Daniel Blain: Founder of This Journal

Fifty years ago Daniel Blain, M.D., the American Psychiatric Association's first medical director, established this journal to promote the exchange of information between clinical and administrative personnel in mental health facilities and others who provide care and advocacy for individuals with mental disorders. Today the journal still serves the same purpose.

Fifty years ago care was provided mainly at public mental hospitals and a small number of private hospitals and clinics. The upheavals of the Depression of the 1930s, followed by World War II in the 1940s, had resulted in understaffed, overcrowded public mental hospitals with varying degrees of custodial care. The war, which brought many physicians into psychiatry, also resulted in a reorganization of APA and the creation of the new position of medical director. Dan Blain was selected for the job.

Dan was born in China to missionary parents. He graduated from Vanderbilt University Medical School in 1929 and later opened a private practice in New York. The war brought him into the public arena via the U.S. Public Health Service and the Merchant Marine. As the war ended and thousands of veterans became charges of the Veterans Administration, Dan was chosen to head the VA's psychiatry and neurology division, where he remained for two years. In 1948, as APA medical director, he transferred APA's business office from New York to Washington, D.C.

Dan began to visit the APA membership, many of whom were employed in state hospitals. He was appalled by the inhumane conditions of patient care he saw in some hospitals and was moved by the efforts of the superintendents despite inadequate budgets, facilities, and staff. But he also saw some innovative and helpful programs that improved care despite adverse conditions. How to bring these good practices to the attention of all hospitals was the problem.

Dan solved the problem by organizing the first Mental Hospital Institute, held in Philadelphia in April 1949. The attendance numbered 125, mainly superintendents, with a few legislators and hospital board members. The next year's institute, held in St. Louis, drew 250 participants.

The early institutes served their purpose, and although the proceedings were published and distributed, the reach of the information was limited. Dan sought a means of gathering and disseminating good practices on a wide scale. To do so, he hired a journalist, Pat Vosburgh, to produce an ongoing publication. The four-page newsletter he established in January 1950 evolved into a journal, Mental Hospitals, a year later. In 1966, reflecting changes in treatment settings, Mental Hospitals changed its name to Hospital and Community Psychiatry, and in 1995 the journal became Psychiatric Services.

Dan resigned as APA medical director after ten years and went on to serve the field in a number of challenging positions, including director of mental hygiene for the state of California. He served as APA president in 1964–1965 and received APA's Distinguished Service Award in 1980. He died in 1981 at the age of 82.

I knew Dan Blain, attended the first and second Mental Hospital Institutes (and many others that followed), and helped Pat Vosburgh edit the journal during its early years. I think Dan would be pleased with the path the journal has taken over these past 50 years and with the people who have produced and contributed to it.