Race, Health Care and the Law 
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African Americans and Spring Grove Hospital

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Vernellia R. Randall
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 excerpted from: "A History of Spring Grove", http://www.springgrove.com/history.html

African American Female Patients at Spring GroveAlthough it is not known exactly when the Hospital accepted its first African American patients, it is known that African-American patients were admitted well before the Civil War -- at a time when Maryland was still a slave state.  The first identified reference to African-American patients at the Maryland Hospital is found in the Hospital's Annual Report of 1849, which mentions the fact that, as of as of the end of December of that year, there were 10 African-American patients (five males and five females) at the Hospital -- nine of which were "free" and one of which was a slave. On January 1, 1853 the Hospital also had 10 African-American Patients (six men and four women). That figure represented 8% of the total number of the 130 patients at the Hospital on that date.  Also in 1853, one of the just four new "public" patient admissions in that year was an African-American female. An annual report published in December 1877 (five years after the new facility opened at Spring Grove) notes that as of that time, the Maryland Hospital for the Insane at Spring Grove was treating 18 African-American patients, and by1896 it was caring for 45 African-American patients (24 male and 21 female). 

An example of a record from 1897African-American patients were identified in the records by the notation "col" or "colored."  To view one of the records from Spring Grove's Centennial year, 1897, click on the image to the right.

Several documents from the period speak, predictably, to the then predominate belief that the races should be separated -- although there was also evidence that therapeutic activities, such as industrial therapy, were integrated.  In 1877, the following report was made by the Hospital's Board of Managers:

"There is separate care and treatment of the colored insane other than has been provisionally made in this Hospital.  It is impossible to provide for this class of insane in State Hospital without associating them with the white patients.  There are now fifteen colored insane in the hospital -- seven males and eight females, and three others have been received since the date of this Report.  Besides these, there are a large number in the almshouses of the State whose condition demands early attention.  Provision should be made for them, without delay, by building a separate accommodation for them in connection with a hospital for the insane.  The cost of construction need not exceed $400 per bed." (Maryland Hospital for the Insane.  Annual Report of the Board of Managers, 1877.)

By one report from the late 1800s, the rate of physical illness and death was lower among the hospital's African-American population than it was among the white population. 

At first, the new facility at Spring Grove seems to have been racially integrated. However, several annual reports from the end of the 19th-century indicate that by that time African-American patients were segregated to certain (less desirable) sections of 1927aerial2.jpg (37388 bytes) the Main Building.  For example, it was noted that in 1896 an old bowling alley that was, evidently, located in the basement of the Main Building, was converted to serve as a ward for African-American patients. (The Annual report of that year suggests that, unlike any of the other units in the hospital, the single African-American ward served both male and females patients.) Records from the turn of the 19th-century also indicate that African-American men often lived in tents on the Hospital's grounds for as many as eight months out of the year.  

In the same tradition, in 1906 a separate building, constructed in back of the Main Building, was opened as a "Cottage for Colored Women" (see above).  This cottage seems to have been the first public hospital building in Maryland that was specifically designated for the treatment of mentally ill African-American patients. 

At the same time, there was a growing awareness throughout the State of the need to provide more and better psychiatric services to Maryland's mentally ill African-American citizens.  Despite the less than ideal circumstances for African-American patients at Spring Grove in the 19th and early 20th Century, conditions were far worse in the almshouses and jails -- where manyAfrican-American Male Patients Often Lived in Tents in 1900 mentally ill African-American Maryland citizens were confined. In response to the identified need for more and better treatment for psychiatrically ill African Americans in Maryland, and because of the racist beliefs of the time, a new state hospital, intended exclusively for African-American patients, was founded in Crownsville, Maryland in 1910. Originally known as The Hospital for the Negro Insane of Maryland, the facility was renamed "Crownsville State Hospital" in 1912.  In that same year, 1912, most male patients of African descent were transferred from Spring Grove to Crownsville. African-American females were transferred from Spring Grove to Crownsville the following year (1913).

Photograph of The Main Building in 1910 It should be noted that according to oral tradition, not all African-American patients were transferred to Crownsville in 1912 and 1913; evidently certain patients remained at the Spring Grove facility because they held unique or indispensable work-skills.  Most people are astonished to learn that the Maryland State hospital system was not officially desegregated until 1963. Spring Grove began the process of reintegration a few years before that, in1961.

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Professor Vernellia R. Randall
Institute on Race, Health Care and the Law
The University of Dayton School of Law
300 College Park 
Dayton, OH 45469-2772
Email: randall@udayton.edu


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