Understanding the Brain

American Psychiatric Association

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The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most[citation needed] influential worldwide. Its some 38,000[citation needed] members are mainly American but some are international. The association publishes various journals and pamphlets, as well as the Diagnostic and Statistical Manual of Mental Disorders, or DSM. The DSM codifies psychiatric conditions and is used worldwide as a key guide for diagnosing disorders.

The acronym 'APA' is also commonly used by the American Psychological Association and its 'APA style guide' for journal articles.


The history of the American Psychiatric Association (APA) reflects the history of psychiatry in the United States. The APA presidents and the membership have provided leadership and support for the events described here:

1812 Benjamin Rush, M.D. (1745-1813), signer of the Declaration of Independence and the Father of American Psychiatry, published the first psychiatric textbook in the United States, Inquiries and Observations on Diseases of the Mind.

1829 Dorothea Dix (1802-1887), a Boston school teacher, visited a jail and found insane people confined there under inhumane conditions. For the next fifty years she successfully involved prominent people to persuade state legislatures to appropriate funds to build mental hospitals. More than 32 state hospitals are credited to her efforts.

1844 The first psychiatric journal, The American Journal of Insanity, was published in June by Amariah Brigham, Superintendent of the Utica (NY) State Hospital. Thirteen (13) superintendents drawn from the then existing 24 mental hospitals met in October in Philadelphia and established The Association of Medical Superintendents of American Institutions for the Insane. The Association's objectives were "to communicate their experiences to each other, to cooperate in collecting statistical information relating to insanity and assisting each other in improving the treatment of the insane."

1851 The Association adopted propositions proposed by Thomas Kirkbride, M.D., Superintendent of the Pennsylvania Hospital for the Insane, for the design and organization of mental hospitals. These policies dictated the architecture of state hospitals for over fifty years.

1865 The Willard State Hospital (NY) opened with 1,000 beds for the first time rejecting the superintendents' policy that mental hospitals be no larger than 250 beds. By mid-20th Century, some state hospitals had over 10,000 beds.

1892 The Association's name is changed to The American Medico-Psychological Association and physicians working in mental hospitals or private offices were eligible for membership. The Association acquired The American Journal of Insanity from Utica State Hospital to be its official journal.

1902 A psychiatric unit was established in the Albany (NY) General Hospital. Currently, more than 1,700 general hospitals provide separate psychiatric services.

1906 The University of Michigan established a psychiatric hospital for research, training and treatment. Similar hospitals followed: Massachusetts Mental Health Center, the Psychiatric Institute in New York and elsewhere.

1909 Sigmund Freud (1856-1939) of Vienna was invited to lecture at Clark University (MA). His new theories and treatment approaches were adopted by prominent psychiatrists. Psychoanalysis became a leading therapy throughout the 20th Century in the U.S.

1912 The National Committee for Mental Hygiene was established by prominent psychiatrists and lay people to foster improved treatment for mental disorders and to prevent their occurrence. The organization was due to the efforts of Clifford Beers (1876-1943) who had suffered from manic depressive illness. On discharge after a three year confinement in Connecticut State Hospital, he advocated for improved mental hospital care. His advocacy and organizational abilities were successful. Now known as the National Association for Mental Health, the lay organization provides strong support for mental health endeavors.

1917 World War I produced numerous psychiatric casualties. Thomas Salmon (1876-1927), Medical Director of the National Committee for Mental Hygiene, became chief psychiatrist of the Army overseas and introduced successful treatment methods which were used in succeeding wars. The Association officially adopted the Statistical Manual for the Use of Hospitals for Mental Diseases as a system for uniform statistical reporting. Over the next three years, the National Committee for Mental Hygiene (publisher of the Manual) successfully introduced the new classification and statistical system into mental hospitals throughout the country.

1921 The American-Medico Psychological Association changed its name to The American Psychiatric Association. The name of the journal became The American Journal of Psychiatry.

1930s The decade saw the introduction of somatic therapies in psychiatry, including insulin, metrazol, and electroconvulsive therapy.

1932 The APA hired an administrator, Austin Davies, housed in New York, who served until 1948 when the office of the Medical Director was established.

1934 The American Board of Psychiatry and Neurology (ABPN) was established under joint sponsorship of the APA, the American Neurological Association, and the American Medical Association to certify standards of training and specialty competence. The 8th edition of the Statistical Manual incorporates the Association's new "Standard Classified Nomenclature of Diseases."

1946 The APA established the first standards for psychiatric hospitals and outpatient clinics. Congress passed the National Mental Health Act establishing the National Institute for Mental Health and, for the first time, provided Federal funds for research into mental disorders, training for mental health professionals, and community psychiatric services. Robert Felix (1904-1990) served as director for 18 years.

1948 Daniel Blain (1899-1981) became the first Medical Director of the APA and served ten years. He was followed by Matthew Ross (4 years), Walter Barton (11 years), Melvin Sabshin (23 years), Steven Mirin (5 years), and James Scully, Jr. (current Medical Director).

1949 The first Mental Hospitals Institute is held in Philadelphia bringing together superintendents and officials of mental hospitals to discuss common problems and seek solutions. The publication of The Mental Hospital Bulletin was begun in 1950 and continued as Mental Hospitals (1953), Hospital & Community Psychiatry (1966), and currently, Psychiatric Services (1995-).

1952 The APA bylaws were amended to provide for District Branches with representation on the APA governing board through the area structure and the Assembly (which convenes in 1953 for the first time). APA published the first edition of The Diagnostic and Statistical Manual of Mental Disorders, now in its 4th edition.

1955 Psychoactive drugs were introduced in the U.S. and widespread use led to increased discharges from mental hospitals. The past half-century has seen a dramatic decline in hospital beds from 560,000 in 315 public mental hospitals to 53,000 beds in 230 hospitals. New problems developed because of inadequate community services leading to homelessness and the incarceration in jails of persons with mental disorders. Congress appropriated funds for a study to be made of national needs and provision for the care of people with mental illness and developmental disorders.

1963 Congress passed the National Community Mental Health and Retardation Act to provide federal funds for construction of facilities followed in 1965 with appropriations for staffing. Subsequent legislation authorized the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse.

1981 The American Psychiatric Press, Inc. (APPI) is established.

1989 The APA launches the Steering Committee on Practice Guidelines to take the lead in describing the best, evidence-based treatments and the range of appropriate treatments available to patients with mental illnesses.

1990s The Decade of the Brain: Research produced new information on the structure and function of the brain through advances in genetics, imaging techniques, and chemistry, which improved diagnosis and treatment of psychiatric disorders.

2000 APA re-incorporates the membership organization and its subsidiaries (the American Psychiatric Foundation, the American Psychiatric Institute for Research and Education, American Psychiatric Publishing, Inc., and the American Psychiatric Political Action Committee) to position the Association for a greater role in public policy and advocacy.

2002 APA reorganizes its component structure of councils and committees.

2003 The APA Board of Trustees adopts A Vision for Mental Health System, a proactive set of guiding principals for promoting the availability, accessibility, and quality of mental health services in the United States.


The American Psychiatric Association is a national medical specialty society whose physician members specialize in diagnosis, treatment, prevention, and research of mental illnesses including substance use disorders.

Association Governance

The American Psychiatric Association, founded in 1844, is the world’s largest psychiatric organization. It is a medical specialty society representing psychiatric physicians from the United States and around the globe. Its members share a common interest in the continuing study of psychiatry and the search for more effective ways to combat mental illnesses. As physicians, psychiatrists are concerned with the medical diagnosis and treatment for all persons with mental disorders, including intellectual disabilities and substance-related disorders.

The Association is governed by the Board of Trustees. The Bylaws of the Association vest the Board of Trustees with the authority to make policy, manage the affairs of the Association and to formulate and implement the policies of the Association. The Board is composed of national and regional officers and trustees elected by the membership.

The Assembly is the entity representing the individual members in the affairs of the Association. It is composed of representatives from the Association’s district branches who are elected by the members of the district branches.

The Joint Reference Committee is a standing committee of the Board of Trustees that acts as a liaison and screening mechanism for the Board, the Assembly, and the Association’s components. It refers issues for study to various components and coordinates their recommendations for further consideration by the Board and the Assembly.

The Components of the Association are the Councils and the committees and task forces which report to the Councils.

Publications and campaigns

APA position statements,[1] Psych.org and practice guidelines[2] and description of its core diagnostic manual the DSM [3] are published.

APA publishes several journals[4] focused on different areas of psychiatry, for example, academic, clinical practice, or news.

APA recently launched a health campaign[5] with a new PR approach[6]

Notable figures


In 1971, members of the Gay Liberation Front organization sabotaged an APA conference in San Francisco. In 2003 activists from MindFreedom International staged a 21-day hunger strike, protesting at a perceived unjustified biomedical focus and challenging APA to provide evidence of the widespread claim that mental disorders are due to chemical imbalances in the brain. APA published a position statement in response[7] and the two organizations exchanged views on the evidence.

There was controversy when it emerged that US psychologists and psychiatrists were helping interrogators in Guantanamo and other US facilities. The American Psychiatric Association released a policy statement that psychiatrists should not take a direct part in interrogation of particular prisoners [8] but could "offer general advice on the possible medical and psychological effects of particular techniques and conditions of interrogation, and on other areas within their professional expertise."

The APA's Standard Diagnostic Manual came under criticism from autism specialists Tony Attwood and Simon Baron-Cohen for proposing the elimination of Asperger's syndrome as a disorder and replacing it with an autism severity scale. Professor Roy Richard Grinker wrote a controversial editorial for the New York Times expressing support for the proposal.

See also


External links