Group for the Advancement of Psychiatry - The Story of GAP

About GAP

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

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.

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.