Kolb Broke New Ground In Community Psychiatry

Former APA President Lawrence Kolb, M.D., who died in October at 95 in Orlando, Fla., was a pioneer in community mental health, psychopharmacology, and research on posttraumatic stress disorder (PTSD). He was APA president in 1968-69.

In addition to his pioneering community mental health work during his 21-year tenure as head of the New York State Psychiatric Institute, he made notable advances in the understanding of phantom-limb pain. Kolb became chair of the Columbia University Medical Center's Department of Psychiatry and director of the affliliated psychiatric institute in 1954. He was the author of Modern Clinical Psychiatry, which for many years was a standard textbook in the field.

In the early 1950s the institute was among the first to test psychopharmacologic medications, and Kolb developed and oversaw the construction of a research building at the institute that was named in his honor. In 1976 Kolb became New York state's commissioner of mental hygiene.

“He was very enthusiastic about the work he was doing,” said Alfred Freedman, M.D., who was APA president for 1973-74, and “his enthusiasm for clinical psychiatry and research never waned.”

Freedman recalled that Kolb was always willing to help. When Freedman was a new resident at the psychiatric institute in 1954, Kolb gave him “a lot of advice on psychiatry. That characterized him. He always was a helpful person.”

He added, “His chief contributions were in the organization of psychiatric services. He developed an outstanding research operation” at the institute.

Kolb's accomplishments began early. While serving as a Navy physician in World War II, he spoke at length with wounded men who said they were experiencing severe pain that felt as though it were occurring in limbs that had been amputated. The result was a definitive account of the phantom-limb phenomenon.

In research in the early 1980s, Kolb headed studies showing how combat stress could cause physical symptoms. This work led to a government study of PTSD in Vietnam veterans.

While director of the psychiatric institute and chair of the Department of Psychiatry at the Columbia University College of Physicians and Surgeons, he also initiated what was then a fledgling concept in mental health care—a community-service unit to treat patients from the medical center's neighborhood. That led to establishment of the Washington Heights Community Service.

“After President Jack Kennedy delivered his community mental health speech in 1963, we were all taken up with it,” Freedman said. Kennedy raised the issue on February 5, 1963, in a special message to Congress in which he proposed a national mental health program to inaugurate “a wholly new emphasis and approach to care for the mentally ill.”

Kolb was born in Baltimore on June 16, 1911. His father, Lawrence Kolb, M.D., was also a psychiatrist. He was a pioneer in the medical approach to narcotics addiction treatment and in public health research and treatment of mental illness. He was one of the first to advocate treating drug addicts as patients instead of criminals.

Another past APA president, John Talbott, M.D. (1984-85), called Kolb his“ scientific father” and said that he had known him for nearly 50 years. “He was the man... who told me a residency slot at Columbia was awaiting me after I'd followed his instructions to travel all over the country to see if any program could offer me a better education, who left me in charge when going on sabbatical in Russia, who trusted me as the then-most junior faculty member at the New York State Psychiatric Institute to make sure a lithium-treatment ward was opened on time, and who gave me my first real job.”

Talbott said Kolb was also “secretly pleased” when Talbott and another faculty member tried to close down a blacktie dinner at APA's annual meeting after Vietnam War protesters were shot at Kent State University in Ohio.

“Perhaps my fondest recollection was his willingness to walk with me to receive my induction into fellowship at APA,” he said. ▪