1
On Being Sane in Insane PlacesA 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 cant

4
Previous Research

• 1952-1971
• 5 Separate Studies
• Valuable Reports
• What is a nice Jewish boy doing in a place like
  this?

5
Rosenhans Questions

• Are mental health professionals able to tell
  the difference between those who are mentally
  healthy and those who arent?
• 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
Rosenhans 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 Rosenhans 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 Rosenhans 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/rosenh
  an/