The American Psychiatric Association (APA) is the main

professional organization A professional association (also called a professional body, professional organization, or professional society) usually seeks to further a particular profession, the interests of individuals and organisations engaged in that profession, and th ...

of psychiatrists and trainee psychiatrists in the United States, and the largest

psychiatric Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry. Initial psy ...

organization in the world. It has more than 37,000 members are involved in psychiatric practice, research, and academia representing a diverse population of patients in more than 100 countries. The association publishes various journals and pamphlets, as well as the '' Diagnostic and Statistical Manual of Mental Disorders'' (DSM). The DSM codifies psychiatric conditions and is used mostly in the United States as a guide for diagnosing mental disorders. The organization has its headquarters in Washington, DC.

History

At a meeting in 1844 in Philadelphia, thirteen superintendents and organizers of

insane asylums The lunatic asylum (or insane asylum) was an early precursor of the modern psychiatric hospital. The fall of the lunatic asylum and its eventual replacement by modern psychiatric hospitals explains the rise of organized, institutional psychiatry ...

and hospitals formed the Association of Medical Superintendents of American Institutions for the Insane (AMSAII). The group included

Thomas Kirkbride Thomas Story Kirkbride (July 31, 1809December 16, 1883) was a physician, alienist, hospital superintendent for the Institute of the Pennsylvania Hospital, and primary founder of the Association of Medical Superintendents of American Institutions ...

, creator of the asylum model which was used throughout the United States. The group was chartered to focus "primarily on the administration of hospitals and how that affected the care of patients", as opposed to conducting research or promoting the profession. In 1893, the organization changed its name to the ''American Medico-Psychological Association''. In 1921, the association changed that name to the present ''American Psychiatric Association''. The association was incorporated in 1927. The cover of the publication ''Semi-Centennial Proceedings of the American Medical Psychological Association'', which the association distributed in 1894 at its 50th annual meeting in Philadelphia, contained the first depiction of the association's official

seal Seal may refer to any of the following: Common uses * Pinniped, a diverse group of semi-aquatic marine mammals, many of which are commonly called seals, particularly: ** Earless seal, or "true seal" ** Fur seal * Seal (emblem), a device to imp ...

. The seal has undergone several changes since that time. The present seal is a round medallion with a purported likeness of

Benjamin Rush Benjamin Rush (April 19, 1813) was a Founding Father of the United States who signed the United States Declaration of Independence, and a civic leader in Philadelphia, where he was a physician, politician, social reformer, humanitarian, educa ...

's profile and 13 stars over his head to represent the 13 founders of the organization. The outer ring contains the words "American Psychiatric Association 1844." Rush's name and an MD are below the picture. An association history of the seal states:

The choice of Rush (1746–1813) for the seal reflects his place in history. .... Rush's practice of psychiatry was based on bleeding, purging, and the use of the tranquilizer chair and gyrator. By 1844 these practices were considered erroneous and abandoned. Rush, however, was the first American to study mental disorder in a systematic manner, and he is considered the father of American Psychiatry.

In 2015, the association adopted a new logo that depicts the serpent-entwined Rod of Asclepius superimposed over the image of two hemispheres of a human brain. The logo appears next to the words "American Psychiatric Association", with the word "Psychiatric" in bold type; the tagline "Medical leadership for mind, brain and body" appears below the logo. The association will continue to use the seal bearing Rush's profile for ceremonial purposes and for some internal documents.

Organization and membership

APA is led by the President of the American Psychiatric Association and a board of trustees with an executive committee. APA reports that its membership is primarily medical specialists who are qualified, or in the process of becoming qualified, as psychiatrists. The basic eligibility requirement is completion of a residency program in psychiatry accredited by the Residency Review Committee for Psychiatry of the Accreditation Council for Graduate Medical Education (ACGME), the

Royal College of Physicians and Surgeons of Canada The Royal College of Physicians and Surgeons of Canada (french: Collège royal des médecins et chirurgiens du Canada) is a regulatory college which acts as a national, Non-profit organization, nonprofit organization established in 1929 by a speci ...

(RCPS , or the American Osteopathic Association (AOA). Applicants for membership must also hold a valid medical license (with the exception of medical students and residents) and provide one reference who is an APA member. APA holds an annual conference attended by an American and international audience. APA is made up of some 76 district associations throughout the country.

Foundation

APA operates a non-profit subsidiary called the American Psychiatric Association Foundation (APAF), offering community-based programs and research initiatives intended to better understand and support issues of mental health. Its strategic partners include the Council of State Governments (CSG) Justice Center,

Substance Abuse and Mental Health Services Administration The Substance Abuse and Mental Health Services Administration (SAMHSA; pronounced ) is a branch of the U.S. Department of Health and Human Services. It is charged with improving the quality and availability of treatment and rehabilitative services ...

(SAMHSA) and the

National Association of Counties The National Association of Counties (NACo) is an organization that represents county governments in the United States.research and development through its Corporate Alliance. Current and recent members of the alliance include: Donors to the foundation in 2019 include the

Austen Riggs Center The Austen Riggs Center is a psychiatric treatment facility in Stockbridge, Massachusetts. It was founded by Austen Fox Riggs in 1913 as the Stockbridge Institute for the Study and Treatment of Psychoneuroses before being renamed in honor of Au ...

BB&T BB&T Corporation (previously known as the Branch Banking and Trust Company) was one of the largest banking and financial services firms in the United States, based in Winston-Salem, North Carolina. In 2019, BB&T announced its intentions to merge ...

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, McLean Hospital,

Menninger Foundation The Menninger Foundation was founded in 1919 by the Menninger family in Topeka, Kansas. The Menninger Foundation, known locally as Menninger's, consists of a clinic, a sanatorium, and a school of psychiatry, all of which bear the Menninger name. ...

, NeuroStar, Newport Academy,

NewYork-Presbyterian Hospital The NewYork-Presbyterian Hospital is a nonprofit academic medical center in New York City affiliated with two Ivy League medical schools, Cornell University and Columbia University. The hospital comprises seven distinct campuses located in the New ...

, Sheppard Pratt, and Silver Hill Hospital.

Publications and campaigns

APA position statements, clinical practice guidelines, and descriptions of its core diagnostic manual (the DSM) are published. APA publishes several journals focused on different areas of psychiatry, for example, academic, clinical practice, or news.

Top five Choosing Wisely recommendations

In coordination with the

American Board of Internal Medicine The American Board of Internal Medicine (ABIM) is a 501(c)(3) nonprofit, self-appointed physician-evaluation organization that certifies physicians practicing internal medicine and its subspecialties. The American Board of Internal Medicine is n ...

, the APA proposes five recommendations for physicians and patients. The list was compiled by members of the Council on Research and Quality Care. The APA places a primary focus on antipsychotic medications due to a rapid increase in sales, from $9.6 billion in 2004 to $18.5 billion in 2011. # Don't prescribe antipsychotic medications to patients for any indication without appropriate initial evaluation and appropriate ongoing monitoring. # Don't routinely prescribe 2 or more antipsychotic medications concurrently. # Don't prescribe antipsychotic medications as a first-line intervention to treat behavioral and psychological symptoms of dementia. # Don't routinely prescribe antipsychotic medications as a first-line intervention for insomnia in adults. # Don't routinely prescribe antipsychotic medications as a first-line intervention for children or adolescents for any diagnosis other than psychotic disorders.

Notable figures

* Donald Cameron, was president of the American Psychiatric Association from 1952 to 1953. He conducted coercive experiments widely denounced as unethical, including involuntary electroshock therapy, drug administration, and prolonged confinement and sensory deprivation funded as part of the Central Intelligence Agency Project MKUltra. * Enoch Callaway, psychiatrist, pioneer in biological psychiatry. * Adolf Meyer, former psychiatrist-in-chief at the Johns Hopkins Hospital, was the president of the American Psychiatric Association from 1927 to 1928 and was one of the most influential figures in psychiatry in the first half of the twentieth century. * Robert Spitzer was the chair of the task force of the third edition of the DSM. * Herb Pardes past president and noted figure in American psychiatry.

Drug company ties

In his book '' Anatomy of an Epidemic'' (2010), Robert Whitaker described the partnership that has developed between the APA and pharmaceutical companies since the 1980s. APA has come to depend on pharmaceutical money. The drug companies endowed continuing education and psychiatric "grand rounds" at hospitals. They funded a political action committee in 1982 to lobby Congress. The industry helped to pay for the APA's media training workshops. It was able to turn psychiatrists at top schools into speakers, and although the doctors felt they were independents, they rehearsed their speeches and likely would not be invited back if they discussed drug side effects. "Thought leaders" became the experts quoted in the media. As Marcia Angell wrote in '' The New England Journal of Medicine'' (2000), "thought leaders" could agree to be listed as an author of ghostwritten articles, and she cites Thomas Bodenheimer and David Rothman who describe the extent of the drug industry's involvement with doctors. ''

The New York Times ''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid d ...

'' published a summary about antipsychotic medications in October 2010. In 2008, for the first time, Senator Charles Grassley asked the APA to disclose how much of its annual budget came from drug industry funds. The APA said that industry contributed 28 percent of its budget ($14 million at that time), mainly through paid advertising in APA journals and funds for continuing medical education. The APA receives additional funding from the pharmaceutical industry through its American Psychiatric Association Foundation (APAF), including Boehringer Ingelheim,

Janssen Pharmaceuticals Janssen Pharmaceuticals is a pharmaceutical company headquartered in Beerse, Belgium, and wholly-owned by Johnson & Johnson. It was founded in 1953 by Paul Janssen. In 1961, Janssen Pharmaceuticals was purchased by New Jersey-based American c ...

, and

Takeda Pharmaceutical Company The is a Japanese multinational pharmaceutical company, with partial American and British roots. It is the largest pharmaceutical company in Asia and one of the top 20 largest pharmaceutical companies in the world by revenue (top 10 followin ...

, among others.

Controversies

In the 1964 election, '' Fact'' magazine polled American Psychiatric Association members on whether Barry Goldwater was fit to be president and published "The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater". This led to a ban on the diagnosis of a public figure by psychiatrists who have not performed an examination or been authorized to release information by the patient. This became the Goldwater rule. Supported by various funding sources, the APA and its members have played major roles in examining points of contention in the field and addressing uncertainties about psychiatric illness and its treatment, as well as the relationship of individual mental health concerns to those of the community. Controversies have related to

anti-psychiatry Anti-psychiatry is a movement based on the view that psychiatric treatment is often more damaging than helpful to patients, highlighting controversies about psychiatry. Objections include the reliability of psychiatric diagnosis, the questionabl ...

and

disability rights The disability rights movement is a global social movement that seeks to secure equal opportunities and equal rights for all people with disabilities. It is made up of organizations of disability activists, also known as disability advocat ...

campaigners, who regularly protest at American Psychiatric Association offices or meetings. In 1971, members of the Gay Liberation Front organization protested the 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 and the two organizations exchanged views on the evidence. The APA's DSM came under criticism from autism specialists

Tony Attwood Anthony John Attwood (born 9 February 1952) is a British psychologist notable for his work on Asperger syndrome. He resides in Queensland, Australia, where he is an Associate Professor at Griffith University. Education He received an honours deg ...

and Simon Baron-Cohen for proposing the elimination of

Asperger's syndrome Asperger syndrome (AS), also known as Asperger's, is a former neurodevelopmental disorder characterized by significant difficulties in social interaction and nonverbal communication, along with restricted and repetitive patterns of behavio ...

as a disorder and replacing it with an autism spectrum severity scale. Roy Richard Grinker wrote a controversial editorial for ''The New York Times'' expressing support for the proposal. The APA president in 2005, Steven Sharfstein, praised the pharmaceutical industry but argued that American psychiatry had "allowed the biopsychosocial model to become the bio-bio-bio model" and accepted "kickbacks and bribes" from pharmaceutical companies leading to the over-use of medication and neglect of other approaches. In 2008 APA was the focus of congressional investigations on how pharmaceutical industry money shapes the practices of nonprofit organizations that purport to be independent. The drug industry accounted in 2006 for about 30 percent of the association's $62.5 million in financing, half through drug advertisements in its journals and meeting exhibits, and the other half sponsoring fellowships, conferences and industry symposiums at its annual meeting. The APA came under increasing scrutiny and questions about conflicts of interest. The APA president in 2009–10, Alan Schatzberg, was identified as the principal investigator on a federal study into the drug Mifepristone for use as an antidepressant being developed by Corcept Therapeutics, a company Schatzberg had created and in which he had several million dollars' equity. In 2021, the APA issued an apology for its historical role in perpetuating racism.

References

Footnotes

Bibliography

External links

* * JAMA (The

Journal A journal, from the Old French ''journal'' (meaning "daily"), may refer to: *Bullet journal, a method of personal organization *Diary, a record of what happened over the course of a day or other period *Daybook, also known as a general journal, a ...

of the American Medical Association) Psychiatr
JAMA Psychiatry – The Science of Mental Health and The Brain

Paul Lowinger papers
Kislak Center for Special Collections, Rare Books and Manuscripts, University of Pennsylvania. Paul Lowinger was a psychiatrist and founder of the Institute of Social Medicine and Community Health, and his papers are largely concerned with his work as a psychiatrist and activist, with significant portions devoted to his work with the American Psychiatric Association. {{Authority control Organizations established in 1844