Topic 1 Rosenhan Study on being sane in insane places Flashcards
Aim:
See if mental hospitals in the USA in early 1970s could tell the sane from insane places
Study 1:
Eight sane people called 12 mental hospitals for an appointment.
They reported hearing a same-sex voice saying “empty,” “hollow,” and “thud.”
Used false names.
After admission, they stopped faking symptoms, joined ward activities, and took notes on staff and patients.
Study 1
Pseudo-patients were admitted with diagnoses of schizophrenia or manic-depressive psychosis.
They stayed 7-52 days (average 19) and were discharged as “schizophrenia in remission.”
Staff didn’t detect their sanity, but 35 of 118 patients suspected them.
Normal behavior was misinterpreted (e.g., note-taking seen as a symptom).
Patients’ records were accessible to anyone.
Orderlies were abusive in front of patients but stopped when staff appeared.
Attendants spent only 11.3% of their shift outside the ward office.
Patients had an average of 6.8 minutes per day with mental health professionals.
Experiment within study 1:
In four hospitals, pseudopatients politely asked staff simple questions and recorded their responses.
A comparison study at Stanford University had a young woman ask busy staff for directions and admission info.
Another study at a University Medical Centre had a young woman ask for a psychiatrist or an internist.
Findings from experiment study 1:
In psychiatric hospitals, most staff (71-88%) ignored pseudopatients, averting their heads.
Eye contact was rare (10-23%), and only a few paused (2%) or stopped to talk (0.5-4%).
At the university, faculty staff always stopped and talked (100%).
At the medical center, asking for a psychiatrist got a response 78% of the time, while asking for an internist got 100%.
Total attempts: 185 (psychiatric hospitals), 1,283 (university), 14-18 (medical center).
Study 2:
A teaching hospital, aware of the first study, was told pseudopatients might try to gain admission over three months.
Staff rated each new patient on a 10-point scale for the likelihood of being a pseudopatient but still provided full treatment.
No pseudopatients actually attempted admission; staff unknowingly rated real patients.
Out of 193 patients, 41 were confidently judged as pseudopatients by at least one staff member.
Three were judged as pseudopatients by a psychiatrist alone, and 19 by both a psychiatrist and another staff member.
Conclusions
In the 1970s, U.S. mental hospitals struggled with valid diagnoses, failing to detect both sanity (Study 1) and insanity (Study 2).
Diagnoses were unreliable—pseudopatients with the same symptoms received different labels (mostly schizophrenia, but once manic-depressive psychosis).
Staff interpreted all behavior through the lens of a patient’s diagnosis, reinforcing labels.
Patients were often treated with disrespect, including verbal abuse from attendants.
