, 2020
When I started out my nursing career, I was a mental health nurse and really enjoyed my years there working in a locked psychiatric unit specializing in the LGBTQ population. Mental Health Nursing will always have a special place in my heart.
Reading this book by Mab Segrest, a longtime activist in social justice movements and a past fellow at the National Humanities Center, gave me an eye opening look at the harrowing and highly racist history of mental health asylum and psychiatric institutions through stories from the founding of what once was the Georgia State Lunatic, Idiot, and Epileptic Asylum in 1841.
This was well written and carefully well researched that addressed the horrific blemished past of psychiatric treatments and its unfair and racist treatment of African Americans and women. Segrest was able to connect how modern psychiatric practice was ultimately formed and lead to the eugenics theories in this modern times.
Absolutely brilliant writing that I learned a lot from.
Reading this book by Mab Segrest, a longtime activist in social justice movements and a past fellow at the National Humanities Center, gave me an eye opening look at the harrowing and highly racist history of mental health asylum and psychiatric institutions through stories from the founding of what once was the Georgia State Lunatic, Idiot, and Epileptic Asylum in 1841.
This was well written and carefully well researched that addressed the horrific blemished past of psychiatric treatments and its unfair and racist treatment of African Americans and women. Segrest was able to connect how modern psychiatric practice was ultimately formed and lead to the eugenics theories in this modern times.
Absolutely brilliant writing that I learned a lot from.
April 11, 2020
Mab Segrest, a feminist and anti-racist author, painstakingly traces the racist origins of psychiatry in the United States through the lens of the patients and doctors who walked the corridors of Milledgeville Asylum in Georgia. These origins begin with the purchase of the land on which the Milledgeville asylum was built in 1841 -- lands that were stolen from native American. In subsequent years, those who practiced in the field of psychiatry would develop pseudo-medical theories that helped consolidate the racism that Georgia and other states in this country would use to justify segregation and white violence against African Americans. For example, lower rates of insanity among African Americans were attributed to the "healthy restraints" of slavery. Unlike white Americans, the "negro brain" was not bothered by the stresses of modern life. Thus "freedom" in the minds of Southern psychiatrists became a "disease factor." Such racist explanations of mental illness did not disappear with the onset of the twentieth century, rather they took new forms, as physicians began to place less emphasis on trauma and more emphasis on heredity as cause for mental disorders. These new theories would provide the justification for the sterilization of those with mental disorders -- a policy that disproportionately affected women and persons of color. For example in North Carolina of the 7797 sterilizations that took place between the 1930s and 1970s, 5000 of them were of African American women. Sadly, as the author shows racism and misogyny continue to inform policies of incarceration at both mental institutions and prisons. In short, the author has provided a thought-provoking history of the entangled relationship between psychiatry, racism, and misogyny. I only wish that in the early pages of this volume that the author had refrained from making quite so many speculative remarks about the feelings and thoughts of the asylum's early occupants. These speculations, at least for me, added little to what was otherwise a powerful and informative history of psychiatry's dark side.
July 7, 2020
Administrations of Lunacy is an account of a single asylum in Milledgeville, GA from its founding on stolen indigenous lands to its eventual decline in the 20th century. Through it, Segrest is trying to tackle a lot of threads to ultimately make the case that early American psychiatry's racist past heavily informs our present.
As someone who wrote her thesis on 19th-century psychiatry and literature, I thought this book was for me, combining my interests and research passions. And to an extent, this book does that. Segrest often nicely contextualizes the specific historical records and lacunae in the broader context of American history--for instance, highlighting the notable lack of attention to very real traumas inflicted on Black Georgians by war, by lynch mobs, and by Jim Crow. (These do not show up as reasons for admission in the records.) She consistently calls attention to the injustices done by the asylum system to Black inpatients, and she vividly tells the stories of, I imagine, everyone that appears for more than a line or two in the historical record.
But my issue with the book is that the writing style is at once too dry and too speculative to really succeed as more than a historical narrative. There are a lot of statistics in this book, and so many patient stories are told that I began to wonder why the story was included at all. It seems like it'd be more impactful to include stories that were emblematic of an issue, but a lot of times it was like "here's another patient who was here in 1872."
As for the speculation, whenever Segrest describes a patient or a person who worked at the Milledgeville asylum, she over-relies on "perhaps" to try to appeal to pathos, but as a text dealing with historical archives, it comes across almost as fictionalizing their stories. For example, Segrest tells the story of Sue Pagan, a white woman who lived and worked as a laundress with a Black family after being separated from her baby and released for the first time from the Milledgeville asylum. She was taken back to the asylum despite presenting "no symptoms of insanity other than insomnia and talking at night." The facts alone are tragic, and Segrest deftly uses them to discuss the intersection of insanity, control, and white Reconstruction-era racial fears. But then she writes, "There is no record of what happened to Sue on the inside. Perhaps her work detail was the laundry, where she could remember the white sheets sailing on the clothes lines back in Shermantown and the two Black women who had treated her well." The perhapses, the fictionalization, galled me because they felt manipulative and detracted from the genre of the book as a historical monograph.
[Shout out to NetGalley for an advance copy to review honestly.]
This is a history not only of the New Jim Crow, but also of the first Jim Crow, and before that of chattel slavery itself and the genocides of Indigenous people, and the still-fighting Confederacy, all of whose afterlives we have yet to vanquish."
As someone who wrote her thesis on 19th-century psychiatry and literature, I thought this book was for me, combining my interests and research passions. And to an extent, this book does that. Segrest often nicely contextualizes the specific historical records and lacunae in the broader context of American history--for instance, highlighting the notable lack of attention to very real traumas inflicted on Black Georgians by war, by lynch mobs, and by Jim Crow. (These do not show up as reasons for admission in the records.) She consistently calls attention to the injustices done by the asylum system to Black inpatients, and she vividly tells the stories of, I imagine, everyone that appears for more than a line or two in the historical record.
But my issue with the book is that the writing style is at once too dry and too speculative to really succeed as more than a historical narrative. There are a lot of statistics in this book, and so many patient stories are told that I began to wonder why the story was included at all. It seems like it'd be more impactful to include stories that were emblematic of an issue, but a lot of times it was like "here's another patient who was here in 1872."
As for the speculation, whenever Segrest describes a patient or a person who worked at the Milledgeville asylum, she over-relies on "perhaps" to try to appeal to pathos, but as a text dealing with historical archives, it comes across almost as fictionalizing their stories. For example, Segrest tells the story of Sue Pagan, a white woman who lived and worked as a laundress with a Black family after being separated from her baby and released for the first time from the Milledgeville asylum. She was taken back to the asylum despite presenting "no symptoms of insanity other than insomnia and talking at night." The facts alone are tragic, and Segrest deftly uses them to discuss the intersection of insanity, control, and white Reconstruction-era racial fears. But then she writes, "There is no record of what happened to Sue on the inside. Perhaps her work detail was the laundry, where she could remember the white sheets sailing on the clothes lines back in Shermantown and the two Black women who had treated her well." The perhapses, the fictionalization, galled me because they felt manipulative and detracted from the genre of the book as a historical monograph.
[Shout out to NetGalley for an advance copy to review honestly.]
dnf
November 1, 2020I'm very sad about it but I had to DNF this book. I did read until I finished the first half of this book but even so it was just a little too hard for me to continue. I will try to write a decent review of it, though, since that's only fair because I received a review copy. But of course no rating because I didn't finish it. This book wasn't just for me, unfortunately.
Administrations of Lunacy: A Story of Racism and Psychiatry at the Milledgeville Asylum by Mab Segrest sounded like a fascinating book when I was emailed about it but it was a little too heavy for me. Don't get me wrong, as far as I got in it, it definitely was an interesting read. I just found myself struggling to continue and I just knew it was best to call it quits.
I want to say that me deciding to DNF it absolutely didn't mean that it was a badly written book or anything. I just think people who are more known with the general topic, especially those who live in the United States will appreciate it more. I just think this was a case of it's not you, it's me.
Administrations of Lunacy: A Story of Racism and Psychiatry at the Milledgeville Asylum by Mab Segrest sounded like a fascinating book when I was emailed about it but it was a little too heavy for me. Don't get me wrong, as far as I got in it, it definitely was an interesting read. I just found myself struggling to continue and I just knew it was best to call it quits.
I want to say that me deciding to DNF it absolutely didn't mean that it was a badly written book or anything. I just think people who are more known with the general topic, especially those who live in the United States will appreciate it more. I just think this was a case of it's not you, it's me.
February 6, 2023
Segrest's look into the Georgia State Lunatic, Idiot, and Epileptic Asylum (renamed four times over the decades) is incredibly in-depth and harrowing. However, I often felt that what she was trying to say or explain was lost in a muddle of statistics, speculation with certain patient's stories that never seemed to truly fit in with the narrative, and a repetitiveness that sometimes felt condescending as if Segrest had to over explain to make sure readers understood what she was trying to get across.
April 17, 2020
3.5 stars rounded up. When I was asked to be a part of this tour, I immediately said yes because I have never seen a book like this. I expected it to be bad, but I did not expect it to be horrifying. This is an interesting take on the Milledgeville Asylum in Georgia, which happened to be in the South so of course racism played a big role. But let me back up.
First of all, this used to be called the Georgia State Lunatic, Idiot, and Epileptic Asylum. Yes, you read that right. Second, in the 40’s and 50’s this was the largest state hospital in the world, with the largest graveyard of disabled people, a whopping 25,000 numbered grave markers that went behind it into the woods. Is your jaw open yet? No? I’ll keep going. In the mid-1850’s, it appears that violence against white wives and daughters was commonplace. When they didn’t sit there and take it, it seems that it landed the women in the Asylum. I haven’t even gotten to the racism yet, which was the foundation of this book. After the Civil War, mental illness was used as another reason to keep whites and blacks separated, and it is heartbreaking to see how this was done. I will end with a quote from this book that was a little dry at times but overall absolutely fascinating and infuriating and a very important read.
“The monster of white rage emerges from its crypt—that crowded vacuum—making violence the relentless response that leaves us all (still) haunted by the (continuing) failures of our Reconstructions and grotesque with supremacist attempts at race wars….It did not have to happen. It happens still. Psychiatry was there.”
Thank you to @tlcbooktours and @thenewpress for the free copy to review!
First of all, this used to be called the Georgia State Lunatic, Idiot, and Epileptic Asylum. Yes, you read that right. Second, in the 40’s and 50’s this was the largest state hospital in the world, with the largest graveyard of disabled people, a whopping 25,000 numbered grave markers that went behind it into the woods. Is your jaw open yet? No? I’ll keep going. In the mid-1850’s, it appears that violence against white wives and daughters was commonplace. When they didn’t sit there and take it, it seems that it landed the women in the Asylum. I haven’t even gotten to the racism yet, which was the foundation of this book. After the Civil War, mental illness was used as another reason to keep whites and blacks separated, and it is heartbreaking to see how this was done. I will end with a quote from this book that was a little dry at times but overall absolutely fascinating and infuriating and a very important read.
“The monster of white rage emerges from its crypt—that crowded vacuum—making violence the relentless response that leaves us all (still) haunted by the (continuing) failures of our Reconstructions and grotesque with supremacist attempts at race wars….It did not have to happen. It happens still. Psychiatry was there.”
Thank you to @tlcbooktours and @thenewpress for the free copy to review!
June 4, 2020
I didn't know what to expect but the history of mental health treatment interests me so I read this book. It was enlightening, tragic, hopeful, and insightful. I listened to the audiobook read by the excellent Hillary Huber. The author, Mab Segrest, follows the attempts to remedy mental illness from 1841 in the Georgia State Lunatic, Idiot, and Epileptic Asylum. This book tells of it's hundred year history and the mental issues caused by slavery and the Civil War. The remedies of eugenics, and other awful treatments includes and highlights how racism influenced psychiatry. Riveting account of the progress we as a society have made, and still need to make, to help bring sanity and justice to the treatment of the mentally ill. Highly recommended if this is a topic you are interested in.
March 30, 2020
Searing, emotional, and informative, Administrations of Lunacy focuses on one asylum in Georgia from pre-Civil War to the modern age. Confronting such topics as the abuse and neglect of the mentally ill, eugenics, racism, misogyny, and the modern prison industrial complex, this novel is a must read for an understanding of how the modern psychiatric community evolved and what the costs were throughout history.
Thank you to Netgalley for an ARC in exchange for an honest opinion.
Thank you to Netgalley for an ARC in exchange for an honest opinion.
March 27, 2025
I learned a LOT reading this book. It tied in with a lot of other reading/learning I've been doing lately but definitely an important read for anyone wanting to learn more about Georgia history, systemic racism, misogyny and the treatment of marginalized and struggling people in general.
November 24, 2025
I’ve been wanting to tackle this one for a few years now. As someone who comes from a long line of women who attended Central State Hospital for various amounts of time, I was surprised to hear how many of my mom’s horror stories about her mom and aunt are most likely true. I cannot imagine how much research went into this book. I just wish Mab Segrest had narrated the entire audiobook. Her speaking voice is authoritative with a soft edge and exactly fits the tone of the book.
June 8, 2020
Originally published on my blog: Nonstop Reader.
Administrations of Lunacy is a dispassionate account of the facts surrounding the Central State Hospital in Milledgeville GA, USA. Released 14th April by The New Press, it's 384 pages and available in hardcover, audio, and ebook formats.
This is an unflinching and unflattering deconstruction of the history of (at one time) the largest facility for treating and housing the mentally ill in the world. In continuous operation since December 1842 and now largely defunct, it's a huge sprawling (and mostly abandoned) complex of over 200 buildings on 2000 acres of land. Author Mab Segrest knits the facts and bald history of the place together with the systemic, wilful, historical administration and in-baked racist policies and treatment that people of color received throughout the institution's almost 180 year history.
Especially in the greater context of the continuing painful racist brutality that is rampant in the world today, this was a very difficult but important read. I found that I had to put the book down and walk away and think about and process the information at several points. The author is unsparing. There are frank discussions of (to modern people) barbaric, cruel, and senseless "treatments" and processes. The author's historical examination of eugenics as practiced by the non-consensual sterilization of inmates, torture, lobotomization, and other procedures is unstinting. The notes and references are academically rigorous, plentiful, and well organized.
General information and historical background are alternated throughout the book with personal stories of inmates (where known) or professionals employed in the care and operation of the facility. The author quotes a former staff member, Joe Ingram, when she devastatingly writes that there are "Rows upon rows of numbered, small, rusted markers as far as you can see... it must be the most gruesome sight in Georgia. Unknown humans, shunned when living, deprived of their very names in death... and literally known only to God".
Difficult reading. This would make a superlative adjunct text for related subjects, history of medicine, gender and race studies, psychiatry, mental health issues, public health, and so forth.
Four stars. Readers should certainly be prepared for triggering subject matter. It makes for grim reading.
Disclosure: I received an ARC at no cost from the author/publisher for review purposes.
Administrations of Lunacy is a dispassionate account of the facts surrounding the Central State Hospital in Milledgeville GA, USA. Released 14th April by The New Press, it's 384 pages and available in hardcover, audio, and ebook formats.
This is an unflinching and unflattering deconstruction of the history of (at one time) the largest facility for treating and housing the mentally ill in the world. In continuous operation since December 1842 and now largely defunct, it's a huge sprawling (and mostly abandoned) complex of over 200 buildings on 2000 acres of land. Author Mab Segrest knits the facts and bald history of the place together with the systemic, wilful, historical administration and in-baked racist policies and treatment that people of color received throughout the institution's almost 180 year history.
Especially in the greater context of the continuing painful racist brutality that is rampant in the world today, this was a very difficult but important read. I found that I had to put the book down and walk away and think about and process the information at several points. The author is unsparing. There are frank discussions of (to modern people) barbaric, cruel, and senseless "treatments" and processes. The author's historical examination of eugenics as practiced by the non-consensual sterilization of inmates, torture, lobotomization, and other procedures is unstinting. The notes and references are academically rigorous, plentiful, and well organized.
General information and historical background are alternated throughout the book with personal stories of inmates (where known) or professionals employed in the care and operation of the facility. The author quotes a former staff member, Joe Ingram, when she devastatingly writes that there are "Rows upon rows of numbered, small, rusted markers as far as you can see... it must be the most gruesome sight in Georgia. Unknown humans, shunned when living, deprived of their very names in death... and literally known only to God".
Difficult reading. This would make a superlative adjunct text for related subjects, history of medicine, gender and race studies, psychiatry, mental health issues, public health, and so forth.
Four stars. Readers should certainly be prepared for triggering subject matter. It makes for grim reading.
Disclosure: I received an ARC at no cost from the author/publisher for review purposes.
April 15, 2022
Having grown up in Milledgeville, Georgia, where the mental hospital that is a subject of this book is located, I was especially interested in
It. The Georgia State hospital or Central State Hospital it was called during my lifetime, loomed large in the psyche as well as the economy of Milledgeville and Baldwin County. More personally, my mother worked as a social worker at the hospital in the 1950s and '60s.
This deeply researched book covers the history of the hospital from 1842 when it opened to its closure in 2010. She illustrates in vivid detail how systemic racism of various administrations of the hospital as well as the overall segregated system of the South disproportionately affected Black patients in many ways - mental health treatment as well as food and other necessities of daily life. She also connects ways that the post-Civil War penal system and Jim Crow laws hugely benefited landowners who were bereft of their formally free labor force by allowing jails and prisons to rent out prisoners to the locals and how the jails and prisons became overflow institutions for housing mentally health individuals, as they still are today.
This book is also a fascinating look at the history of psychiatry of this period, especially regarding the evolution of treatment theories and effects of racism of doctors on Black patients who believed not only in Black IQ inferiority but also greater tolerance for pain. She also covers the dark period of eugenics and its effects on the institutionalized, especially indigent women.
Georgia continues its race to the bottom in terms of treatment of the mentally ill, especially the indigent. Georgia's Republican leadership refused to take advantage of the expanded Medicare aide available under the affordable Care act, this denying insurance assistance to low-income persons and economically depriving hospitals of much needed income. And jails and prisons continue to incarcerate mentally ill persons.
It. The Georgia State hospital or Central State Hospital it was called during my lifetime, loomed large in the psyche as well as the economy of Milledgeville and Baldwin County. More personally, my mother worked as a social worker at the hospital in the 1950s and '60s.
This deeply researched book covers the history of the hospital from 1842 when it opened to its closure in 2010. She illustrates in vivid detail how systemic racism of various administrations of the hospital as well as the overall segregated system of the South disproportionately affected Black patients in many ways - mental health treatment as well as food and other necessities of daily life. She also connects ways that the post-Civil War penal system and Jim Crow laws hugely benefited landowners who were bereft of their formally free labor force by allowing jails and prisons to rent out prisoners to the locals and how the jails and prisons became overflow institutions for housing mentally health individuals, as they still are today.
This book is also a fascinating look at the history of psychiatry of this period, especially regarding the evolution of treatment theories and effects of racism of doctors on Black patients who believed not only in Black IQ inferiority but also greater tolerance for pain. She also covers the dark period of eugenics and its effects on the institutionalized, especially indigent women.
Georgia continues its race to the bottom in terms of treatment of the mentally ill, especially the indigent. Georgia's Republican leadership refused to take advantage of the expanded Medicare aide available under the affordable Care act, this denying insurance assistance to low-income persons and economically depriving hospitals of much needed income. And jails and prisons continue to incarcerate mentally ill persons.
October 2, 2020
This book tried to do too much. Too much of it was a general history of the United States or race. It was not tied closely enough to the institution and thus I lost the thread of what was going on in the institution. The author would have been better served to either write a book about race and lunacy in general or write about about the institution more specifically
December 11, 2020
This book is full of good information and historical context, but it was very difficult for me to follow because it isn't well organized. The content within chapters frequently wanders very far afield before returning to the primary subject. Additionally, Segrest occasionally jumps to dramatic conclusions without much evidence and without considerations of alternate possibilities.
September 12, 2020
You can find my full review here: http://allthebookblognamesaretaken.bl...
I received a digital ARC from the publisher via NetGalley in exchange for an honest review. Review to come. Incredibly detailed.
I received a digital ARC from the publisher via NetGalley in exchange for an honest review. Review to come. Incredibly detailed.
October 16, 2020
Wow I loved this book. Such an important topic deserves the utmost respect, research, and objectivity, and Lab Segrest has curated just that experience in this haunting recollection of systemic racism and its far-reaching implications. A must-read for anyone in the helping professions.
April 20, 2020
Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgewille Asylum by Mab Segrest is a difficult read not because of the actual writing but because the facts presented indict not just our collective past but our toxic present in crimes against humanity, all under the guise of "medical treatment."
The horrifying history of what has taken place in mental hospitals and insane asylums is widely known. Not usually in great detail but enough that it is easy and smug to shrug and claim "I didn't learn very much new" when we read more detailed accounts. This is a particularly effective knee jerk response when we just don't care enough about those groups that were, and still are, being hurt by these institutional monstrosities. Don't make that mistake with this book, read it with an open mind and accept that, if you're going to claim some of society's positive as your own because you are a citizen, you must also claim the same society's horrendous negatives as your own. We are all in this together and the sooner we stop being defensive about it and start working to improve our society, the better.
Mental health treatment, in the absolute loosest sense, became the de facto method by which to maintain control over marginalized groups, in particular for this story African-Americans. The transition, starting mostly under Reagan, into using the "justice" system to replace the finally abandoned asylum system to control and punish, indeed to terrorize, African-American communities has been one of the few areas that seem to consistently have bipartisan support, though usually with different terminology.
This book looks closely at the system through the lens of what at one time was the largest such institution, and one that had the full and complete backing of the governments and communities, by which I mean the inherently racist governments and communities of Georgia and the United States as a whole. This example takes place in the south, and while there may have been a more open willingness to support clearly racist practices, it was and is far from limited to just the south. As I mentioned before, if we claim to be a citizen of any state in the country and, indeed, of the country itself, then we are all implicated to some degree and it is our responsibility to learn from the mistakes of the past.
I recommend this read to anyone who doesn't use the cop-out "but none of my relatives ever..." when avoiding responsibility for past atrocities. Don't dwell on how much or whether you are responsible, rather focus on learning and making the world better. We can't improve what we don't understand and this book does a wonderful job and taking facts and connecting them into a coherent whole rather than a bunch of separate items that can be dismissed as isolated instances. This is not and was not isolated, accidental, or unknown to the powers that be and most of the surrounding communities. Care for each other, is that really too much to ask?
Reviewed from a copy made available by the publisher via NetGalley.
The horrifying history of what has taken place in mental hospitals and insane asylums is widely known. Not usually in great detail but enough that it is easy and smug to shrug and claim "I didn't learn very much new" when we read more detailed accounts. This is a particularly effective knee jerk response when we just don't care enough about those groups that were, and still are, being hurt by these institutional monstrosities. Don't make that mistake with this book, read it with an open mind and accept that, if you're going to claim some of society's positive as your own because you are a citizen, you must also claim the same society's horrendous negatives as your own. We are all in this together and the sooner we stop being defensive about it and start working to improve our society, the better.
Mental health treatment, in the absolute loosest sense, became the de facto method by which to maintain control over marginalized groups, in particular for this story African-Americans. The transition, starting mostly under Reagan, into using the "justice" system to replace the finally abandoned asylum system to control and punish, indeed to terrorize, African-American communities has been one of the few areas that seem to consistently have bipartisan support, though usually with different terminology.
This book looks closely at the system through the lens of what at one time was the largest such institution, and one that had the full and complete backing of the governments and communities, by which I mean the inherently racist governments and communities of Georgia and the United States as a whole. This example takes place in the south, and while there may have been a more open willingness to support clearly racist practices, it was and is far from limited to just the south. As I mentioned before, if we claim to be a citizen of any state in the country and, indeed, of the country itself, then we are all implicated to some degree and it is our responsibility to learn from the mistakes of the past.
I recommend this read to anyone who doesn't use the cop-out "but none of my relatives ever..." when avoiding responsibility for past atrocities. Don't dwell on how much or whether you are responsible, rather focus on learning and making the world better. We can't improve what we don't understand and this book does a wonderful job and taking facts and connecting them into a coherent whole rather than a bunch of separate items that can be dismissed as isolated instances. This is not and was not isolated, accidental, or unknown to the powers that be and most of the surrounding communities. Care for each other, is that really too much to ask?
Reviewed from a copy made available by the publisher via NetGalley.
November 22, 2023
Torn on how to review this one. I almost feel like I read three different books.
The first part focused on the early history of the Milledgeville asylum and consisted mostly of vignettes, giving short biographies of the handful of patients who seem to have actually left behind stories to tell. But with so very little actual information to go on, it seemed like the author's themes were not backed up. So many "possibly" "we can speculate" "perhaps" and "seemingly" statements in a row, do not make for a strong argument. I found the stories interesting, but not convincing evidence for the themes the author was presenting. Organization was lacking throughout the beginning of the book and really could have used some editing help. It rambled a lot without making much of a point.
The middle of the book was great, if heartbreaking. Well researched, containing lots of history both of the asylum and the world of mental health, this probably should have been the entirety of the book. From the different methods that came into fashion in treating mental health issues, to the evils of eugenics, etc, there was a lot of solid material to back up her arguments. And while I was familiar with many of the themes presented, I still learned a lot.
Last part of the book was a long epilogue, that I struggled with. Criticizing the modern mental health system without having ideas for a solution doesn't really move the conversation forward. We all know it's a mess. We all know we must do better. But I would like to see more ideas on possible solutions, whether I agree with them or not. I'm so far from an expert in the area, but I can easily point out the faults. I was hoping for some more solid policy ideas to think about.
The first part focused on the early history of the Milledgeville asylum and consisted mostly of vignettes, giving short biographies of the handful of patients who seem to have actually left behind stories to tell. But with so very little actual information to go on, it seemed like the author's themes were not backed up. So many "possibly" "we can speculate" "perhaps" and "seemingly" statements in a row, do not make for a strong argument. I found the stories interesting, but not convincing evidence for the themes the author was presenting. Organization was lacking throughout the beginning of the book and really could have used some editing help. It rambled a lot without making much of a point.
The middle of the book was great, if heartbreaking. Well researched, containing lots of history both of the asylum and the world of mental health, this probably should have been the entirety of the book. From the different methods that came into fashion in treating mental health issues, to the evils of eugenics, etc, there was a lot of solid material to back up her arguments. And while I was familiar with many of the themes presented, I still learned a lot.
Last part of the book was a long epilogue, that I struggled with. Criticizing the modern mental health system without having ideas for a solution doesn't really move the conversation forward. We all know it's a mess. We all know we must do better. But I would like to see more ideas on possible solutions, whether I agree with them or not. I'm so far from an expert in the area, but I can easily point out the faults. I was hoping for some more solid policy ideas to think about.
This entire review has been hidden because of spoilers.
October 25, 2023
Overall I really appreciated this book for the wide-ranging and excellent information about both the particulars of this Georgia mental health institution and the broader historical and societal trends in race and mental health from the early 1880’s through the mid- to late-1900’s. I recognized a number of excellent resources that Segrest used (e.g. Alexander’s The New Jim Crow and Washington’s Medical Apartheid), and know those books to be well-researched and insightful resources in and of themselves.
I didn’t love how, early in the book, Segrest frequently worked to make information more story-like by talking about historical individuals and then loading their known information with statement after statement of how he “could have” lived in this town (and then described a local town) or she “might have” looked out her window to see something that was a reasonable thing to occur at the institution. If I could, I would say to the author, “Tell me what you know. Don’t make up possibilities you don’t.” But that tended only to happen at the start of the book, I suspect because historical records became more complete over time and Segrest could just write from actual records.
Overall the book was solid, informative, well organized, and appropriately disturbing about this part of our country’s history. Recommended.
I didn’t love how, early in the book, Segrest frequently worked to make information more story-like by talking about historical individuals and then loading their known information with statement after statement of how he “could have” lived in this town (and then described a local town) or she “might have” looked out her window to see something that was a reasonable thing to occur at the institution. If I could, I would say to the author, “Tell me what you know. Don’t make up possibilities you don’t.” But that tended only to happen at the start of the book, I suspect because historical records became more complete over time and Segrest could just write from actual records.
Overall the book was solid, informative, well organized, and appropriately disturbing about this part of our country’s history. Recommended.
July 27, 2021
This really took me a while to get through but I really felt like I learned a lot by the end of the book. My biggest critique is that I think this book spends a lot of time establishing the historical context for treatments and philosophies for care (or lack there of) seen at Milledgeville. At times I really felt like I had gotten into the weeds of history before I remembered what exactly it related to.
I did really appreciate the level of research and care that went into this book. I appreciated that the author wove in as many individual stories as possible to give better insight into the day-to-day experiences of many of the people who endured Milledgeville or similar situations.
I think this is a great foundational book for readers who are just beginning their research into how disability rights play into other forms of activism. I think that individuals either have done lots of research on disability rights or who have plenty of lived experience with the intersection of race and disability might view this work differently.
I did really appreciate the level of research and care that went into this book. I appreciated that the author wove in as many individual stories as possible to give better insight into the day-to-day experiences of many of the people who endured Milledgeville or similar situations.
I think this is a great foundational book for readers who are just beginning their research into how disability rights play into other forms of activism. I think that individuals either have done lots of research on disability rights or who have plenty of lived experience with the intersection of race and disability might view this work differently.
April 3, 2020
Administrations of Lunacy is an eye-opening book on the racism in psychiatry. The author does the research to inform readers of an asylum in Georgia. She details reports and facts from her findings to show how racism shaped the world of psychiatry.
Mab begins the book and starts with details about the Milledgeville Asylum. There are many facts presented that show the conditions that patients, in particular, African Americans were put through. It is heartbreaking to know how poorly they were treated because of their race. She even shows how it impacted future theories like eugenics.
I learned a lot from this book. I really appreciated the detail and findings because the author was able to back up statements and opinions.
I give Administrations of Lunacy 4 stars. This book is a history lesson that needs to be talked about more. If you have ever wanted to know more about the world of psychiatry and the origin of some of its beliefs, then you will want to read this one.
Mab begins the book and starts with details about the Milledgeville Asylum. There are many facts presented that show the conditions that patients, in particular, African Americans were put through. It is heartbreaking to know how poorly they were treated because of their race. She even shows how it impacted future theories like eugenics.
I learned a lot from this book. I really appreciated the detail and findings because the author was able to back up statements and opinions.
I give Administrations of Lunacy 4 stars. This book is a history lesson that needs to be talked about more. If you have ever wanted to know more about the world of psychiatry and the origin of some of its beliefs, then you will want to read this one.
August 3, 2020
This book gives a history of mental health practices in the United States alongside the history of the Milledgeville Asylum in Georgia. This history encompasses racism in healthcare in general and mental health specifically.
One of the most interesting things to me was the way that prisons, rather than smaller community-based healthcare operations, have largely taken the place of state mental hospitals.
This book is interesting, educational, and clears the view of today's still-flawed mental health practices, especially in regards to racism.
One of the most interesting things to me was the way that prisons, rather than smaller community-based healthcare operations, have largely taken the place of state mental hospitals.
This book is interesting, educational, and clears the view of today's still-flawed mental health practices, especially in regards to racism.
February 23, 2023
Pandemic reading, finished over several stretches: I had to read this after hearing the author lecture on the work in progress courtesy of Emory's James Weldon Johnson Institute.
Man, this is important, and by no means the last word.
Georgia's mental hospital is tied to America's history of race and gender relations. No surprise, but important and filled with stories - and buried stories.
Highly recommended.
Man, this is important, and by no means the last word.
Georgia's mental hospital is tied to America's history of race and gender relations. No surprise, but important and filled with stories - and buried stories.
Highly recommended.
April 18, 2020
Thoroughly researched and insightfully written, this study of what was at one point the largest mental institution is a comprehensive study of the history of psychiatry, institutions, and government policy over the past 150 years. It’s rather terrifying how relevant this history still is in the current moment.
September 16, 2020
Segrest expertly shows how racism, mental illness, slavery, imprisonment, and white supremacy combine to create the hellscape of the "good ol' South" in the post-Civil War years, a legacy still very much alive today.
January 22, 2021
It’s a no brainer for many that the justice system is messed up and mental health needs are heckin important why aren’t we making them more accessible guys but if you come across some privileged, entitled twit that just doesn’t get it then feel free to chunk this book directly at their face.
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October 23, 2021I'm going to have to DNF this one. The publisher was lovely enough to send me a copy in a non-fic grab bag last year, and I finally started it back in the spring, and I just haven't picked it up again. I'm very glad this book was written, but it's not the right book for me at the right time.
July 7, 2023
Even thought this topic is very heavy, it was a very easy to read book. Very detailed and having all of the patients stories made the book feel much more personal. Would highly recommend reading this.
September 11, 2024
Detailed, approachable, great look into the evolution of how social changes and historical events have molded how mental illness is viewed, treated, with a specific look at the influence of racism and sexism.
November 25, 2020
Rare combination of impassioned activism, scrupulous scholarship, and nuanced conclusions.
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