American psychiatry in the 21st century: the discipline, its practice, and its work force.

As the 21st century nears, various forces are affecting American mental health care delivery. After reviewing these forces in terms of their impact on psychiatry, the author summarizes the nature of psychiatry and psychiatric practice as branches of medicine. He then presents a picture of new and graduating psychiatric residents, focusing on (1) their changing views of the role of biological and psychological work with patients, and (2) their future career plans. The author concludes with a challenge to maintain a definition of psychiatry that links mind and brain, and from this foundation to demonstrate to students, society, and policymakers alike a model of psychiatry that integrates biological, psychological, and social perspectives in the treatment of patients.