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.

Key sources:



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.


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.


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."


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.


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.


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.


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


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.


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.


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.


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.


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


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


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


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."


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.


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).


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-).


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.


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 health and developmental disorders.


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.


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


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 health.


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.


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.


APA reorganizes its component structure of councils and committees.


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.


© American Psychiatric Association, 2003