Your [psychiatric] hospitals are not our hospitals; your ways are not our ways. You live out of range of critical shot; you are not preceded and followed any award work by clever rivals, or watched by able residents fresh with the learning of the schools.

I am strongly of opinion that the influences which for years led the general profession to the belief that no one could, or should, treat the insane except the special practitioner, have done us and you and many of our patients lasting wrong.

[Silas Weir Mitchell, MD addressing the American Medico-Psychological Association in 1894]