Group for the Advancement of Psychiatry - The Story of GAP

About

Table of Contents
Introduction
The Story of Gap
Postwar Challenge
Gap is Organized
Basis for Action
 No Auditors Needed
APA Reforms
Light on the Law
Psychiatry and Socials Issues
Child Psychiatry
Brain Surgery
International Relations
Federal Agencies
Medical Education
Industry
How Reports are Processed
Influence Abroad
Gap Symposia
Statements on Current Issues
Mental Health Campaign
The Essence of Gap
The Attack on Gap
A Small Striking Committee
The Financial History of Gap

 

Light on the Law

To a remarkable extent, the GAP reports were not only widely read, but widely used.  They were, in general, truly action documents, put to effective use not only by psychiatrists and psychiatric organizations, but by medical schools, psychology and social work departments and agencies, governmental bodies, courts, industrial plants, public schools, community health and welfare agencies, etc.  One of GAP's most influential committees was that on Psychiatry and the Law (originally called the Committee on Forensic Psychiatry).  Its first published report,  Commitment Procedures  (GAP Report No. 4, April 1948)< helped to modernize existing laws and regulations in many states and localities.  Its second report, :Psychiatrically Deviated Sex Offenders  (GAP Report No. 9, February 1950), was widely praised as the clearest statement of that complex problem to appear in recent years.  The report embodied, in essence, the advanced thinking of the foremost contemporary experts on the subject, making clear distinctions between morality and the law, and has been quoted repeatedly in lawyers' briefs and court opinions.  Even more influential, perhaps, was its third report,  Criminal Responsibility and Psychiatric Expert Testimony  (GAP Report No. 26, May 1954), which was cited as a basic document in the famous Durham opinion drawn up by Judge David L. Bazelon of the U.S. Court of Appeals, which overthrew the century-old McNaghten  right-and-wrong  rule in federal courts in favor of modern scientific interpretations of human behavior.

Psychiatry and Socials Issues

Soon after the U.S. Supreme Court rendered its classic decision on school integration in 1954, the GAP Committee on Social Issues started on an extensive and intensive study of psychiatric aspects of the problems of racial desegregation in communities affected by the historic opinion.  Consultations were held with educators, sociologists, anthropologists, authorities on public administration, race relations experts, and others over a period of more than three years.  Members of the GAP committee made personal observations in localities facing the integration problem.  Finally, in May, 1957, after many drafts and revisions, GAP Report No. 37,  Psychiatric Aspects of School Desegregation,  was published.  It was a sober exposition of expert insights, and included many useful recommendations for civic leaders seeking to introduce school integration with the least possible friction.  It has become a veritable handbook on human relations in many communities.

The GAP report came in for bitter attack from some extreme segregationists in certain areas of the deep South, but elsewhere it won high praise for its moderation and soundness.  A school superintendent in a community moving from segregation to integration congratulated the Committee on  a magnificent job in an area about which very little is known,  and made the following characteristic comment:   It will give some of us who are deeply involved in this problem supporting material that we have been searching for.

Some years earlier, in GAP Report No. 13 (July 1950), the Committee on Social Issues had drawn up a thought-provoking document entitled  The Social Responsibility of Psychiatry:  A Statement of Orientation.

The establishment by GAP of a Committee on Social Issues,  the report stated,  carried with it the tacit admission of the principle that the psychiatrist has a pertinent role in the study of social problems.   A considerable part of the report was devoted to a discussion of relationships between personality and society, leading to a suggestion that  concepts of psychiatry be broadened in the following directions :

  1. Redefinition of the concept of mental illness, emphasizing those dynamic principles which pertain to the person's interaction with society.
  2. Examination of the social factors which contribute to the causation of mental illness, and also influence its course and outcome.
  3. Consideration of the dynamic processes of intra-and intergroup relations.
  4. Consideration of the specific group-psychological phenomena which are relevant, in a positive sense, to community mental health.
  5. The development of criteria for healthy and pathological patterns of social organization.
  6. The development of criteria for social action, relevant to the promotion of individual and communal mental health.

One of the most active GAP committees has been that on Psychiatry and Social Work, which produced several important reports, now used widely in social work schools and agencies.  Its first two reports outlined the role of the psychiatric social worker in the psychiatric hospital and the psychiatric clinic (GAP Reports No. 2, January 1948, and No. 16, September 1950, respectively).  Its third (GAP Report No. 34, March 1956) outlined the functions of the consultant psychiatrist in a family service agency.  The GAP Committee on Hospitals, through its series of reports and through the radiating activities of its individual members, played a significant role in the sharp rise in mental hospital standards during the past dozen years.  Incidentally, it was while Dr. Kenneth E. Appel was chairman of this committee that he conceived his idea of a  Flexner Report  for psychiatry.*  As a result, the Commission on Mental Health and Mental Illness was established by Congressional act in 1955, with authority to make a sweeping survey of the field during a three-year period.  A sum of $1,250,000 was appropriated for the purpose.  It is interesting that the three top officers of this important commission were GAP members:  Dr. Jack R. Ewalt as director, Dr. Appel as president, and Dr. Leo H. Bartemeier as chairman of the board.