Classic study: Rosenhan(1973) Being Sane in Insane places

Question 1

Aim

Answer 1

-test reliability of MH diagnosis+ whether saneness could be recognised in a clinical setting (distinguish normal from abnormal)
-investigate treatment of patients in psychiatric hospitals

Question 2

Sample

Answer 2

-8 pseudopatients: 5 men and 3 women: one Psychology graduate, 3 psychologists, pediatrician,psychiatrist, painter + housewife: personal histories of pseudopatients kept the same,apart from professions.
-upon admission sample switches to staff+ patients at the hospital

Question 3

Procedure

Answer 3

• 12 hospitals: 5 different states in East/ West USA, some old/new, some well-staffed/short-staffed, one privately funded
  -duration of stay was 7-52 days to be discharged:mean length of stay was 19 days.
  -begins as a field experiment, upon admission switches to a covert observation
  -pseudopatients rung hospitals reporting hearing voices saying ´empty´, ´hollow´,´thud´- unfamiliar and of the same-sex as the pseudo patient
  -upon admission pps behaved normally + said the voice had disappeared
  -structured observation: 3 hospitals- record how many patients voiced suspicions + how much time staff spent interacting with patients
  4 hospitals- pseudopatients asked staff when they would be released- staff responses recorded
• pseudopatients took part in continual note-taking- this was described as ´writing behaviour´ from doctors (regarded as a symptom of their disorder
  -nursing reports labelled pseudopatients as compliant and pleasant

Question 4

Follow- up study

Answer 4

Rosenhan carried out a second study to satisfy criticisms of his first study
-hospital staff aware pseudopatients would be seeking admission in next 3 months:questionaire to rate likelihood of each patient being a pseuo patient
- Rosenhan did not send in any pseudo patients
-41/193 were rated as pseudo patients by at least 1 staff member

Question 5

Results

Answer 5

-upon admission 11 hospitals diagnosed patients with schizophrenia, private hospital: manic depression ( bipolar disorder)
-all discharged with a diagnosis of ´ ´
´schizophrenia in remission´
-patients not being treated as humans by staff: eg invasion of privacy,speaking about them as if they were not there
-35/118 patients accused pseudo patients of lying e.g accusing them of being a journalist
-staff behaving as if the illness was contagious:nurses only spending 11.3% of their time on ward, doctors coming on ward an average of 6.7 times a day.

Question 6

Conclusion:

Answer 6

-false positives (deeming a sick person healthy) is common in normal diagnoses, but false negatives (deeming a healthy person as sick) occur when ´stakes are high´ e.g when the hospital knows they are being assessed
-psychiatric labels are hard to remove/change once attached
-conditions in psychiatric hospitals make patients worse.