ABSTRACT
Psychiatric hospitals are almost as old as our country, but psychiatric units in general hospitals date to 1902, in the Albany Hospital. It was not until the 1920s, under the influence of Adolph Meyer, that there were psychiatric units in general hospitals akin to what we would recognize as such today (Kaufman, 1965). Initially, many of the general hospital units were like small private psychiatric hospitals, with lengths of stay measured in months and even years. There were several developments that occurred in close temporal proximity that profoundly affected the practice of psychiatry: World War II; academic psychiatry' embracing of psychoanalysis; the therapeutic community/social psychiatry/community psychiatry model and movement; the introduction of modern psychopharmacological agents; and the expansion of health insurance, both public and private. We review some of these factors.
