Psychiatry is rapidly changing. The authors review the history of psychiatry in the United States, its gradual integration into medicine and society, and the dialectic between its "biologic" and "mentalist" outlooks. After describing the current state of the profession and its knowledge base, they discuss the likely future of the field: psychiatry's projected mode of practice and economics; its future as a science for understanding human behavior; its expected boundaries with other treatment disciplines; its anticipated relationship with academia and with the community at large; and internal issues for the profession. Unprecedented internal and external pressures on the field are likely to require important reconceptualizations of psychiatry both by its members and by the rest of the American public.
