ADMINISTRATIONS OF LUNACY:
Racism and the Haunting of American Psychiatry at the Milledgeville Asylum

“In a gripping narrative,” writes Glenda Gilmore, C. Vann Woodward Professor of History at Yale, “Segrest retells southern history through the experiences of patients committed to the Georgia State Lunatic, Idiot and Epileptic Asylum.” It is, to Gilmore’s way of thinking, an “astonishing and compelling feat” that gives voice to the 25,000 unclaimed bodies that lie in unmarked graves around the institution’s grounds.  Turning away from memoir to the depths and expanses of historical archives, Segrest takes on an epic story and brings it home.  

Today, 90 percent of psychiatric beds in the United States are located in jails and prisons, institutions that confine disproportionate numbers of African Americans. After more than a decade of research, 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 1842, The Georgia State Lunatic, Idiot and Epileptic Asylum was opened on land stolen from the Muscogees in a building paid for by state profits from that theft.  For the first quarter of a century, its patients were the white settlers whose psyches were shaped by these wars of displacement and the inherent violence of plantation slavery.  After Emancipation, counties sent African Americans into a growing psychiatric fiefdom brutally segregated by race with its modern diagnostic categories blaming the people that Jim Crow most harmed and also marginalizing women, sexual outcasts, and the white poor. 

Over a hundred years later, it had become the largest insane asylum in the world with over ten thousand patients, considered by psychiatric historians as “American asylum psychiatry writ large.”  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. Its revelations are, by turns, infuriating, tender, funny, scathing – and always surprising.

Through meticulous research and 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 from a single asylum the factors that helped set the stage for the eugenic theories of the twentieth century and the persistent racial ideologies with devastating consequences in our own times.  She also traces the connections to today’s dissident psychiatric practices that offer sanity and create justice.

Being hailed as a landmark of scholarship, a gripping and compelling narrative, and a monumental accomplishment, Administrations of Lunacy restores a vital thread between past and present and reveals the tangled racial roots of psychiatry in America.