What a Jim Crow-era asylum can teach us about mental health today

TONYA MOSLEY, HOST:

This is FRESH AIR. I'm Tonya Mosley. And my guest today is journalist and author Antonia Hylton. She's written a new book called "Madness: Race And Insanity In A Jim Crow Asylum." And in it, Hylton traces one of the last segregated asylums in the nation - Crownsville Hospital in Maryland, built in 1911 from the ground up by 12 Black men who would later become patients there, some spending their entire lives in the hospital. As Hylton writes in her book, by the end of the 20th century, the asylum faded from view as prisons and jails became America's new focus to house the mentally ill.

Hylton, who was a journalist with NBC, spent more than a decade of investigative reporting and archive retrieval to piece together the 93-year history of Crownsville. She explores what that history tells us about the state of mental health services and public perception today. And Hylton also grapples with her own family's experiences with mental health and the shame it has reproduced for generations. Antonia Hylton is a Peabody and Emmy Award winning journalist for NBC News reporting on politics and civil rights and the co-host of the award-winning podcasts "Southlake" and "Grapevine."

Antonia, welcome to FRESH AIR.

ANTONIA HYLTON: Tonya, thank you for having me.

MOSLEY: Well, this story of Crownsville Hospital in Maryland - it gripped you right from the start. How did you first learn about it?

HYLTON: I first learned about Crownsville when I was just 19 years old. I was in college. I was a freshman. And I stumbled across a monograph by a social worker named Vanessa Jackson, and she was writing about race and mental health and looking at the history of segregated asylums very broadly. So there was just, I think, maybe two paragraphs about Crownsville and a couple notes and conversations from a site visit and maybe one or two staff members that she had spoken to. And I was transfixed and transformed in a split second.

I had this longing and this searching, I think, that stems all the way back to my childhood. I come from a very big Black family. We're very tight. We spend a lot of time together. But the one thing that we had - for so many years had a hard time talking about was mental health and mental well-being. And it was because I had family members who had been sent to institutions like this one, who had suffered, and then kind of retreated from our family's day-to-day fabric. And so there was all this shame surrounding that, but I would ask questions of my parents or grandparents, and they wouldn't fully answer them.

And so I think when I came across this information, and I realized, first, you know, I'm not alone. There are a lot of other Black families and families like mine all over the country - and that there's this history there. There's a way to learn about psychiatry from the perspective of Black Americans and their very fraught relationship to these systems. I guess I became obsessed.

MOSLEY: Right. Well, that obsession is important to talk about because you assert in this book that Crownsville and what happened there over this 90-plus-year period is representative of something larger - that we basically can't understand the current mental health care system and stigma around mental health, specifically in the Black community, if we don't first understand what happened during the Jim Crow era with segregated asylums. Can you say more about that? - because we're going to get deep into the book and what you learned through your research - but just that overarching idea that understanding what happened during that period can give us a lens into today.

HYLTON: Yeah. I think you have to go back before you can go forward because we're at this strange moment right now where I think people want to talk more and more about mental health or self-care. People are admitting publicly that they've sought therapy or that they're on certain medications. But very few people in the Black community - and I would argue, really, every community in the country - very few people understand why our system operates this way.

But if you go back to the early 20th century, to 1911, when Crownsville is first being created, you start to see the way in which the legacy of slavery and the ideas that white doctors and politicians and thinkers of the time - the way that their beliefs about Black people's bodies and minds completely shape the creation of this system. And it informs their decision to purposefully segregate Black and white patients to create these separate facilities and then to treat them differently within those facilities.

And so, you know, this was going on even before emancipation. Doctors would write very openly about their theories. And initially, the belief was that Black people were immune to mental illness because they so enjoyed being enslaved, they were protected by their masters, and they got lots of good time in the outdoors while working on plantations. That theory starts to shift once more and more Black people become free or they escape these plantations, and certainly after emancipation.

Doctors then start writing that they see a rise in mental illness in Black communities around the United States. And instead of spending a lot of time considering the ways in which slavery and the experience of being owned by another person and forced to work from day to night might cause trauma and poor health outcomes, they just assume that Black people can't handle being free.

MOSLEY: Right, right. So your book actually starts with this time period right after construction, when our country was grappling with how to integrate what was basically millions of newly freed Black Americans into the fabric of our nation. And politicians and city officials in the early 1900s began to document what they were calling problems with the formerly enslaved. I want to slow down here and have you take us to that time period and what these officials were responding to in Maryland society as it pertains to these newly freed enslaved people.

HYLTON: Well, what they wrote in journals and in medical papers was that they were seeing large numbers of Black patients, primarily Black men, who were landing in almshouses and poorhouses and who were unable to function or to work. In one record, they describe Black men in a town as terrorizing children and taking up space in almshouses.

And what you see in photographs is that, at the time, those institutions, those very small facilities, were not really properly segregated, although that was the hope. And so what they would do is send Black men basically into the basement or into the barn of these almshouses and chain them to walls or to poles. And in one record from the early 20th century, officials described them as really no better than beasts of the field.

And so there's this sort of strange mix of - you know, you can tell that they have some alarm. And in some ways, you almost see some slight compassion, a recognition that we shouldn't treat them this way. But when they then try to take the next leap to figure out - OK, what could be causing this; what should we do to treat them, their idea really is to reconstruct the antebellum structure. That's their belief about what is best for Black people.

And it's why, when you look at photos of Crownsville in the early years or of those almshouses right before Crownsville is created, what you see is a massive bucolic farm. You see patients dressed in workmen's overalls and work boots - not in, you know, white hospital gowns or comfy clothes for relaxation. They are out working.

MOSLEY: Being used for labor.

HYLTON: Yeah. And the idea is that this hard labor will somehow remind them of the good days, and it will restore them to health.

MOSLEY: So thinking about Crownsville - 1911, as you mentioned, officials in Maryland came up with this solution - a segregated institution. And this place had to be built from the ground up. So they had these men who would become patients there build this institution. You ask this fundamental question about this time period - what does it mean to be healthy and well enough to clear the woods, to build a road, to construct a hospital, yet be considered so mentally unwell that you need to be institutionalized?

HYLTON: That is the first question that sat on my spirit when I started this work. And I don't have a satisfactory answer to it, but what I can see are other threads and connections. And so the heart - part of the heart of this book is that question of, you know, what's the difference between labeling people incurable, labeling them as irredeemable, seeing them as patients, classifying them as criminal? And you see it in that very first moment, in that first day, March 13, 1911, when these men are marched in.

And we're to believe that they're so dangerous and so unwell that they cannot function. They can't stay at the almshouses that they've been transferred from or from other hospital wings. They can't go back home. They need to be here. But they are also talented enough to build buildings that still stand and have good bones, mind you. In the heart of Anne Arundel County, Md., to this day, you can go drive down Crownsville Road right outside Annapolis. You'll be able to see these buildings that were constructed in 1911, '12 and '13 with immense amounts of patient labor.

MOSLEY: Can you give us a sense of what it was like inside of Crownsville during those early days? What did people eat? What was the manual labor like on those farms?

HYLTON: Well, Crownsville was both a highly modern and productive farm but also a very desolate place. Inside the wards from the descriptions and the oral history, what we know is that it could be incredibly hot. The sweltering heat some months inside these wards that were packed - people shoulder to shoulder, sleeping head to foot beside each other in these wards - that there was a stench that emanated from most of the buildings so strong that generations of employees describe never being able to not smell that smell again, never being able to fully feel they washed it out of their clothes or their hair. And this was because of sort of filthy practices and a lack of care for many decades for the patients housed there.

There were patients in the daytime if you came to visit just constantly working outside with cattle, out with spears harvesting tobacco, running the morgue and, you know, constructing gardens all around the facility. And in some ways, it was beautiful because they're in the heart of this stunning forest in what would today be the Bacon Ridge Natural Area in Maryland. But in the inside, it was very dreary. Small windows, bars on windows and doors, seclusion cells that patients could be left in for days or weeks at times - having very little real interaction and therapy or activities or games.

In the hospital records, they would produce these monthly reports. What you often see was a lot more commentary about the labor and the amount of products that patients could produce than you would see about mental health care outcomes, so - you know, which I think tells you a lot about a facility's priority. If their monthly report, the main message they're trying to send to the state about what this institution is doing to, you know, impress state leadership - if it's really about the amount of rugs and baskets that the patients have made and sold and you don't see a whole lot about recovery and a return to community, I think that says a lot of what you need to know about that early period there.

MOSLEY: Let's take a short break. If you're just joining us, my guest today is Antonia Hylton. She's written a new book titled "Madness: Race And Insanity In A Jim Crow Asylum." We'll continue our conversation after a short break. This is FRESH AIR.

(SOUNDBITE OF THE INTERNET SONG, "STAY THE NIGHT")

MOSLEY: This is FRESH AIR. Today we're talking to Antonia Hylton. She's written a new book titled "Madness: Race And Insanity In A Jim Crow Asylum." Antonia Hylton is a Peabody and Emmy award-winning journalist for NBC News, reporting on politics and civil rights, and the co-host of the podcasts "Southlake" and "Grapevine." She graduated magna cum laude from Harvard University, where she received prizes for investigative research on race, mass incarceration and the history of psychiatry.

I'm just curious in contrast to white asylums because we've also heard horror stories about those...

HYLTON: Absolutely.

MOSLEY: ...Places, too, during this same time period and also that labor was considered good as a mental health treatment - that these people needed to be doing something. Can you give us a little bit of contrast between the differences in what you found here and maybe some of those places?

HYLTON: Yes. And I should note there was not a whole lot in the way of therapy. None of the antipsychotic or antidepression medications that many of us are familiar with - they did not exist until the mid-20th century. And so we were very much in the dark ages of all of this at the time, and so you do have to consider that first.

The other piece here is labor for patients and time spent outdoors working in gardens or on farms was seen very broadly as something positive for people struggling with their mental health, no matter their color or creed. But the original intention behind this was really an industrial therapy and a vocational program. And it was modeled on programs that had been designed first in Europe and then came to the United States where patients would go through sort of a gradient of employment. They'd get the opportunity to be somebody's apprentice, they'd gain a skill, maybe that was weaving or shoemaking, or they would learn to work on an assembly line. And the idea was that staff at the hospital would almost then be their reference, so that when they left, they were seen as hireable.

MOSLEY: Wow.

HYLTON: And they could go back into the community. That is not what we see necessarily at Crownsville. We see a massive farm expanding year after year for decades, the renting out of patients to businesses. They are not making any money. They are not acting as references. Employees tell me that many of those businesses posted incredibly bigoted signs all throughout Annapolis. So they had no intention of actually working with or desiring to see economic uplift in the local Black community in Annapolis, this was about getting access to free Black labor.

MOSLEY: You mentioned these Black men who were living in these almshouses and the behaviors that folks were seeing that they thought were problematic, but what were some of the other reasons people were institutionalized, too? What was the parameter for what was considered mentally ill among Black populations? What kinds of behaviors were they being institutionalized for?

HYLTON: That parameter was incredibly wide and flexible, and it could look like something different. And most of it depended on the perspective of white police officers, of white neighbors and residents. I tell the story of a patient who was found in records by a Black staff member who comes to work at Crownsville in the 1960s, and she discovers that the patient's only reason for arriving at Crownsville is that they startled a white person driving in the road. They cut them off in traffic and startled their horse, and they are sent to Crownsville and labeled as insane. This idea that they would even dare get in the way of a Black - of a white person is the entire impetus for their arrival at Crownsville and they are, at the time that this employee discovers that record, in the institution for decades.

I tell another story at another point about a woman named Marie Gough, who is in her 90s and still alive in the Annapolis area, who is one of the first Black women hired in the 1950s. And she arrives, and she comes to work on a massively overcrowded ward working with men. And she meets one man, he has a British accent, and she's really never heard anything like that before. And she is advocating for her patients, trying to get permission to bring them outside to go see the sun and enjoy the outdoors. And she finds out a little bit more about this patient.

She discovers that her superior, in collaboration with authorities, brought this patient into the hospital when he was, you know, walking around Baltimore and speaking in this funny accent. And they thought that he must have been making it up, essentially. They really had never met a Black person with an English accent. And so this man is brought to Crownsville and it's not until a Black woman arrives and starts to see him as human and worth talking to or his story worth looking into that she discovers that he is from London and was a jockey and had moved to Baltimore and fell on hard times. And so...

MOSLEY: He was institutionalized because of his accent?

HYLTON: His accent. And so that's not to say that there was - there were absolutely patients there struggling with real mental health diagnoses who had, in some cases, served in wars and come back and struggled with what we would recognize today as PTSD but would have been called at the time something more like shellshock. And so there were real mental health diagnoses, and there was real therapeutic opportunity, actually, at this place. But all of that is complicated by and mixed in with the fact that the hospital really becomes a receptacle for any kind of Black person who ends up deemed as being unworthy, unwelcome or too unusual to, you know, meet the status quo and function in broader society in Maryland.

MOSLEY: And these were men, women and children. You tell this story of a toddler who was admitted. Her name was Addie Belle Sellars (ph). And she was young - I mean, 3 years old.

HYLTON: Yeah. And when I came across that record, something about it actually made me very emotional initially because all you know about Addie is that she's wearing a blue snowsuit, that she's been left at the hospital all alone, that she is physically disabled, unable to see and unable to sit up at 3 years old. And anyone who knows children and - or has raised children would be devastated by that information and by the understanding of just what a physical disability and delay this child must have been dealing with. And the records are very cold, the description of just sort of, she'll be processed as all the other patients are. When you come across something like that, you're reminded of all these people, young and old and big and small, who - there's so much about their life's story that we'll never get to know. And I think seeing her or imagining her, it devastated me at first, but it also kind of filled me with this drive then to try to fill in as many of the gaps as I possibly could.

MOSLEY: Antonia, let's take a short break. If you're just joining us, my guest today is Antonia Hylton. She's written a new book titled "Madness: Race And Insanity In A Jim Crow Asylum." I'm Tonya Mosley. This is FRESH AIR.

(SOUNDBITE OF WYNTON MARSALIS SONG, "MY SOUL FELL DOWN")

MOSLEY: This is FRESH AIR. I'm Tonya Mosley, and today we're talking to Antonia Hylton. She is the author of the new book "Madness: Race And Insanity In A Jim Crow Asylum." She's a journalist for NBC News reporting on politics and civil rights and the co-host of the award-winning podcasts "Grapevine" and "Southlake," which won a Peabody for podcast radio and was named a finalist for a Pulitzer Prize for audio reporting. Hylton graduated magna cum laude from Harvard University, where she received prizes for her investigative research on race, mass incarceration and the history of psychiatry.

You know, one thing that you write about pretty extensively in this book as well - it's a through line - is the stigma around the experiences of families who had family members who were there and also, more generally, mental health and mental illness. You write about the patient William Murray, who was brutally murdered by a white employee at Crownsville, and his family members and his daughter, who was forever impacted by it. Her life - she thought that what happened to her father would also, in some way, happen to her - that she would suffer from mental illness. I think she said something like, the fear hung over our family kind of like a curse. How pervasive was that stigma and shame during the course of your reporting in modern day for this book?

HYLTON: It's absolutely pervasive. And one of the strange and dizzying experiences or aspects of this experience for me was that I was living something very similar at the same time. I have not just a history and past loved ones who have spent time in institutions like this one. While I was reporting on this, a family member of mine was in the midst of a psychiatric break. And they speak with me about these experiences in the book, and I shared them because I felt like I should disclose that as a journalist. I should tell you my connections to the story that I'm writing about. But it was also - it complicated the work, too. It slowed the work down often because my family had to go into crisis mode to try to support this person and find care for them in a system that is really hostile, at least from my loved ones' perspective and their belief and feeling after leaving these systems in the present day that is still very hostile to Black people.

MOSLEY: It's hostile. And you come from a family that has all of the resources.

HYLTON: We have great insurance. I work at NBC. I should be able to find the best psychiatrist or therapist. And we couldn't. We were on monthslong waiting lists to get them care. And at one point, I write about a police officer entering my loved one's home and me desperately having to beg that person to not respond with weapons, to not respond with violence the next time they felt called to check on or visit my family member. And that was very painful for me and for my entire family. And you also start to wonder, well, what could be lying in my own DNA? What's in my own genetic script? What if I start to struggle like this? Who's going to have my back? I'm doing all this work for this person, and I'm trying to keep my job and write my book all at the same time. And it led me to open up at times to my sources, to my subjects in a way that I don't normally as a reporter. And what I found was that I wasn't alone.

MOSLEY: Right, because you write about how it's easier to write about it than to actually talk about it with your friends and...

HYLTON: Yeah.

MOSLEY: ...Loved ones. Many people who might have worked with you or friends with you in the past might be learning this information for the first time.

HYLTON: Oh, definitely.

MOSLEY: How has writing this book maybe given you insight into your own family dynamics? - because you learn you're not alone, for one. But then there are also these other things that you can put into context now.

HYLTON: It's taught me a few lessons. The first is that I really deeply believe that if you try to swallow or stifle or hide your suffering, your pain, your worst memories and you refuse to talk about them or seek help even if some part of you knows that you need it - that it never goes away. It never digests. You actually pass it on. And when I think about the research that some geneticists, epigenetics are doing now that shows that trauma can actually be passed on, it can alter our DNA, you can interpret what I said in a very literal, scientific way if you would like. But I also mean it in a metaphysical way.

When I think about the fact that I suffer myself with anxiety and have sought treatment for that and I think about elders in my family who, you know, tried to hide things that they were going through from me but I knew as a child so much more than I think they thought I could catch on to - and so I think about the way in which generations can pass down sadness. They can pass on anxiety. They can pass on unease to those who come after them. And you might think that you're successfully hiding those things or saving the people who come after you from ever experiencing them. But in not talking about it, you almost compel them. You push them toward that fate, too. That's a belief that I've come to in this work.

MOSLEY: If you're just joining us, my guest today is Antonia Hylton. She's written a new book titled "Madness: Race And Insanity In A Jim Crow Asylum." We'll continue our conversation after a short break. This is FRESH AIR.

(SOUNDBITE OF SOLANGE SONG, "WEARY")

MOSLEY: This is FRESH AIR. Today we're talking to Antonia Hylton. She's written a new book titled "Madness: Race And Insanity In A Jim Crow Asylum." Antonia Hylton is a Peabody and Emmy-Award winning journalist for NBC News, reporting on politics and civil rights, and the co-host of the podcast "Southlake" and "Grapevine." She graduated from Harvard University, where she received prizes for her investigative research on race, mass incarceration and the history of psychiatry.

As the years go on and there's this real push to lessen the need for institutions, to find other ways to deal with mental health issues, what were the realities for patients as they started to be released into the world? I mean, this was also the time period where, as you point out in your book, the growth of what we know as mass incarceration started to come into fruition as we enter the '80s into the '90s.

HYLTON: Well, there's all these concurrent movements, concurrent and intertwined movements going on at the same time in the '60s and '70s. So there's this newfound sympathy for patients, this idea that we got to get them out of the mammoth institution and back home into community clinics and group homes. And then there's also the civil rights movement, though. And what we see then is actually a criminalization of protest, a lot of anger and conflict in big cities like Baltimore, and that protest at times being pathologized.

And so at the exact moment they're trying to push people out of the hospital, new people are coming to the hospital under sort of strange circumstances. So I write in one chapter about a group called the Elkton Three, who are brought to Crownsville in the '60s for the crime of trying to eat at a white-owned restaurant. And they're labeled as insane for doing that by the courts. And so you can see there how Black protest, Black demands for equality start to be pathologized and classified differently, even at the same exact moment we believe we're actually more enlightened and we're treating patients better than we have ever before.

And then the other thing that's happening is there's this rise of fear around protest, a desire to bring police officers into schools for the first time. We're starting to criminalize poverty, so people are getting charged for things like vagrancy and loitering, actions that in the past would have been seen more as evidence of a mental health challenge than as real criminal activity. And so all of those things are happening at the same moment and having sort of hypocritical and unintended impacts on these communities.

And what we see through the lens of Crownsville is that what it means is that a lot of white patients are able to go back to the community. They often have better access to health care, they have better insurance, they have more money to see good doctors and psychiatrists. And in some of their communities, some of these community clinics that politicians initially envisioned were actually constructed. But for Black people, there's not a whole lot of community and safety infrastructure and safety net to go back to. And so they come back and they're out on the street. Many of them become homeless for the first time, and they end up interacting with police officers and the justice system instead of with the mental health care system.

MOSLEY: You know, in reading those parts of the book, of course, I can't help but think about the crisis that we're currently dealing with here in Los Angeles. I see every day the unhoused population. It's a crisis, and the data shows us that many of these people suffer from mental conditions or drug use, which one could argue is a mental health issue. I'm just wondering, for you, having gone through this process of learning this history, it has brought for you a deeper understanding on what we're seeing in our populations around us every single day.

HYLTON: Definitely. And it's been a reminder, really, of how subjective and random some of these decisions are about how we describe and classify and see our neighbors. You know, at a time, everything that you just described would have been a community challenge met with some kind of mental health response. And that's not to say that that mental health response would have been effective or necessarily therapeutic or good, but it would have been classified in a different way than the way we often look at those challenges now. And, you know, I think about that when I see cities enacting policies to remove things like park benches or to make it illegal for people who are unhoused to sleep in certain areas and make that something that's punishable. That is not always the way that we've viewed people struggling in their lives in that way.

And so it's a reminder that all of these decisions that we make about people and our neighbors, they are influenced by our history. They're influenced by our beliefs about different groups and types of people and how deserving they are, what we're willing to fund to support them and the ways in which we might be willing to pay for one kind of institution rather then or over another option, another kind of a social tool or support. These are decisions we make and that we're all implicated in. And they affect people of color disproportionately, but they don't just affect Black Americans.

MOSLEY: I just wonder how, then, do you look at communities that are still struggling? I mean, the state of California has ideas on the table that look a lot like institutionalizing people as a way to deal with the crisis around unhoused populations, of course, with different modalities, because we're in a new time and we understand mental health a little bit better. But what can we learn from Crownsville as we think through solutions?

HYLTON: For me, most urgently, I think we need to have a new discussion and vision around what community means and the role that that plays in mental health care, because as you'll see in this book, at many points which there is a recovery, there is a rescue, there is a patient whose story ends with positivity, it's not necessarily medication or a wonder drug or discovery that makes all the difference in their life, it is a community that wraps their arms around them. It is that they actually have support, and they actually are able to recover with the full knowledge that they'll be welcomed back somewhere, that they have a life ahead of them. And there are a whole lot of Americans and communities that do not feel that way. And the role that that plays in exacerbating and contributing to mental health crisis for adults but also, many clinicians believe, really, for children right now, it's at a crisis level. That's probably, for me, one of the primary takeaways.

MOSLEY: It was almost impossible for you to find patient records during these early time periods. But were you able to find in any way anything like drawings or paintings from patients or writings from patients during that time period?

HYLTON: Yes, and I've integrated them throughout the book. Inside the book, you'll be able to see patient artwork, patient poetry. And I wanted to do that to give them a voice, to give you a way to experience their perspective and their world in a period of the hospital's history in which doctors really weren't paying so much attention to the patients' personal lives and experiences. And you can see they write about their loneliness. They write about fear. They write about their paranoia in this poetry. And so you really do get a sense of the patient experience. You write about the way - they write, at times, about the way in which they feel trapped there or like people can be lost to this place.

MOSLEY: Can I have you read one of those poems? It is by a pseudonym, Mr. New Unit, written in April of 1952.

HYLTON: (Reading) If you get sick against your will, they will bring you to Crownsville. But if you're a lucky so-and-so, it won't be long before you go. The doctors keep you until, and there you'll stay in Crownsville. And if they don't make up their mind, you'll stay there for a long, long time. But when it's time for you to go, you and everybody will know. And your mission you'll fulfill. Then you can leave Crownsville. But someday, in the sweet by and by, you won't have to stay here until you die. Just trust in God, and you can depend. He will bring things to an end.

MOSLEY: Oh, Antonia, when you found that - can you take me there when you discovered that? It's such a powerful poem.

HYLTON: I discovered that in a personal collection in a former employee named Paul Lurz's home that he had kept in a box in his attic. And I was so moved by the poem, written in 1952 by a patient in a part of the hospital - the new unit was a nickname for a part of the hospital that was notoriously overcrowded where patients could go for weeks without ever interacting with a doctor or nurse. And so I felt everything. I was very emotional. And actually, as Paul shared some of these records with me, he and I would sometimes sit there together in silence with tears welling up in our eyes. And so it's hard to find the words. But there is this hope, this - I think the idea of sitting down to write poetry in such dark circumstances - there's something stunning and unbelievably brave and wonderful about that. But you also see the hopelessness and the pain and all of the texture of what this place is. I mean, that poetry represents to me everything that Crownsville was, is, could have been to its patients. And so I knew the second I found that, I had to share that with everyone else.

MOSLEY: Antonia Hylton, thank you so much for this conversation and this book.

HYLTON: Thank you for having me.

MOSLEY: We spoke with Antonia Hylton. Her new book is "Madness: Race And Insanity In A Jim Crow Asylum." Coming up, rock critic Ken Tucker reviews the album "The Interrogator" by the band The Paranoid Style. This is FRESH AIR.

(SOUNDBITE OF KYLE EASTWOOD'S "SAMBA DE PARIS")

TONYA MOSLEY, HOST:

This is FRESH AIR. When it comes to rock music with literary flair, rock critic Ken Tucker thinks you can't do much better than the band called The Paranoid Style. They're a Washington, D.C.-based group that's been making music since 2012, led by songwriter and lead singer Elizabeth Nelson. She's also a music critic who's been published in places like The New Yorker and The New York Times. The Paranoid Style's new album is called "The Interrogator." Here's Ken's review.

(SOUNDBITE OF SONG, "LAST NIGHT IN CHICKENTOWN")

THE PARANOID STYLE: (Singing) From the last of the ninth to the trundling haze to the genie in tights, the experimental phase. I don't stop at lights. I don't sleep for days. I've been seeing the sights. Baby, I'm amazed - last night in Chickentown.

KEN TUCKER, BYLINE: The signature sound of The Paranoid Style is the voice of songwriter Elizabeth Nelson - a sure, firm tone clearly enunciating the cascade of words that fill out every lyric. Most often half-sung, half-spoken, Nelson's declarative sentences reveal themselves to be artfully composed verse packed with wordplay, jokes and an undercurrent of serious dread.

(SOUNDBITE OF SONG, "ARE YOU LOATHSOME TONIGHT?")

THE PARANOID STYLE: (Singing) I'm struck at the beating heart of another bad occasion I can't ignore. And I can't parse the slow disintegration. Savoy truffles finely bake minds. Media kerfuffles - are you loathsome tonight? The outside is dim. The silhouettes are slithering. Everything you loved has grown hidebound and withering. Did you fight out of passion? Or was it just obligation? Believe me. I know how to vouchsafe a nation - lots of incidents, lots of situations. One has its doubts about various vacations. Time grows short, and time is tight. One last look - are you loathsome tonight? Are you loathsome tonight?

TUCKER: That's "Are You Loathsome Tonight?" And, yes, this band is indeed named after Richard Hofstadter's 1964 essay "The Paranoid Style In American Politics." I suppose you could call The Paranoid Style a cult band consisting of people who read books and listen to a lot of music that wasn't just recorded in the previous year. This is the band's second album in a row that namechecks P.G. Wodehouse, now with the added bonus mention of another great humorist, S.J. Perelman. It's a wonder she didn't call the song "P.G. And S.J." The interrogator also continues a mini tradition of contorting other artists song titles. On their last album, the band inverted The Eagles to give us "The Worst Of My Love." On the new one, they take Nick Lowe's title "I Love The Sound Of Breaking Glass" and offer a more political alternative, "I Love The Sound Of Structured Class."

(SOUNDBITE OF SONG, "I LOVE THE SOUND OF STRUCTURED CLASS")

THE PARANOID STYLE: (Singing) Sitting on the front porch, still waiting on the lifeline from the kind of folks who share opinions like mine. I have spent time in education. I have spent time in jail. I've drunk from the river basin. I have skied in Vail. Time in capsules, Vitamin C. Everybody knows this is nowhere but me. Everyone knows this is Valhalla or bust, an unliving will and a living mistrust. Sympathy for the devil is the last of your concerns. Bow down to your level, and attend to your burns. I have seen strong men crying out for help. I have pulled books from a very high shelf. The next time you call me, make sure it's important - withering on the vine, living by appointment. Everyone's outnumbered, and no one has a past. I love the sound of structured class.

TUCKER: All of this garrulousness could easily become coy and tiresome, but Nelson's remarkable range of references keep everything buzzing along with both vigor and rigor. And, oh, yeah, there's the music. This is The Paranoid Style's most tuneful album to date, at least in part because of its new lead guitarist, Peter Holsapple, co-founder of the great pop rock band The dB's. Nelson, Holsapple and the rest of the band, including Nelson's guitarist husband Timothy Bracy, hit a peak of pleasure with the guitar solo in the middle of a song called "The Ballad Of Pertinent Information."

(SOUNDBITE OF SONG, "THE BALLAD OF PERTINENT INFORMATION")

THE PARANOID STYLE: (Singing) Burned in the fire, hung in a cell there are oh so many dudes who think they get me so well. Turn it on. I got some things you'll want to see. Turn it on - a mire of ecstasy. Turn it on. I've tampered with the occasional witness. Turn it on. I'm not in the pleasure business. Turn it on. I want access to everything - turn it on - from the dawn of man to the final gathering. Turn it on. I like the fact that you're so tall. Turn it on. I like the way you hold a stone. Turn it on.

TUCKER: Elizabeth Nelson says on another song here, something about rock 'n' roll makes me defensive, and you could hear much of "The Interrogator" as an album-length justification for believing that an artist can put anything she thinks about, believes in and desires into the lyric and melody of a three-minute rock song without sacrificing any degree of complexity or emotion. To listen to Nelson and The Paranoid Style work out such an argument over the course of 13 compositions is what makes spending a lot of time with this album so rewarding.

MOSLEY: Ken Tucker reviewed the album "The Interrogator" by The Paranoid Style. To keep up with what's on the show and to get highlights of our interviews, follow us on Instagram at @NPRFreshAir. FRESH AIR'S executive producer is Danny Miller. Our technical director and engineer is Audrey Bentham. Our interviews and reviews are produced and edited by Amy Salit, Phyllis Myers, Sam Briger, Lauren Krenzel, Heidi Saman, Ann Marie Baldonado, Therese Madden, Thea Chaloner, Seth Kelley and Susan Nyakundi. Our digital media producer is Molly Seavy-Nesper. Roberta Shorrock directs the show. I'm Tonya Mosley.

(SOUNDBITE OF SONG, "STYLES MAKE FIGHTS")

THE PARANOID STYLE: (Singing) Saw you there with long, blonde hair, saw you bracing in the middle of the night. Never thought I'd make it to the vice chair - mismatch on the page. Your styles made fights. I would punch you between the eyes. I would punch you in the illegal zone. I will haunt you day and night to bring you my love. Styles make fights. Styles make fights like the whale and martini (ph). Styles make fights like the Moosy-loosalini (ph). Styles make fights that can't left hand win, praying for oblivion. From the latest craze to the latest persecution, so many things that Pitchfork got wrong. Every chance they choose adds up in disillusion and take (inaudible) rights. Styles make fights. By the crook of the neck and the useless apartment, the last thing you bet on was less than one.

Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.