Book Review: Administrations of Lunacy: Racism and the Haunting of American Psychiatry from Georgia’s Milledgeville Asylum
Milledgeville, Georgia was once home to the largest mental asylum in the world. Opened in 1842, the Georgia State Lunatic, Idiot, and Epileptic Asylum grew to an expansive 2,000 acres, 200 buildings, and 12,000 patients. It’s now known as Central State Hospital, Georgia’s custodial center for justice system referrals. Administrations of Lunacy unpacks the history of this iconic and infamous Southern institution. Author Mab Segrest seeks to tell the patients’ stories through the founding of Georgia and the asylum, post-Civil War and Reconstruction, the advent of the convict lease system, and the evolution of psychiatric treatment in the US.
One of the first questions Segrest presents to the reader is, “How can a state that conquered and enslaved then be responsible for deciding the sanity of others?” She describes Milledgeville, Georgia’s former capital, as being on a political fault line in the early 1800s. On one hand, Georgia just received federal funds that it could use to build an asylum and care for the less fortunate. On the other, those funds were payments for lands taken from the Muscogee and Cherokee tribes during the Trail of Tears. Segrest explains that this “conquest mentality” shaped Georgia’s justice system at the time and would also shape how the asylum operated.
A large portion of Administrations of Lunacy focuses on race relations pre-Civil War and during Reconstruction. As Segrest describes it, “the state asylum is where there’s a mediation between the psyche of the individual, and the culture, and the needs of the state.” When African Americans were first admitted to the asylum, their patient records often read “no history provided.” Segrest argues that this is an attempt to remove any responsibility and blame from the state – the asylum chose not to acknowledge the distress of slavery, war, lynchings, loss, and other traumas. At the time, doctors did not understand post-traumatic stress disorders; those suffering from mental ailments were often called insane or the product of poor genetics. (Asylum superintendents would later lobby for sterilization and eugenics legislation). Segrest also claims that segregation inside the asylum and assigned “occupational therapy” roles worked to re-create the plantation system. The asylums relied on their African American patients for agricultural production, and in return, they were given disparate lodging, supplies, and medical care. Segrest connects the post-war racial tensions to the development of the convict lease system, describing it as a “black penal system” in which Georgia residents were rounded up into chain gangs (rather than the state paying for a spot at the asylum) and used for cheap labor.
In addition to examining how politics, law, and race relations shaped the asylum system, Administrations of Lunacy also looks at the evolution of psychiatric treatment – both at the asylum and in the country. The author explains the three major therapies employed at the asylum. Heroic therapy is focused on balance; patients are forced to expel bodily fluids in order to bring their energy levels down. (This treatment caused germs to spread, and disease outbreaks were common). Moral therapy is the use of routine and nature to transform the environment into curative spaces. The asylum’s occupational therapy involved assigning tasks to the patients based on their interests and ability levels. However, some of these work assignments lead to significant physical injuries – especially for those working in agriculture and farming. While Segrest is highly critical of the asylum’s diagnostic systems and therapies, she does give credit to the asylum’s achievements in the identification and eradication of pellagra, a disease caused by lack of vitamins that ravaged the Southeast in the early 1900s.
While the Georgia’s Bar Journal’s readers will undoubtedly be shocked to learn about the laws that avoided or allowed the atrocities happening at the asylum, it is the patients’ stories that may resonate the strongest. Segrest is an activist, and she takes an aggressive and critical approach to the material. But she also clearly cares for these patients. She wants to make sure that their stories are heard. In Administrations of Lunacy, you’ll learn about 34-year-old Frances Edwards, whose husband brought her to the asylum in 1856 after he beat her with a horsewhip, and she “alienated” him. Patient John Wade, also 34 years old, was admitted to the asylum in 1844 for hallucinations of a slave revolt. He was treated with heroic therapy (constant vomiting, diarrhea, bloodletting) until he calmed down enough for the paranoia – and everything else – to go away. Eliza Busy was admitted to the asylum in the early 1870s after she tried to kill herself. Eliza had just lost her husband in the Civil War. She lost her home. She had no means to take care of herself or her six children. She was diagnosed as being overly excited.
In writing Administrations of Lunacy, author Mab Segrest wanted to understand Georgia’s scrubbed history and how politics, economics, race relations, and culture have shaped our modern psychiatric practice. The Milledgeville asylum provides some rich materials and insights, but in Segrests words, “there’s so much more to go.”
About the Author
Mab Segrest is an activist, writer, and scholar. Born in Alabama (near the Georgia border) in 1949, Segrest says she learned about Central State Hospital as a child when it was commonplace to tease each other with threats of “being dragged off to Milledgeville.” Segrest was inspired to write about the asylum after reading an Atlanta Journal-Constitution article about the campus conditions in the 1990s. She said that she had a strong emotional response for the patients; she felt they were shunned while alive and then abandoned in death. It called to mind her great-grandfather, a Civil War veteran who was admitted to an Alabama asylum for shooting at hallucinations of soldiers. He later died in the asylum from an infection. Segrest spent 15 years working on Administrations of Lunacy.
Mab Segrest earned her Ph.D. in English literature from Duke University. She’s worked for the World Council of Churches and National Humanities Center, chaired the Gender and Women’s Studies Department at Connecticut College, and has taught at Tulane University, Emory University, and Georgia College and State University. She currently lives in Durham, North Carolina. You can learn more about her writing and activism at mabsegrest.com.
Touring the Central State Hospital Campus
Photo By Megan Hodgkiss
The Milledgeville-Baldwin County Convention & Visitors Bureau offers guided trolley tours of the Central State Hospital campus. Led by a former CHS employee, the tour explores the grounds while educating guests about the historical buildings, significant figures, and certain periods of growth and development. The trolley also stops at the Chapel of All Faiths and Cedar Lane Cemetery (both on the CHS campus). Central State Hospital currently serves more than 200 existing patients; the campus encompasses 2,000 acres of land. For those interested in the themes discussed in Administrations of Lunacy, the tour presents an interesting in-person perspective and experience. For more information about tours and ticketing, visit visitmilledgeville.org.
This article was featured in the December 2021 issue of the Georgia Bar Journal
