Association of Medical Superintendents of American Institutions for the Insane

Last updated

The Association of Medical Superintendents of American Institutions for the Insane, also known as The Superintendents' Association, was organized in Philadelphia in October, 1844 at a meeting of 13 superintendents, making it the first professional medical specialty organization in the U.S.


The objectives of the Association were "to communicate their experiences to each other, cooperate in collecting statistical information relating to insanity, and assist each other in improving the treatment of the insane." The name of the organization was changed in 1892 to The American Medico-Psychological Association to allow assistant physicians working in mental hospitals to become members. In 1921, the name was changed to the present American Psychiatric Association.

The original thirteen

At a meeting in 1844 in Philadelphia, thirteen superintendents and organizers of insane asylums and hospitals formed the Association of Medical Superintendents of American Institutions for the Insane (AMSAII). The group included Thomas Kirkbride, creator of the asylum model which was used throughout the United States. [1]

It 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. [2]

At the meeting they passed the first proposition of the new organization: "It is the unanimous sense of this convention that the attempt to abandon entirely the use of all means of personal restraint is not sanctioned by the true interests of the insane." [3]

The list of the "original thirteen" members and their organizations provide a good index to well-established psychiatric institutions in the U.S. as of 1844. They included: [4]

The American Journal of Insanity

The American Journal of Insanity (AJI) was first published in June, 1844, by Amariah Brigham, Superintendent of the Utica (N.Y.) State Hospital. He was said to have been the author of the entire first issue, which included six articles, a list of existing mental asylums in the U.S., and notes on insanity from France. His aim for The Journal was to acquaint its readers with the nature and varieties of mental illness and with methods of prevention and care for patients.

The AJI remained the property of the Utica State Hospital, though it served as the official publication of the Superintendents’ Association. In 1892, the journal was bought by The Association, and in 1921, the name was changed to the present American Journal of Psychiatry by The American Psychiatric Association.

Relations with the American Medical Association

The American Medical Association (AMA) was organized in 1847 in Philadelphia through the efforts of Nathan Davis and Nathaniel Chapman primarily to deal with the lack of regulations and standards in medical education and medical practice. Some mental hospital superintendents became active members. Cordial relations between the two groups continued, and members of each attended the others’ meetings.

In 1854, the AMA established a Committee on Insanity which ended in 1867, when a psychology section was organized. Merger of the AMA and the Superintendents’ Association was considered frequently over the years. In 1871, the Superintendents' Association delegated Dr. John Curwen to attend the AMA meeting in San Francisco and explain The Association's rejection of the invitation to a merger. The reasons were that the Superintendents held their annual meeting in a venue where an asylum was located both to assure citizen interest in the care of the insane and to allow the superintendents to visit the asylum. Also, the Association's meetings were devoted solely to topics relating to the care of the mentally ill, an area of limited interest to general practitioners, and the Association included only psychiatric hospital superintendents.

Over the years, the relationship between the two organizations has waxed and waned. In the 21st century, the APA is an active participant in AMA activities.

The neurologists, S. Weir Mitchell, and The Superintendents' Association

The American Neurological Association, organized in 1875, grew out of the Civil War experiences of physicians who had been involved in caring for soldiers with traumatic injuries of the brain and nerves. The neurologists were mainly in private practice and considered mental illness within their purview because the brain was involved. Relations between the neurologists and the Superintendents' Association were marked by mistrust and hostility. Believing that the asylums were mismanaged and providing inadequate care to patients, in some places, the neurologists called on state legislatures to investigate the asylums. [5]

In 1894, to mark the 50th anniversary of its founding, The Superintendents' Association invited Dr. S. Weir Mitchell, a prominent Philadelphia neurologist to address the annual meeting. After querying a number of his colleagues, Dr. Mitchell delivered a scathing address to the superintendents. He said that they had isolated themselves from medicine and they sought no new scientific information through their work, their medical records were inadequate, and their educational efforts among the profession were minimal. The superintendents made little reply to the address. [5] [6]

In 1897, Dr. Bernard Sachs, a New York neurologist, was invited to address the Association's annual meeting. He gave a placating speech saying that both professional groups should be working together in the interest of patients. [5]

Related Research Articles

American Psychiatric Association United States organisation of psychiatrists

The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. Its some 38,800 members are mainly American but some are international. 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 worldwide as a guide for diagnosing disorders.

Pliny Earle (physician) American psychiatrist

Pliny Earle II, MD was an American physician, psychiatrist, and poet. He was the son of the inventor Pliny Earle of the Earle family.

Utica Psychiatric Center mental health facility

The Utica Psychiatric Center, also known as Utica State Hospital, opened in Utica on January 16, 1843. It was New York's first state-run facility designed to care for the mentally ill, and one of the first such institutions in the United States. It was originally called the New York State Lunatic Asylum at Utica. The Greek Revival structure was designed by Captain William Clarke and its construction was funded by the state and by contributions from Utica residents.

Amariah Brigham

Amariah Brigham was an American psychiatrist and, in 1844, one of the founding members of the Association of Medical Superintendents of American Institutions for the Insane, which eventually became the American Psychiatric Association. While serving as the first director of the Utica Psychiatric Center, Dr. Brigham launched and became the first editor of the Association's official journal, The American Journal of Insanity.

Jean-Étienne Dominique Esquirol French psychiatrist (1772–1840)

Jean-Étienne Dominique Esquirol was a French psychiatrist.

Thomas Story Kirkbride American psychiatrist

Thomas Story Kirkbride was a physician, advocate for the mentally ill, and founder of the Association of Medical Superintendents of American Institutions for the Insane (AMSAII), a precursor to the American Psychiatric Association.

Isaac Ray Fourth president of the American Psychiatric Association

Isaac Ray was an American psychiatrist, one of the founders of the discipline of forensic psychiatry. In 1838, he published A Treatise on the Medical Jurisprudence of Insanity (Boston), which served as an authoritative text for many years.

The Opal (1851–1860) is a ten volume journal written, edited and printed by the patients of the Utica State Lunatic Asylum, circa 1851. On its more than 3,000 pages, writers talked of their experiences and world views, giving great insight to the environment of New York's premiere state-operated Asylum, in Utica, New York. Themes that continuously arose in the poetry, prose, political commentary, and articles about insanity include issues concerning medication, restraint, seclusion, human rights, liberty, overcoming oppression, and support.

William A. F. Browne

Dr William Alexander Francis Browne (1805–1885) was one of the most significant asylum doctors of the nineteenth century. At Montrose Asylum (1834–1838) in Angus and at the Crichton Royal in Dumfries (1838–1857), Browne introduced activities for patients including writing, group activity and drama, pioneered early forms of occupational therapy and art therapy, and initiated one of the earliest collections of artistic work by patients in a psychiatric hospital. In an age which rewarded self-control, Browne encouraged self-expression and may therefore be counted alongside William Tuke, Vincenzo Chiarugi and John Conolly as one of the pioneers of the moral treatment of mental illness. Sociologist Andrew Scull has identified Browne's career with the institutional climax of nineteenth century psychiatry.

"Browne was one of the reformers of the asylum care of the insane whose improvements and innovations were chronicled in his annual reports from The Crichton Royal Institution, but who in addition published almost on the threshold of his career a sort of manifesto of what he wished to see accomplished...." Richard Hunter and Ida Macalpine (1963) Three Hundred Years of Psychiatry 1535–1860, page 865.

Lunatic asylum Place for housing the insane, an aspect of history

The lunatic asylum was an early precursor of the modern psychiatric hospital. The Quakers in Philadelphia were the first in America to make an organized effort to care for the mentally ill. The newly opened Pennsylvania Hospital in Philadelphia provided rooms in the basement complete with shackles attached to the walls to house a small number of mentally ill patients.

John Charles Bucknill

Sir John Charles Bucknill was an English psychiatrist and mental health reformer. He was the father of judge Sir Thomas Townsend Bucknill QC MP.

Henry Mills Hurd

Henry Mills Hurd was the first director of the Johns Hopkins Hospital and remained in that post for 22 years (1889–1911) following which he was appointed Secretary to the Board of Trustees (1911–1927). He was also the first Professor of Psychiatry at the medical school from its opening in 1893 until 1905.

St. Brendans Hospital, Dublin Hospital in North Dublin, Ireland

St. Brendan's Hospital was a psychiatric facility located in the north Dublin suburb of Grangegorman. It formed part of the mental health services of Dublin North East with its catchment area being North West Dublin. It is now the site of a modern mental health facility known as the "Phoenix Care Centre". Since the official opening of the Richmond Lunatic Asylum in 1815 the Grangegorman site has continuously provided institutional facilities for the reception of the mentally ill until the present day. As such the Phoenix Care Centre represents the continuation of the oldest public psychiatric facility in Ireland.

John Curwen, M.D. (1821–1901) was Superintendent of the first public mental hospital in Pennsylvania. He personally knew the thirteen founders of the Association of Medical Superintendents of American Institutions of the Insane (AMSAII), now the American Psychiatric Association. He served as secretary-treasurer of the Association for 34 years (1856–1890).

John B. Chapin M.D. (1829-1918) was an American physician and mental hospital administrator. He was an advocate for the removal of mentally ill patients from the almshouses in New York State to a hospital setting and helped to pass a state law that provided hospital care for the patients.

Edward Nathaniel Brush, M.D. (1852–1933) was an American physician, a mental hospital administrator, and an editor of psychiatric journals.

Owen Copp, M.D. (1858-1933) was an American physician and a psychiatric administrator. He was president of the American Psychiatric Association from 1921 to 1922, and proposed a progressive program in mental health in the United States.

George Alder Blumer, M.D. (1857-1940) was a physician, a mental hospital administrator, and a journal editor. He was a leader in the provision of humanitarian care for mental hospital patients.

Mohawk Valley Psychiatric Center is a psychiatric hospital located in Utica. Its predecessor was established in 1836.


  1. Ozarin, Lucy D. (2005-12-01). "Past and Current Views on the Use of Seclusion and Restraint in Treatment". Psychiatric Services. 56 (12): 1621–a. doi:10.1176/ ISSN   1075-2730.
  2. "The Original Thirteen". Hospital & Community Psychiatry. 27 (7): 464–467. July 1976. doi:10.1176/ps.27.7.464. PMID   776775.
  3. Ozarin, Lucy D. (December 2005). "Past and Current Views on the Use of Seclusion and Restraint in Treatment". Psychiatric Services. 56 (12): 1621–1622. doi:10.1176/ PMID   16339632.
  4. Hurd, Henry M.; Drewry, William F.; Dewey, Richard; Pilgrim, Charles W.; Blumer, G. Adler; Burgess, T.J.W. (1916). "Association of Medical Superintendents of American Institutions for the Insane, 1844-1893". In Hurd, Henry Mills (ed.). The Institutional Care of the Insane in the United States and Canada. 1. Baltimore, MD: Johns Hopkins Press. pp. 11–12 via Google Books.
  5. 1 2 3 "Diseases of the Mind: Highlights of American Psychiatry through 1900 - 19th Century Psychiatric Debates". Retrieved 2017-07-17.
  6. Mitchell, S.W. (1894). "Address before the fiftieth annual meeting of the American Medico-Psychological Association". Proceedings of the American Medico-Psychological Association. 1. pp. 101–121.