With large funding now going to the treatment of mental health patience—especially returning soldiers—there was greater public awareness of and concerns about mental illness. The Veterans Administration was established, and a new, more consistent classification system was called for. Within the United States, there were actually three competing classification systems. The military was using the Armed Forces Nomenclature, while a 1942 system (the Standard Classified Nomenclature of Disease) was used with the Civilian population. Finally, the Veterans Administration had its own classification system. None of these were fully aligned with the systems being used in traditional medical settings (as is still the case).
What was to be done? As often seems to be the case when there is a major crisis in a specific society—and when the existing assumptive world is being challenged, a commission was convened made up of “experts” in the field. These commissions were often at least implicitly given the charge not so much of challenging and changing the existing set of assumptions, but rather of repairing the dysfunction of the existing world and patching up the cracks that have appears so that everything can proceed without further controversy or internecine warfare. Such was the case when the American Psychiatric Association convened a commission to establish a common and consistent classification system for mental illness.
The APA Committee on Nomenclature and Statistics prepared a report in 1952 that led to the first version of DSM. A first draft of DSM was sent out to about ten percent of the members of APA (but not other mental health professionals) for their approval. Virtually, all of the respondents approved of the draft and DSM was firmly founded and now fortified by those with the greatest authority (accepted expertise) and clout (access to governmental legislation and funding) A second draft was produced and approved by the APA membership in 1951. DSM-I ended up being 145 pages long and included a total of 106 disorders—substantial but nothing compared with the length of and number of classifications offered in later editions.
Perhaps it is most important to note that the first DSM version tended to be aligned in structure with the classification system being used by the traditional medical community. In fact, many of the descriptions of mental illnesses were borrowed directly from Medical 203 (a widely used and accepted document in the medical field). If we are going to treat emotional and mental disturbances as “mental illness” then we need to look a lot like the physicians. The first versions of DSM were also closely aligned with psychodynamic (psychoanalytic) perspectives on mental illness. The more behavioral and cognitive perspectives on mental illness had not yet been firmly established in psychiatric and clinical psychological practices.
