VUMC Reporter Series: Psychiatry has rich history, promising future
The Department of Psychiatry at Vanderbilt University School of Medicine is celebrating its 60th anniversary this year with new faculty, expanded services and cutting-edge research.
Under the leadership of Stephan Heckers, M.D., who became the department's fourth chairman last year, clinical services in the Vanderbilt Psychiatric Hospital and outpatient clinics are being revitalized and the research effort is burgeoning.
“There are two frontiers in psychiatry — genetics and neuroimaging,” said Heckers, a native of Germany who formerly directed the Schizophrenia and Bipolar Disorder Program at the famed McLean Hospital in Boston.
These twin frontiers — advances in functional brain imaging and genetic studies of mental illness — already are helping to improve diagnosis and selection of treatment for psychiatric disorders. “We are much closer to really translating our research findings into better patient care,” Heckers said.
Psychiatry has been taught at Vanderbilt since at least 1913, but before a formal department was established, psychiatry was largely the effort of one man — Frank Luton, M.D.
Luton, who earned his medical degree from Vanderbilt, trained in psychiatry at Johns Hopkins University. When he returned to Vanderbilt in 1929 as an assistant professor of Medicine, he reorganized the medical school's psychiatric curriculum.
He became known for ground-breaking studies of mental health needs in then-rural Williamson County. According to a history of the department written by Warren Webb, Ph.D., professor of Psychiatry (Psychology) Emeritus, the study “led to the first psychiatric outpatient clinic in a county health department.”
Luton worked tirelessly for the establishment of a psychiatry department. But it took World War II and the passage of the National Mental Health Act in 1946 to achieve that goal.
Of the 18 million men screened for service in World War II, nearly 2 million were rejected because of psychiatric or emotional disorders. Another 500,000 soldiers were discharged because of combat-related “psychiatric collapse.” Yet by the end of the war, there were only about 3,000 psychiatrists working in the United States.
In response, the National Mental Health Act, championed by Tennessee Congressman Percy Priest, authorized funding of psychiatric hospitals, clinics and training programs and establishment of the National Institute of Mental Health. With the awarding of a $31,000 federal grant in July 1947, Vanderbilt's long-awaited Department of Psychiatry became a reality.
Another Vanderbilt-trained physician, William Orr, M.D., was named the department's first chairman. During Orr's tenure, Vanderbilt's first 16-bed psychiatric inpatient unit opened in what is now the Clinical Research Center in Medical Center North. In 1961, Vanderbilt became the first medical school in the Southeast to open an inpatient child psychiatry unit.
In 1964, Orr also appointed the medical school's first black resident physician, Harold Jordan, M.D., who went on to become commissioner of the state Department of Mental Health and chair of Psychiatry at Meharry Medical College.
Luton preceded Jordan as state mental health commissioner, as did Richard Treadway, M.D., a Vanderbilt alumnus and associate clinical professor of Psychiatry. The current commissioner, Virginia Trotter Betts, M.S.N., R.N., J.D., is a graduate and former faculty member of the Vanderbilt University School of Nursing.
By the end of Orr's tenure in 1969, the Department of Psychiatry had grown more than tenfold to 57 full- and part-time faculty members.
Orr was succeeded by Marc Hollender, M.D., who continued to grow the faculty and, under the leadership of Charles Wells, M.D., reorganized the residency training program.
The department's third chairman, Michael Ebert, M.D., attracted several researchers during his 17-year tenure, including Peter Martin, M.D., who leads the Division of Addiction Medicine, and Herbert Meltzer, M.D., an internationally recognized authority on the treatment of schizophrenia.
The department added specialized programs in forensic psychiatry, geriatric psychiatry and mental health policy studies.
Ebert also played a critical role in planning, building and opening the Child and Adolescent Psychiatric Hospital in 1985 as a cooperative venture with Columbia/HCA HealthCare Corp.
Later renamed the Psychiatric Hospital at Vanderbilt, it was the first psychiatric hospital in the country to be built and operated cooperatively by an academic medical center and an investor-owned corporation. In 1999, Vanderbilt obtained sole ownership of the facility.
When Ebert retired in 2002, George Bolian, M.D., was appointed interim chair.
Bolian, who also has served as residency training director, director of the Division of Child and Adolescent Psychiatry and medical director of the psychiatric hospital, currently is vice chair for clinical services.
A new era for psychiatric research dawned in 2002 with the recruitment of John Gore, Ph.D., and his team from Yale University to establish the Vanderbilt University Institute for Imaging Science.
“That is a major reason why I'm here,” said Heckers, who studies the mechanisms of psychosis. “I wouldn't have come if Vanderbilt had not been so committed to neuroimaging.”