PAST, PRESENT, AND FUTURE OF PSYCHIATRY - PERSONAL REFLECTIONS

Objective: To review the past half century of North American psychiatr y from personal experience and to gauge its future prospects. Method: An examination of the relevant literature, recollections from a long a cademic career, and analysis of trends. Results: The pendulum of psych iatric theory continues its swing from its psychological to its biolog ical pole; current economic forces are driving it toward reductionisti c biology. The very, considerable gains in the psychosocial and neurob iogical knowledge base of our field will ultimately have a potent yiel d in patient care once the restrictive controls on its application to service provision are lifted. Conclusion: The future of research in th e sciences basic to psychiatry has never been more promising. How rapi dly progress will occur will be a function of the resources society is willing to commit to mental health research. The prognosis for the tr anslation of the new findings to clinical practice will depend on whet her professionals can mobilize public support for quality care for the mentally ill.