This paper examines the early origins of the shift away from institutional psychiatry in the USA. It focuses on the period between 1900 and 1950. Attention is paid to the role of neurologists and disaffected asylum doctors in the early emergence of extra-institutional practice; to the impact of the National Committee for Mental Hygiene and Thomas Salmon; to the limited role of psychoanalysis during most of this period; and to the influence of the Rockefeller Foundation’s decision to focus most of its effort in the medical sciences on psychiatry.
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