“On Being Sane in Insane Places” A study by D.L. Rosenhan 1973

1. “On Being Sane in Insane Places”A study by D.L. Rosenhan1973 Christinia Stokley, Sara Smith, & Ruth Halls February 10, 2003 Psy405-001

2. David L. Rosenhan • Professor of Law and Psychology at Stanford University, Stanford, CA. • 1951 AB Mathematics • 1953 MA Economics • 1958 Ph. D. Psychology

3. “However much we may be personally convinced that we can tell the normal from the abnormal, the evidence is simply not compelling.” D. L. Rosenhan, 1973 • Yes we can • No we can’t

4. Previous Research • 1952-1971 • 5 Separate Studies • Valuable Reports “What is a nice Jewish boy doing in a place like this?”

5. Rosenhan’s Questions • Are mental health professionals able to tell the difference between those who are mentally healthy and those who aren’t? • Rosenhan wanted to know that if the patients were misdiagnosed, what the consequences were. • He also wanted to know whether the characteristics that lead to physiological diagnoses reside in the patients themselves or in the situations and contexts in which the observers (those who do the diagnosing) find the patients. (Hock, 2000)

6. Rosenhan’s Study • He conducted a study where he had eight pseudopatients pretend to be mentally ill and try to gain admittance into various psychiatric institutions. • There were five men and three women all from various backgrounds used in the study. There were three psychologists, one graduate student, one psychiatrist, one homemaker, and one painter.

7. Patients Instructions • Participants were instructed to call the 12 different hospitals on both the east and west coasts and set up an appointment. • All participants complained of the same thing… hearing voices saying “empty”, “hollow”, and “thud”. • All participants were admitted into the institutions and all but one were diagnosed to have schizophrenia.

8. Admission to the Hospitals • There were 12 hospitals in five different states located on the east and west coast that patients tried to gain admittance to. • Immediately after being admitted to the hospitals the pseudopatients stopped showing any symptoms of abnormality. • The patients would commonly try to engage other patients and staff into conversation.

9. After being Admitted • The pseudo patients had no idea of when they were going to be released, when being admitted they were told they would have to get out on their own devices. • Each person was discharged with the label of schizophrenia in remission. • The length of hospitalization was 7 to 52 days with an overall average of 19 days.

10. Observations • Each pseudo patient took notes on their observations while being in the hospitals. • Many times the patients would witness physical abuse of other patients. • Powerlessness became a huge issue with the pseudopatients. • Rosenhan found that the average daily contact with psychiatrists, psychologists, residents, and physicians combined ranged from 3.9 to 25.1 minutes with a mean of 6.8.

11. Proving Others Wrong • Rosenhan had many critics when he performed this study. They wanted to know if situation could be reversed. • Staff rated patients on a 10-point scale, 1 being very confident that the patient was a pseudopatient. • In a 3 month period 193 patients were admitted. • 41 were rated with a 1 by at least 1 member of the staff • 23 were suspected by at least 1 psychiatrist • 19 by 1 psychiatrist and 1 staff member • There were no pseudopatients that tried to gain admittance.

12. Why was Rosenhan’s Study Important? • People became aware that the basis for diagnosis might not be correct. • The study also showed in certain situations the label becomes self-limiting and self-confirming. • Most of all Rosenhan’s Studies proved that the hospital could not distinguish the mentally sane from the insane. “ The hospital itself imposes a special environment in which the meaning of behavior can be easily misunderstood.” D. L. Rosenhan, 1973

13. Questions The Studies Created • How valid are psychological diagnosis across mental health settings? • Is diagnosing more of a bias opinion then Science? • Do labels injure patients rather than help guide therapy?

14. Has Psychology Changed? Could you replicate this study today and achieve the same results?

15. Bibliography 1.) Rosenhan, D. L. (1973). On being sane in insane places. Science, 179, 250-258. 2.) Greenberg, J. (1981, June/July). An interview with David Rosenhan. APA Monitor, 4-5. 3.) Hock, R. R. (2002). Forty Studies That Changed Psychology: Explorations Into the History of Psychological Research 4th Edition (pp. 221-229) 4.) Stanford University, Retrieved on February 5, 200. http://www.law.stanford.edu/faculty/rosenhan/