That the practice of medicine reflects the values of a particular time and place has become conventional wisdom for many historians. Clearly, this book supports that point of view. It also demonstrates that modern medicine has the power to change the way race matters in American life. The historian and psychiatrist Jonathan Metzl argued in 2009 that psychiatry has not just mirrored changing ideas about race, but it has also helped shape the meaning and practice of race in the twentieth century. The story told here confirms Metzl's argument. In tracing the efforts of the civil servants and psychiatrists who extended psychiatry's reach across 110th Street in Harlem, the preceding chapters demonstrated how these individuals altered psychiatry and its allied professions. More important, the institutional changes they made affected the lives of ordinary African Americans in practical ways, increasing their access to a medical specialty whose practitioners once doubted whether blacks were even human enough for them to help.

Between 1936 and 1968, racial liberals came to understand racial equality as equal black potential for mental health and stability, transforming the African American psyche into a site worthy of public investment and civil-rights activism. They expected that all races would be fully capable of benefiting from the latest developments in psychiatric theory and practice. Although racial liberals were never a majority, enough of them did gain positions of power within New York's systems of justice, medicine, and education. As they institutionalized their race-neutral understanding of the human psyche within their workplaces, more opportunities for African Americans to experience psychiatry emerged in schools, courts, and hospitals.

Thanks to Justine Wise Polier and the support of Mayor Fiorello La Guardia, this racial change began in New York's system of juvenile justice and corrections in 1936. Given overlapping personnel and interdepartmental networking between the courts and schools, psychiatrists such as Max Winsor, Viola Bernard, and Marion Kenworthy extended this process into the public schools’ Bureau of Child Guidance and the private Wiltwyck School for Boys in 1940. After the battle against mental health disparities intersected with the wartime civil-rights movement in 1942, it suffered a slight retrenchment in the early Cold War.