Critical Evaluation of Rosenhans Study 'on Being Sane in Insane Places'

In the article ‘Who’s Crazy Here, Anyway?’, Rosenhan’s reason for research was because Rosenhan doubted whether the characteristics that lead to psychological diagnoses reside in the patients themselves or in the situations and contexts in which the observers find the patients. The hypothesis generated by Rosenhan was, that the staff will recognize the sanity of the patients, question their diagnosis and follow to release them. The objective was to observe whether personal or environmental factors dictate mental health diagnosis and professional treatment. Rosenhan recruited eight subjects which consisted of three women and five men, one graduate student, three psychologists, one pediatrician, one psychiatrist, one painter, and one homemaker.

Diagnosing an individual with a mental illness balances on a fine line between giving a life-long label and misdiagnosing. Mental illness is best viewed on a continuum allowing for a varying degree of severity. In the field, mental health professionals are faced with determining what signifies the appropriateness of diagnosing a mental illness. A professional’s judgment is impacted by their personal perceptions and observations, societies views and norms, and the patient’s history. The film, “How Mad Are You? A Search for Insanity” demonstrates the difficulties in distinguishing those who are mentally ill from those seen as healthy ( ). I will explore my reactions and thoughts regarding the participants’ experience as well as the mental health professionals. Additionally, I will share how this information is applicable to my future career in the field of social work.

Nearly a century later in 1975, American psychologist David Rosenhan published a paper called "On Being Sane in Insane Places" detailing the experiment that he conducted on psychiatric institutions themselves. The first part of his experiment involved sending pseudopatients (a group of eight totally mentally sound associates, including David himself) to knock on institution doors and falsely report that they 'd been hearing voices. Once admitted, the fake patients abandoned their fake symptoms and behaved as they normally did, waiting for administrators to recognize them as mentally healthy.

When we first got this stimulus, everyone focused on the common idea of madness as an illness and based at mental institutions, as madness is socially constructed and everyone differs to different people, we decided not to follow that path as there are many people who doesn’t fit the set meaning of insane but are still regarded as insane and this also made us question ‘who is insane/sane?’.

In Chapter 3 of Opening Skinner’s Box, “On Being Sane in Insane Places,” Lauren Slater discusses the contentious issue psychiatrists faced in 1972 after psychologist David Rosenhan conducted his most famous experiment, proving how psychiatrists already label patients when they walk through the door to be evaluated. The author, Slater is a psychologist herself in which her writing in this chapter is supportive to Rosenhan’s findings. This may limit supporting arguments on crediting psychiatric conceptualization. The meaning of behavior can easily be misunderstood, a patient can be diagnosed according to the doctor’s capacity of knowledge to specific behaviors.

In 1973, psychologist David Rosenhan published “On Being Sane in Insane Places” which documents the results of studies he and his confederates conducted at 12 different psychiatric hospitals across the United States. The studies were an examination into the reliability of psychiatric diagnosis methods. Rosenhan’s research focused on testing the hypothesis of whether or not psychiatrists and medical staff can distinguish the sane from the insane and if the characteristics that lead to diagnoses relate more to the patient or to the environment and context in which they’re being assessed. (Rosenhan, 1973) The study was divided into two main parts. Participant observations and comparative information studies were noted as well as they gave valuable insight into the treatment of psychiatric patients, conditions in psychiatric hospitals, and the effect that diagnostic labels had on how patients were perceived by staff. Ultimately, the study discovered that psychiatrists could not reliably distinguish the sane from the insane and insight was gained into how diagnostic labels and environmental context play a strong role in the perception of behavior.

Susanna confronts this classification of BPD as she makes its imprecisions clear. She feels that the vagueness surrounding the ‘social contrariness’ and the ‘generally pessimistic outlook’ result in an unfair justification of BPD, as these behaviours are clearly not predictive of her adult life. She feels that there obviously should be more substantial medical indicators to this passage regarding BPD. There is only subjective content, resulting in inevitable confusion over true presence of insanity. Consequently, insanity can easily be confused with social non-conformity due to minor indicators in early life, which is otherwise categorized as simply being different as an adolescent.

Mental illness becomes a bigger issue with a long lasting cultural stereotyped due to the manner in which it has long been labelled (Miles, 1988). Although mental illness is very much connected to instabilities in one’s mental health state, as previously mentioned, a person can be mentally healthy but still suffer from a mental illness. What is understood by mental illness is that it

Diagnosing an individual with a mental illness balances on a fine line between giving a life-long label and misdiagnosing. Mental illness is best viewed on a continuum, allowing for a varying degree of severity. In the field, mental health professionals are faced with determining what signifies the appropriateness of diagnosing a mental illness. A professional’s judgment is impacted by their personal perceptions and observations, societies views and norms, and the patient’s history. The film, “How Mad Are You? A Search for Insanity” demonstrates the difficulties in distinguishing those who are mentally ill from those seen as healthy ( ). I will explore my reactions and thoughts regarding the participants’ experience as well as the mental

- The original question of the study was: ‘If sanity and insanity exist, how shall we know them?’ but Rosenhan narrowed it down in order to make it easier to answer and less of a philosophical debate. ‘Do the salient characteristics that lead to diagnoses reside in the patients themselves or in the environments and contexts in which observers find them?’ The question was narrowed down to patients, referring to those declared unwell in mind by medical institutions, and wonders whether diagnoses are made based on the patients themselves or preconceived societal notions and the unique living situation within the hospital.

Entering the taboo world of mental illness, stigmatized as the crazy and psychotic by decades of

Thomas J. Scheff has written an interesting theory about labeling a mental illness in his book “Labeling Madness. This book challenged the reliance of misleading labels such as “schizophrenia” and the harmful isolation of many people. This theory was accepted by many sociologists but had very little impact even to those in public. Thomas Scheff sought to challenge how the medical model with what is called a mental illness to something more of a social model.

Ethically there was concern, that the level of deception involved, could have caused detriment to future patients, since the embarrassment from the initial study had a direct affect on the judgements of genuine patients. The reliability of these results may be questioned, as the participant numbers were relatively small; however they were valid as the results showed a strong correlation from each of the hospitals investigated. Rosenhan’s studies have been a catalyst towards further research into schizophrenia, especially since they were ecologically valid.

Eight sane people were admitted into twelve different hospitals, where their diagnostic experiences would be part of the data of the first part of the article, while the rest will be devoted to a description of their experiences in psychiatric institutions. The patients were all very different from each other, three were women and five were men. Among them were three psychologists, one psychology graduate, a pediatrician, a housewife, a psychiatrist, and a painter. The ones that were in the mental health field were given a different occupation in order to avoid special attentions that might be given by the staff, as a matter of courtesy or caution. No one knew about the presence of the pseudopatients and the nature of the program was not known to any of the hospital staff. The settings were different as well. The hospitals were in five different states on the West and East coasts. Some were considered old and shabby and some were

Chapter 3 During the Middle Ages some “authorities” classified abnormal behaviors into two groups, those that resulted from demonic possession and those due to natural causes. The 19th-century German psychiatrist Emil Kraepelin was the first modern theorist to develop a comprehensive model of classification based on the distinctive features, or symptoms, associated with abnormal behavior patterns (see Chapter 1). The most commonly used classification system today is largely an outgrowth and extension of Kraepelin’s work: the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. Why is it important to classify abnormal behavior? For one thing, classification is the core of science. Without labeling and organizing patterns of abnormal behavior, researchers could not communicate their findings to one another, and progress toward understanding these disorders would come to a halt. Moreover, important decisions are made on the basis of classification. Certain psychological disorders respond better to one therapy than another or to one drug than another.