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The
Story of GAP
Fifteen psychiatrists sat around
the crowded, smoke-filled room of Brigadier General William
C. Menninger at Chicagoís Palmer House on the night of May 26,
1946. They had gathered there at the behest of General
Menninger, chief of neuropsychiatry in the U.S. Army Medical
Corps at the time, and were engaged in earnest discussion of
postwar problems and prospects of American psychiatry.
The group consisted of Drs. Daniel Blain, Wilfred Bloomberg,
Douglas D. Bond, Henry W. Brosin, Norman Q. Brill, Robert H.
Felix, Roy R. Grinker, M. Ralph Kaufman, Marion E. Kenworthy,
William C. Menninger, Karl Menninger, John M. Murray, Thomas
A.C. Rennie, John Rtomano, and Lauren H. Smith. Most of
those present had been in wartime military service; many were
still in uniform. The few civilians among them had rendered
signal contributions to wartime psychiatry; one, a woman, had
played a key role in stimulating improved psychiatric standards
in the armed forces.
It was the
eve of the 102nd annual meeting of the American Psychiatric
Association, the oldest national medical society in the United
States. Many of its members had been appalled to find
how weak was the voice and how vacillating the action of their
loosely organized group during the national defense
and ensuing wartime emergencies. Despite a succession
of distinguished officers, the APA was unable to assume professional
leadership because of constitutional, procedural, and traditional
obstacles. Responsibility thus devolved upon a relatively
few far-sighted, persistent, and courageous psychiatrists, along
with non-psychiatric agencies and individuals, to press for
more adequate mental health standards and services on both the
military and civilian fronts. During the prewar and early
war years many serious problems had resulted from the general
failure to utilize available psychiatric knowledge and skills
in the screening of military recruits and in the prevention
and treatment of mental breakdowns among military
personnel. The lessons learned at great cost during World
War I had been virtually forgotten. On the civilian front,
too, organized psychiatry had played a pitifully ineffectual
role in efforts to sustain and strengthen community defenses
against mental illness.
Many psychiatrists,
frustrated in their desires to practice or promote first-rate
medicine in or out of the armed forces, and deeply frustrated
by their professional society's failure in leadership, were
bent on doing what they could toward remolding the APA into
a more flexible, active agency that would assume a dynamic role.
General Menninger himself had encountered many difficulties
in efforts to develop a modern, efficient psychiatric service
in the Army. To a large number of his colleagues he had
become a symbol of progressive psychiatry. Throughout
the war he had repeatedly received urgent appeals from colleagues
to accept leadership in a drive to energize the profession and
to prepare for the formidable problems awaiting psychiatry in
the post-war period. One East Coast psychiatrist, in a
lengthy letter to General Menninger, wrote that the increasing
dissatisfactions among psychiatrists were bound to develop into
a Young Turks movement one the war was out of the
way, and that Menninger was a natural to lead it
toward constructive goals.
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Postwar
Challenge
With war's end, it was obvious that American psychiatry was
faced with Herculean tasks of reconstruction and expansion.
The wholly unanticipated percentage of military draft rejections
on neuropsychiatric grounds, the huge toll of psychiatric casualties
in the armed forces, the alarming deterioration in public mental
hospitals, the grave inadequacies in community mental health
facilities, the acute shortage of psychiatrists and ancillary
personnel--these and other shortcomings were in painful evidence.
An extraordinary public interest had been aroused in these problems,
notably by a steady stream of discussions in the media of mass
communication. This public interest generated considerable
public pressure for action all along the psychiatric front.
Psychiatrists were being called upon to take leading roles in
planning and effectuating improvement and enlargement of mental
health services, research, and training and in public enlightenment.
American psychiatry was on the threshold of a new and dramatic
stage of development, and its practitioners were challenged
to transform the forward movement from undirected drift to guided
goals.
This was
the atmosphere in which the fifteen psychiatrists met on the
eve of the 1946 American Psychiatric Association convention.
The major questions before them were: What could be done
to galvanize the APA into an active force in promoting better
mental health for the nation? What could psychiatrists
do to advance that movement outside the APA? Several among
the attending fifteen spoke up strongly in favor of a clean
break from the APA and the creation of a new, independent body,
expressing the blunt opinion that the old organization was beyond
redemption as a medium of psychiatric advancement.
The purpose
of the informal gathering, as noted by a participant, was
to discuss ways and means to promote action for the advancement
of psychiatry in the current scene. The discussion
ranged far and wide. Several members of the group expressed
the opinion that the venerable APA was too heterogeneous and
unwieldy a body, its constitution too restrictive, to encourage
or even to permit effective action under its banner. These
skeptics suggested the creation of a new formal society, possibly
to be called the American Academy or College of Psychiatry.
The majority, however, were convinced that the APA could be
turned into a more effective agency. They favored the
creation of a small, informal group to help vitalize the APA
and to stimulate action on the pressing problems of postwar
American psychiatry.
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