Dr Kylie M. Smith NLM G13 Application. Title: Jim Crow in the Asylum: Psychiatry and Civil Rights in the American South Abstract: Disparities in mental health, especially for minorities and African Americans, have a long and complex history. Jim Crow in the Asylum: Psychiatry and Civil Rights in the American South, analyzes the practices and politics of segregation in psychiatric institutions in Georgia, Alabama and Mississippi in the 1960s and 70s. The project pays particular attention to the impact of the Civil Rights Act of 1964 and Medicare and Medicaid in 1965 on the operation of state institutions, demonstrating that different approaches to the issues of racial segregation had varied consequences for services in these states. During the 1960s a number of mental health professionals and Civil Rights lawyers attempted to change the ways in which services were provided and patients cared for. Alabama was particularly significant in this period as the judicial activism of Judge Frank Johnson, who ruled in favour of patients in a number of medical segregation and minimum standards cases, set national precedents. Despite the significance of Johnson's court for national mental health law, there is no existing research on the process of desegregation in the psychiatric hospitals of Alabama or neighboring states Georgia or Mississippi who had their own particular responses to legislative and cultural change. Similarly, there is no analysis of the long-term implications of the racist psychiatric thinking which underpinned disparities in these states. This project aims to expand on recent scholarship in the history of psychiatry that focuses on Northern states, by analyzing the ways in which the legacy of segregation has shaped the development of mental health services in the South. The advent of Medicare and Medicaid funds gave leverage to government and judicial enforcement of Title VI of the Civil Rights Act, finally forcing the formal desegregation of these facilities. However, underlying racist attitudes were harder to shift. These attitudes can be linked to current disparities in mental health care and to the complex relationship between mental illness and mass incarceration.
Disparities in mental health service provision have a long history and disproportionately affect minorities and African Americans. This project analyzes this history in Georgia, Alabama and Mississippi, focusing on the impact of the Civil Rights Act on psychiatric facilities. It examines the ways in which segregation was maintained and then challenged and considers the long term consequences of these processes for the mental health of African Americans in the South today.