In April 1910, Maryland established the "Hospital for the Negro Insane" at the 566-acre Boswell-Garret farm beside the railroad station in Crownsville as the state's first segregated Black mental health facility, admitting patients of all ages under a broad definition of "mental illness" that included chronic conditions, homelessness, and epilepsy. On March 13, 1911, the first twelve male patients arrived from Spring Grove Asylum in Baltimore. Renamed Crownsville State Hospital in 1912, the institution aimed to be a modern facility for Black patients and adopted what were then considered advances in psychiatry, but it operated within Jim Crow's separate-but-equal system. Previously, mentally ill Black patients had been confined in overcrowded almshouses or neglected in all-white state asylums, often in separate, squalid conditions marked by abuse. As the patient population grew between 1913 and 1930, additional wards and infrastructure became urgently necessary, and patients provided essential labor to build nearly a dozen campus structures, including the Administration Building, a kitchen, a tuberculosis ward, a children's ward, and the Superintendent's House. By the 1930s, the hospital held more than 1,000 patients and suffered from understaffing and overcrowding that seriously harmed care and living conditions. Patients included not only people with mental and physical illnesses but also marginalized Black citizens who were admitted despite being of sound body and mind after challenging authority during segregation. Under the banner of "industrial therapy," Superintendent Robert Winterode used forced patient labor to operate the campus as a self-sufficient plantation throughout his tenure, with patients raising willows and weaving baskets, clearing land, constructing buildings, farming, and performing food service, laundry, and sewing work. Hospital records valued involuntary patient labor at $3,239.75 in 1911, equal to about $100,000 in 2024 dollars, and this model shaped the hospital's first decades.
