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Psychiatry gained its legitimate status as a medical specialty in the post-World War II years. In the place of the alienist of an earlier era, now stood the psychiatrist as a world citizen with a role to play in mending a fractured world. The World Federation for Mental Health was formed 50 years ago to help psychiatrists achieve that role.
Dilip Ramchandani, M.D.
History Notes Editor
By Eugene B. Brody, M.D.
The World Federation for Mental Health (WFMH) celebrates its 50th birthday in 1998, but its origins go back to 1909. In that year Clifford Beers, a recent mental hospital patient, formed the U.S. National Committee for Mental Hygiene and called for a network of mental hygiene societies throughout the world. The first step came in 1919 when he formed the predecessor of WFMH, the International Committee for Mental Hygiene (ICMH), along with Clarence Hincks, M.D., of the Canadian Medical Association, and the support of a number of well-known Americans, including Arthur Ruggles, M.D., superintendent of Butler Hospital; Adolph Meyer, M.D., of Johns Hopkins Hospital; and psychologist William James of Harvard.
In addition to the United States and Canada, the new organization’s first members were the mental hygiene societies of Finland and South Africa. In 1930 the ICMH’s first International Congress of Mental Hygiene attracted more than 4,000 participants to Washington, D.C. A second congress was held in Paris in 1937, but further international contact was halted by World War II.
The resurgence of an international mental hygiene movement was foreshadowed by the Canadian army’s creation, in autumn 1941, of the Directorate of Personnel Selection, led by psychiatrist George Brock Chisholm, M.D. In that role he became a friend and confidant of American psychiatrist Harry Stack Sullivan, M.D., then a consultant to the U.S. Selective Service. Both were concerned with how to select a civilian army and what public mental health resources would be necessary after the war.
Immediately after the bombing of Hiroshima in 1945, Sullivan invited Chisholm, then director of medical services for the Canadian army, to lecture at the William Alanson White Foundation. In two addresses, titled "The Psychiatry of Enduring Peace and Social Progress," he articulated his view of psychiatry and psychology as the disciplines that could make it possible for human beings to abandon war and become "citizens of the world." He and Sullivan were already thinking in terms of "a psychiatry of peoples."
Not long thereafter a number of international organizations asked the National Association for Mental Health of England and Wales to organize a third international mental hygiene congress. John R. Rees, M.D., who had been a distinguished senior consultant in psychiatry to the British Army, accepted the tasks of organizing the congress and serving as its president. In 1946 his first move was to go to New York, where he obtained ICMH’s agreement (through its president, Frank Fremont-Smith, M.D., of the Macy Foundation) to sponsor the projected congress and recruited the North American psychiatric leadership who he considered were essential to its success. In the small office of George Stevenson, M.D., medical director of the U.S. Committee for Mental Hygiene and APA president-elect, he met with Hincks, Ruggles, and Chisholm, now slated to be the first director general of the U.N.’s new World Health Organization (W.H.O.).
Chisholm, according to Rees, was "the person primarily responsible" for suggesting a new organization to be called the World Federation for Mental Health. The idea was immediately accepted by his four colleagues, and its Articles of Association were produced in 1947. Meanwhile, Rees had initiated preparatory groups in many countries. In the United States participants included members of the infant Group for the Advancement of Psychiatry (GAP), led by recent Brigadier General William Menninger. They were sensitive to the new organization’s definition of purpose: "To promote among all peoples and nations the highest possible level of mental health. . .in its broadest biological, medical, educational, and social aspects." But many in APA were critical of colleagues who, in their view, had no business dabbling in social concerns.
Meanwhile, Sullivan, Canadian social psychologist Otto Klineberg, M.D., Ph.D., and others had been further stimulated by participation in UNESCO’s project on reducing international tensions. In the last week of July and the first week of August 1948, they were joined by Chisholm, social scientists such as Margaret Mead (the federation’s second U.S. president), and others in an international commission convened at Sullivan’s suggestion. It produced the new federation’s founding document, Mental Health and World Citizenship, which was adopted during the Third International Congress on Mental Hygiene in London on August 21. John Rees was the organization’s first president (1948-49) and its first director (1949-61). According to Rees’s reminiscences, sensitivities about U.S. dominance delayed the election of a U.S. president until the election of Frank Fremon-Smith, M.D., for the 1954-55 term.
Dr. Brody has been the secretary general of the World Federation for Mental Health since 1983.