Summary And Background Of The Rosenhan Study In 1973

Summary And Background Of The Rosenhans Study In 1973rosenhans 1973

Rosenhan’s 1973 study aimed to investigate the reliability of staff in psychiatric hospitals to identify the sane from the insane. He wanted to see if people who posed as mentally ill would be identified by staff in psychiatric hospitals as sane rather than insane. The participants he used had never been diagnosed with a mental illness. Rosenhan asked eight ‘sane’ people to telephone psychiatric hospitals for urgent appointments, complaining of hearing unclear voices saying ‘thud, hollow, empty’. All eight were admitted to the hospital; all but one was diagnosed with schizophrenia, and the other with manic-depressive psychosis.

Upon admission, all pseudo-patients stopped showing any symptoms and took part in ward activities. The average length of stay was 19 days. All participants had agreed to stay until they had convinced staff they were no longer ill. On release, the pseudo-patients were given the diagnosis of schizophrenia ‘in remission’. In a second follow-up study, one hospital was told that sometime over the next three months, one or more pseudo-patients would try to be admitted, and hospital staff was asked to rate the patients who presented themselves on a scale of 1-10 on the likelihood of them being a pseudo-patient.

44% were judged by at least one member of staff to be a pseudo-patient. Rosenhan concluded that we cannot reliably distinguish the sane from the insane and that hospitalization and labelling can lead to depersonalization, powerlessness, and segregation, which are counter-therapeutic.

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During Rosenhan’s study, pseudo-patients were mandated to take antipsychotic medication if prescribed once admitted; however, Rosenhan’s main focus was on the perception and labeling of mental illness rather than medication effects. When pseudo-patients were given medication, they often experienced side effects which could potentially influence staff perceptions, though Rosenhan's primary observation was that staff failed to recognize the pseudo-patients’ sanity despite their behavior aligning with that of typical hospital patients. The pseudo-patients found that they could be released after behaving normally and convincing staff that they no longer experienced symptoms. They achieved this by acting cooperatively, not displaying any hallucinations, and engaging in routine activities.

The other patients in the hospital were generally suspicious of the pseudo-patients’ identity, but Rosenhan noted that staff and patients often had difficulty differentiating between genuine and fake patients. The pseudo-patients often observed that staff tended to ignore normal behaviors or dismiss suspicious signs, which contributed to the successful concealment of their sanity. During their stay, pseudo-patients reported feelings of powerlessness and depersonalization, with staff consistently viewing them through the lens of their labeled diagnosis rather than as individuals.

When released, pseudo-patients were often diagnosed with schizophrenia “in remission”, a label that persisted even after their behavior was normal. Rosenhan argued that this exemplified the problem of diagnostic labels sticking to individuals, affecting how they are perceived long-term. Such misdiagnosis or label persistence could still occur today, especially with continued reliance on psychiatric labeling systems, although advances in diagnostic techniques and increased awareness aim to reduce such errors.

References

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