In 1912, the state of Maine razed a small mixed-race island community to the ground, evicting dozens and institutionalizing eight in the Maine School for Feeble-Minded. This study investigates how what transpired on the island, where race, dispossession, and treatment were braided together as one, points towards theoretical arenas too often marginalized in social welfare scholarship. Marshalling theories of comparative race studies and racial capitalism, I analyze this history as an exemplar of the imbrication of race and treatment in the early formulation of clinical social work and elucidate its implications for the field of mental health today. Guided by the interdisciplinary methods of cultural history, I conduct close, theory-driven readings of diverse primary source materials from the close of the long nineteenth century (1875-1914). These sources span archives related to Malaga Island, such as those at the Phippsburg Historical Society and the Maine State Archives, and broader social work history archives, including the Social Work Archives at Smith College and the National Conference on Social Welfare Proceedings. I examine various archival media types that reflect the interdisciplinarity of my methodological approach. These include clinical case notes, period photographs, agency reports, newspaper articles, personal letters, scholarly publications, and poems. I organize these primary source materials into three analytic themes, each explored in a dedicated chapter: Care, property, and labor. Through this framework, I unfold the narrative of Malaga Island’s dispossession and institutionalization alongside the emergence of clinical social work as a distinct field within the larger frame of social work. I argue that clinical social work, even in its contemporary social justice commitments, emerged not simply as a helping profession but as a stabilizing force for racial, colonial, and capital formations. Additionally, I contend that racial logics unfolding at the close of the nineteenth century were entangled with the early development of clinical social work, positioning the field as a significant and understudied player in the history of the broader structure of racial capitalism.