It was in this context that the revolutionary idea for a psychiatric research institution came to fruition. The New York state legislature passed the State Care Act in 1890, assuming responsibility for the mentally ill in the state. As biological theories of mental illness became more popular, the State Commission in Lunacy advocated for a central pathology lab to service all the state mental hospitals. The lab, which opened in 1896, was the genesis of what was to become the New York State Psychiatric Institute.
The Columbia Connection
In 1902, the Pathological Institute, later renamed the Psychiatric Institute, moved to an abandoned bakery next to Manhattan State Hospital on Wards Island. Following a fire at Manhattan State Hospital, Dr. C. Floyd Haviland, chairman of the state hospital commission and a supporter of the institute, pushed for the creation of a state mental research hospital in Manhattan. Gov. Al Smith initiated a $50 million bond in 1923 for construction of new mental hospitals in New York state, with priority given to the Pathological Institute. Dr. Thomas Salmon, a professor of psychiatry at P&S, persuaded Dr. Haviland to build the hospital on the Washington Heights site where the medical school and Presbyterian Hospital were to move.
When Dr. Salmon began to gain support for the idea from Columbia faculty, he ran into one stumbling block Edward Harkness, donor of the medical center site. He opposed bringing the Psychiatric Institute into the fold, fearing political ramifications with state agencies. Greatly influenced by P&S dean William Darrach, Harkness relented. In 1925, an affiliation agreement was signed. Dr. George Kirby, in addition to his role as director of the institute, would become chairman of psychiatry at P&S, setting a precedent for the dual position.
The new building was dedicated at Columbia-Presbyterian Medical Center on Dec. 24, 1929. There was, from the beginning, a synergetic relationship between PI and Columbia, says Dr. Donald Kornfeld, associate dean and professor of psychiatry, who was a psychiatry resident at the institute from 1957 to 1960. We could recruit people and give them academic credentials, which attracted better candidates.
Dr. Kirby resigned as PI director in 1931 but remained chairman of psychiatry for less than a year. He was succeeded by Dr. Clarence Cheney, who had been president of the American Psychiatric Association, as director of the institute and chairman of psychiatry. Under his five-year tenure, the first Rorschach scoring technique was developed and a major epidemiological study began on ecological influences on psychiatric disorders.
In 1936, Nolan D.C. Lewis, a professor of neurology in the Neurological Institute, was named director and chairman of psychiatry, the first academician to be hired. He created the departments of neurochemistry and genetics and the psychoanalytic clinic. Novel patient treatments were introduced at the institute, including electroshock and insulin shock therapies.
Dr. Sidney Malitz, who began as a resident at the institute in 1949, recalls that Dr. Lewis looked and talked like a farmer and had a great cackle. He was known for having invented the square tomato to fit better into shipping crates. He was also very interested in the significance of art produced by psychotic patients and amassed a great collection, which he shipped to Germany to be printed. It was seized by the Nazis, who considered it subversive and set it ablaze.
The Psychopharmacological Revolution
In 1954, Lawrence C. Kolb became director, a position he held for more than 20 years before becoming commissioner of mental hygiene for New York state. In the early part of the 1950s under Dr. Kolbs leadership, the institute became one of the first to test psychopharmacological medications. He was a pioneer in the medical approach to narcotics addiction treatment and in public health research and treatment of mental illness. During his tenure, PI marked advances in social science research, created Columbia Universitys community and social psychiatry division, and opened a lithium clinic.
During the same period, Dr. Malitz remembers thorazine coming to the institute from France. I gave it to about 10 patients and they became far more manageable. Dr. Malitz was also among the practitioners who administered hallucinogens to patients, but they had no therapeutic effect. We also gave it to volunteers to see what its effect would be independent of psychosis. Medical students at P&S were among the volunteers. All it did was increase their anxiety.
It was a very exciting time, says Dr. Kornfeld. Testing of a variety of medications, including antidepressants and antipsychotics, was just beginning. PI was one of the few institutions to be studying them. We relied primarily on talk therapy in those days.
In the 1970s, Dr. Robert Spitzer, professor of psychiatry and chief of biometrics research at PI, led the development of several instruments widely used in psychiatric research, including the Schedule for Affective Disorders and Schizophrenia, the Research Diagnostic Criteria, the Global Assessment of Psychopathology, and the Structured Clinical Interview for "Diagnostic and Statistical Manual of Mental Disorders" (third edition, revised, 1987), or DSM-III (revised), and DSM-IV, "Diagnostic and Statistical Manual of Mental Disorders" (fourth edition, 1994).
In 1974, the Center for Neurobiology and Behavior was established under the direction of Dr. Eric Kandel. The integrated approach to neural science that the center developed has become the accepted model in the field. Studies conducted have led to insights into the biological mechanisms that underlie human behavior.
Under the leadership of Dr. Edward Sachar from 1976 through 1981, PI placed a renewed effort on biological research, child psychiatry research and training programs were expanded, and the departments of therapeutics and behavioral endocrinology were created.
Dr. Malitz, now professor emeritus of clinical psychiatry, served as acting director of PI from 1981 to 1984. During his tenure, in 1982, the Lawrence C. Kolb Research Laboratory on Haven Avenue opened, providing increased space for new scientific studies.
In 1984, Dr. Herbert Pardes, director of the National Institute of Mental Health at the NIH since 1978, became director of PI. He enhanced genetic research and was instrumental in getting the institute involved in the Human Genome Project. Also in the 1980s, the molecular genetics unit opened, headed by Dr. T. Conrad Gilliam. The lab assumed an international role in the search for genes associated with single-locus and complex psychiatric and neurological disorders.
Dr. Pardes became vice president for Columbia Health Sciences and dean of the Faculty of Medicine in 1989, while retaining the post of chairman of psychiatry. Dr. John Oldham, who was deputy director of PI and vice chairman of psychiatry, succeeded Dr. Pardes as director of the institute. He expanded the neuroscience division and strengthened research in schizophrenia.
In May 1994, ground was broken for a new home for the New York State Psychiatric Institute a six-story state-of-the-art research, teaching, and patient care building on Riverside Drive to replace the building used at Haven Avenue and 168th Street since 1929. It was completed in 1998.
The affiliation with P&S has been a major asset to the institutes growth as a premier research center, as expressed by Gov. George Pataki in a commendation plaque presented at PIs centennial celebration: The alliance with Columbia Universitys College of Physicians and Surgeons, it reads, gave rise to pioneering science and beneficial public policy to help those who suffer from crippling mental conditions.
Many areas of P&S have strong ties with the Psychiatric Institute. PI scientists have been an integral part of the U.S. Genome Project, using physical mapping techniques and sequencing to yield information about disease genes. Brain imaging has become an essential tool in the institutes research endeavors, with continued discovery of information about neurotransmitters involved in depression and aggression.
When PI moved to Washington Heights, five psychiatry residents trained and lived in the facility. In the 1930s, a psychiatric residency program and a postgraduate course for neurology and psychiatry were created. In the 1940s, formal psychoanalytic education was established at the institute. The Columbia Psychoanalytic Clinic for Training and Research was the first psychoanalytic institute to be affiliated with an American university. It has since been renamed the Center for Psychoanalytic Training and Research.
Today, PI and its faculty from P&S form one of the largest teaching departments of psychiatry in the world. The institutes Department of Medical Student Education in Psychiatry is responsible for approximately 500 medical students and 48 psychiatry residents and supervises a teaching curriculum at P&S that extends throughout the four years of medical school.
After Dr. Kolb arrived, he decided to designate a community service unit for the treatment of patients from the medical center neighborhood, a new concept at the time. His decision reflected two qualities of Dr. Kolbs leadership style: innovation and a sense of responsibility to the community.
Since then, the institute has made a commitment to providing treatment mostly free of charge to Washington Heights and Inwood residents. The Washington Heights Community Service provides services and medication to all eligible clients regardless of ability to pay. It consists of a 22-bed inpatient service unit and two outpatient clinics the Audubon Avenue Clinic and the Inwood Clinic. Other community services include the Neuroscience Clinic for Mood and Personality Disorders, offering free treatment or, in some cases, financial compensation for participation in studies; the Substance Treatment and Research Service, which provides free drug abuse treatment; and the Anxiety Disorders Clinic and the Hispanic Treatment Center, which offer treatment without charge to patients enrolled in research studies.
As the premier psychiatric research center in the country, PI is always among the nations top recipients of federal funds and research grants. This has fueled continued innovation and discoveries into the cause and treatment of mental illness. Some examples:
A major study of the effects of 9/11 on New York City school children helped secure a $33 million federal grant to the city to meet post-9/11 mental health needs of school children.
Ritalin has been accepted as the treatment for ADHD in school-age children due in large part to a national study led by Dr. Larry Greenhill.
Innovative research by Dr. John Mann has isolated an area of the brain through postmortem analyses of brain tissue that is implicated in suicide.
Dr. Madelyn Goulds work in youth suicide has helped illuminate the concept of suicide contagion and shaped guidelines for suicide reporting by the news media.
Nobel Laureate Eric Kandels work on the cellular processes that underlie learning and memory has implications for major psychiatric disorders.
Novel approaches to schizophrenia treatment may develop from research that showed a change in the dopamine receptor in the brains frontal cortex associated with memory defects.
Dr. Harold Sackeims research in electroconvulsive therapy helped set the standard for the treatment of medication-resistant depression.
Landmark research by Dr. Alexander Glassman established that the SSRI sertraline is effective and safe for depression in patients after heart attack.
These groundbreaking research discoveries and many others have made the Psychiatric Institute a leader in its field. One of the pleasures of working here is that clinical care, research, and education go on side by side, says Dr. Ronald Rieder, vice chairman for education in the Department of Psychiatry at Columbia and director of postgraduate education and the residency program at the institute. PI is a microcosm of psychiatry nationwide. So much goes on here and it is all so extraordinary. We have leaders in every area of psychiatry.
The institutes proximity to and close working relationship with Columbia, says Dr. Alexander Glassman, chief of psychiatric research for clinical psychopharmacology, has attracted great researchers. As a result, PI has spearheaded a revolution in psychiatry.
Eric Levy is a staff writer in the Office of External Relations at Columbia Health Sciences.