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Am J Psychiatry 1946;102:694-700.
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Your committee recognized that it was faced with a complicated problem. On the one hand, it had the request of the President of the Association that a definite program be proposed. It also received from a small but very articulate minority of the membership, strong objections to the carrying out of its assignment. Finally, it was handicapped by the silence of 92% of the membership. (Members of the committee have been informed by quite a number of the members of the Association that they did not receive the questionnaire sent out routinely by the central office of the APA. The committee has no explanation for this.)On the basis of the number of replies received, or rather not received, one might infer that a large number of the members would seem to lack sufficient interest in the affairs of our Association.Therefore, your committee recommends that questions about reorganization be deferred pending a further expression of opinion on the part of the membership. It must be recognized that suggestions of change and reorganization, when first presented, stimulate disunity rather than unity. It must also be recognized that at present there are wide gaps in understanding between groups within the Association, representing various interests and kinds of psychiatric activity.With that in mind, your committee believes that the number one task before the Association, deserving our best attention, is not whether to reorganize in this way or that, or to remain as we are. Neither is it to meet together and report our latest thoughts and researches in a scientific meeting, as we customarily do in our annual meeting.Instead, we recommend that the next convention of the Association be devoted to a serious, down-to-earth discussion of the practical problems our members meet in their daily work ; that the convention be divided into discussion groups small enough to be workable; and that there be no, or at least only a few, formal speeches and papers. In setting up discussion groups the Program Committee should provide a way for members to exchange ideas about those problems with which they are most concerned. There should be predetermined topics in which they have expressed an interest. The function of the discussion group leader would be not to pontificate or expertize, but rather to encourage members of the group to put questions and express ideas of their own. Inasmuch as a majority of the membership is on the staffs of governmental hospitals, the emphasis of the convention must be on their problems.It is the hope of your committee that out of such a meeting steps in the direction of an effective work program for the Association may be taken and that increased unity of the membership may be promoted. We recommend that the question of reorganization be referred to the incoming administrationThe idea of dispensing with a formal program of papers, and dividing the participants of the convention into working groups is not new. Educational organizations and some other professional groups have used it with gratifying results.There are various techniques for setting up such a program. This is a matter for the Program Committee to consider. However, in order to explain more fully our recommendation we will give a brief elaboration of this idea.One simple plan is as follows: In order to find out how many groups should be set up and around what constellations of topics, a canvass of the membership would need to be made in advance by mail, offering selections of topics and soliciting additional ones. Registration for the convention is obtained in advance by mail and assignments to discussion groups would be made in advance also, on the basis of preferences indicated. Leaders for the groups would be assigned to particular topics and each leader would have a separate room for the meeting of his group. He would remain in the same room but would hold more than one session. The participants in the first session would split up at the end of that period and, according to previous assignment, move to other groups so that each one may have an opportunity then to take part in discussions with an entirely different group of men.The evening of the first day may be used by the discussion group leaders to report and discuss their experiences. They can also arrange for interchange of significant data between groups during the next day's session. Finally, they should decide what method is to be used for summation of the discussion and which decisions require action.The convention may be concluded by a half day or full day during which various groups could make reports to the entire assembly, and the necessary business of the Association would be transacted. Groups considering like topics should probably be arranged under various sections. Sections might be organized according to various fields of interest; the following are merely suggestive: [SEE SECTION AND TOPICS IN SOURCE PDF]We believe the problems of the institutional psychiatrists should have a major place on the program. Seventy to eighty percent of the APA membership serves on the staffs of governmental hospitals. These men serve at low salaries, and in some instances, under conditions of political control that cripple their effectiveness. Individually and as a group they carry responsibilities far beyond those of most other psychiatrists.Their discharged patients are not an alumni body which can lobby in the legislatures for their interests, as the alumni of the state universities can. The legislators are under pressure from the taxpayers to pare budgets. The state hospital staffs know better than anyone else how much of their energy and attention must be given to problems of economical administration, at the sacrifice of service to patients.The road boosters and universities have their lobbies. Who will speak for the state hospitals? This is especially pertinent now when the surplus funds of the states amount to a total of seven billion dollars.The importance of this problem must not be overlooked. The welfare of a half million psychiatric patients depends on it. Other problems are of very great importance and deserve thoughtful discussion. Medical education, recruitment of superior students into our field, expansion of research, Veterans Administration, standards for hospitals and clinics, and the National Health Bill, are only a few of these.

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