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In 1973, the renowned professor of psychology at Stanford University, David Rosenhan, published an article titled On being sane in insane places () which became one of the most read and controversial articles in the field of psychology. This article details the details of Rosenhan’s experiment: in 1969 he and a group of 7 perfectly healthy volunteers presented themselves at the admission offices of 12 mental institutions in the United States, where they were admitted and diagnosed with Schizophrenia or bipolar disorder.
“The staff only had contact with the pseudopatients admitted for 6 minutes a day.”
Rosenhan and his team did not aim to prank the directors of the institutions, but rather had a specific mission: Question psychiatry’s ability to distinguish between a psychosis and sanity.
At the admission interview, all subjects claimed to hear noises and voices, which resulted in all subjects being admitted with diagnoses of schizophrenia or bipolar disorder. Once inside the institution, the research participants stated that they no longer had symptoms and began to behave normally. Even so, psychiatrists tried to start treatment with psychotropic drugs.
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According to Rosenhan:
“A scientist is someone who looks at his field of study with skepticism and sees what the problems are. My main fear was that psychiatry would not fulfill its purpose of helping people, but on the contrary, that it would end up harming them.”
Over the course of his hospitalization, Rosenhan took notes about his experience during his stay in the mental institution:
“The assistant took me to a room, pointed to a chair and said: You missed dinner but I’ll get you something to eat and left. I waited for almost two hours and around 6:15 p.m., another nurse arrived with a tray. ‘This is your dinner,’ he said and left.”.
According to Rosenhan, on average, staff only had contact with the inpatient pseudopatients for 6 minutes a day.
“I felt uncomfortable, I didn’t know where the bathroom was, where my things were or where I was going to sleep. What is one doing here? I asked myself. Is there a telephone? Can I call my family? When will I see the doctor? I had to wait until 10:45 p.m. for one of the assistants to show me where I was going to sleep. They paid very little attention to me, almost as if I didn’t exist.”
On average, pseudopatients were hospitalized for 19 days. Although Rosenhan assured that he was already feeling well and that he wanted to retire, the doctors kept them for 52 days. Despite all the days they spent hospitalized, no doctor on staff realized that they were impostors.
How important context is
Referring to the topic, clinical psychologist and friend of Rosenhan, Florence Keller said: “The most interesting thing is how context informs everything.” “If you see a man with a gun you immediately assume that he is a criminal. If the context is a movie studio, then the context tells you that the man is an actor.” Rosenhan maintained that the context of the psychiatric clinic makes it clear that anyone who looks like a patient suffers from a pathology.
¨They paid very little attention to me, almost as if I didn’t exist.”
One of the most curious points of the investigation is that although the medical staff did not realize that they were pseudopatients, the real patients did notice the difference.
Hank ‘O Laura (Rosenhan’s student and study participant) supported that “Some said things like you’re not crazy, you must be a teacher, a journalist or something like that. It must be that you are studying this hospital”.
When the doctors decided to discharge the pseudopatients, they did so on the grounds that the subjects were already better, but making it clear that the symptoms were in remission and that they were not completely cured.
What effects did the results of the Rosenhan Experiment have on Psychiatry and Psychology?
Rosenhan’s results were really controversial, it was like someone dropped a bomb on the psychiatric establishment. The public was fascinated, but mental health professionals hated it. They accused him of using deception and cheating and strongly criticized his methodology and his conclusions.
The most interesting thing is how the context informs everything
The authorities of one of the mental institutions invited him to send as many pseudopatients as he wanted, assuring him that they would recognize each one. Rosenhan accepted, and after a while, the directors of the mental institution proudly said that they had recognized 41 impostors, but Rosenhan had not sent any pseudopatients.
Beyond all the tension generated by the research results, the experiment demonstrated the imprecision in the differential diagnosis between subjects with and without psychiatric disorders, causing the manual of psychiatric diagnoses in the United States to be rewritten and also the relationship to be reevaluated. doctor-patient in mental institutions, thus reducing depersonalization and labeling in psychiatric institutions.
Finally Rosenhan concluded:
“In a more benign environment, in an environment linked to a more global diagnosis, the behaviors and judgments of the medical staff could have been more effective.”
Fountain: Article in Spanish: