THE FIRST RESORT THE FIRST RESORT THE HISTORY OF SOCIAL PSYCHIATRY IN THE UNITED STATES MATTHEW SMITH Columbia University Press New York Columbia University Press Publishers Since 1893 New York Chichester, West Sussex cup . columbia. edu Copyright © 2023 Columbia University Press All rights reserved Library of Congress Cataloging- in- Publication Data Names: Smith, Matthew, 1973– author. Title: The first resort : the history of social psychiatry in the United States / Matthew Smith. Description: New York : Columbia University Press, [2022] | Includes bibliographical references and index. Identifiers: LCCN 2022027575 (print) | LCCN 2022027576 (ebook) | ISBN 9780231203920 (hardcover) | ISBN 9780231203937 (trade paperback) | ISBN 9780231555289 (ebook) Subjects: LCSH: Social psychiatry— United States—H istory—2 0th century. | Mental illness— United States—H istory—2 0th century. | Mental health services—U nited States— History—2 0th century. | Psychiatric hospital care— United States—H istory—2 0th century. Classification: LCC RC455 .S594 2022 (print) | LCC RC455 (ebook) | DDC 362.20973— dc23/eng/20220802 LC record available at https:// lccn . loc . gov / 2022027575 LC ebook record available at https:// lccn . loc . gov / 2022027576 Columbia University Press books are printed on permanent and durable acid- free paper. Printed in the United States of America Cover design: Milenda Nan Ok Lee Cover photo: H. Armstrong Roberts / ClassicStock / Alamy To Dashiell and Solveigh and the hope for a kinder world. And to Gordon Laxer, who taught me that such a world is possible. CONTENTS Abbreviations ix Introduction: The Magic Years 1 1 The Origins of Social Psychiatry 17 2 From Hobohemia to the Gold Coast 63 3 Swamp Yankees and Proper New Haveners 107 4 Madness in the Metropolis 151 5 From Cove to Woodlot 195 6 The Decline of Social Psychiatry 237 Epilogue: Social Psychiatry and Universal Basic Income 271 Acknowledgments 281 Notes 283 Bibliography 359 Index 397 ABBREVIATIONS AECM Albert Einstein College of Medicine AJP American Journal of Psychiatry AJS American Journal of Sociology APA American Psychiatric Association ASA American Sociological Association ASS American Sociological Society BMHC Bristol Mental Health Centre CMHC Community Mental Health Center DSM Diagnostic and Statistical Manual of Mental Disorders EFO Ethnic Family Operation GAP Group for the Advancement of Psychiatry IHR Institute of Human Relations IJR Institute for Juvenile Research ISHL Illinois Social Hygiene League JCMHC Joint Commission on the Mental Health of Children JCMIH Joint Commission on Mental Illness and Health LHMHS Lincoln Hospital Mental Health Service MHM Mental Health in the Metropolis: The Midtown Manhattan Study NCMH National Committee for Mental Hygiene NIMH National Institute of Mental Health