by Victoria Toh
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| David Rosenhahn |
David Rosenhan, a Stanford social psychologist, found in 1973 that diagnosis at the time was severely flawed. Now 50 years on, his famous study has been challenged and questioned by many and has led to many setbacks within the world of psychiatry.
His study was 8 pseudopatients (‘fake’ patients in effect) that presented themselves at 12 mental hospitals. They all complained of hearing the same voice in their head saying ‘hollow, empty and thud’. Aside from this symptom, they all behaved completely normal. All of them were admitted into the hospital with all bar one being diagnosed with schizophrenia. They then behaved normally after they had been admitted and showed no symptoms. The real participants being studied were not the 8 pseudos but the nurses and psychiatrist who had not been told of this study. They were being tested to see whether they would notice their ‘normal’ behaviour. On average the pseudo participants remained in the hospital for an average of 19 days before being discharged with the label of ‘schizophrenia in remission’. This label led to compromises in their future afterwards.
Rosenhan’s paper caused an uproar within the psychiatric world with many ridiculed for being incapable of the most basic of tasks to differentiate the sane and the insane. His findings lead to changes in the DSM (diagnostic and statistical manual) with new symptoms added to schizophrenia’s criteria. His paper was highly influential to social science in the 20th century with it leading to a new manual in 1980 emphasising the rigidly biologically-reductionist psychiatry. Some even questioned whether mental hospitals were even curing mental illnesses or creating the illness itself. “How many patients might be ‘sane’ outside the psychiatric hospital but seem insane in it – not because craziness resides in them, as it were, but because they are responding to a bizarre setting?” Rosenhan wrote in his paper.
An in-depth follow up of his work conducted by Cahalan where she immersed herself in his work so much to feeling on the brink of suicide uncovered some shocking facts. She had decided to follow up on the participants of his study many years later and tracked down the volunteers and their lives after the experiment. She found an account by Rosenhan on Harry Lando, a volunteer of the study, who had been dismissed from the study after Rosenhan had noted Harry Lando ‘LIKES IT!’. It further showed that Rosenhan himself had not been admitted for just hearing voices but had told his psychiatrist his auditory hallucinations included the interception of radio signals and listening to other people’s thoughts. These discoveries exposed Rosenhan’s study and the fraud he had pulled off. The work he did has greatly impacted diagnosis today and made many question psychiatry and experiments conducted for it. 50 years on his flawed experiment is still affecting psychiatry today.
People with mental illness are still often stigmatised and poorly treated. It is estimated that of those that have come forward, 1 in 10 people have a mental illness and with the US predictions that in 2025 there could be more than 15,000 psychiatrists short. How will the human population be able to overcome this negative stigmatisation on mental health and tackle this serious issue of mental health.
Rosenhan may not have created these issues, but by only pretending to expose their true nature, he had contributed to a culture that has caused harm to the people in greatest need.
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