Jim Crow in the Asylum: The Fight for Civil Rights in Southern Psychiatry

In February of 1969 US District Judge Frank M. Johnson of Alabama handed down his finding in a case called Marable v. Alabama Mental Health Board which he described as “long and complicated litigation over a rather straightforward problem” – that there was no medical justification for segregation in Alabama’s psychiatric facilities. Johnson’s ruling came at the end of a protracted battle over the federal mandate to desegregate public accommodations in the South, in which psychiatric hospitals in Mississippi and Alabama were late hold-outs.

Unravelling this case reveals the way that psychiatric hospitals became unexpected sites of Civil Rights resistance in Alabama and Mississippi as politicians in those states sought to avoid what they saw as federal overreach. But the resistance to integration in psychiatric hospitals also spoke to much more deeply embedded stereotypes about the nature of the Black personality itself. Politicians were able to use these stereotypes to stoke popular support for resistance to integration, but in doing so they also risked depriving all their constituents of new federal health funding.

In this paper, I set out the ways that the federal government and grass roots activists sought to enforce Civil Rights compliance in psychiatric hospitals and how in doing so they revealed decades of abuse and neglect of many thousands of Black patients. The arguments that politicians in these states used against desegregation reveal the lengths they would go to undermine Civil Rights, but also demonstrates the ways that psychiatry itself was implicated in the production of anti-Black racism. The court ruling in 1969 may have ended formal segregation, but the consequences of the racist resistance to federal funding continue to be felt in mental health systems across the South today.