Do healthy people admitted to psychiatric hospitals recognize each other? Rosenhan's experiment

If the sanity and the folly do they exist, how can they be recognised? The question is not provocative, but it is what drove it psychologist David Rosenhan in one of his famous ones experiment. In the 1973 the professor conducted a study, published in the journal Science with the title On being sane in unhealthy places (in Italian “On being healthy in crazy places”), which expanded the study of psychiatric diagnoses: he meant to verify if in a psychiatric hospital doctors were able to distinguish a person “healthy” From one “with psychiatric disorders”. To this end, Rosenhan had eight healthy people admitted to different psychiatric hospitals, hiding their true identities and telling them to complain of vague symptoms. Although their personal experiences and behaviors did not indicate real psychiatric problems, they were not discovered as false patients.

How the pseudopatient experiment took place

In the course of his experiment Rosenhan ensured that 8 people without mental disorders were admitted to different hospitals, pretending to be sick: if the psychiatrists had remained faithful to scientifically based diagnoses, they would have had to unmask these people declaring them healthy.

The eight people who underwent the experiment were very different from each other: students, elderly people, psychologists, housewives. Even the hospitals were different from each other: there were old structures, new ones, with research spaces, with adequate staff numbers, others not and so on.

The people were presented at the fact-finding appointment as complainants vague symptoms, complaining of hearing voices. The personal history of each person was then presented: the relationship with the family, relatives and other information which apparently should not have given signs of mental illness, but of a life that was all in all peaceful and “in order”.

Once the stay in the facility began, the pseudo patient began to to behave how would he have behaved if he hadn't been in that place, then as a “healthy” person. When the staff conducted interviews with them to understand their psychological state, the pseudo patients did not hide the fact that they felt well and that they no longer felt the initial symptoms.

Despite their behavior as “healthy” subjects, they were never discovered by the doctors, but in some cases they were unmasked by the other patients in the facility, who accused them of being in the wrong place because they were healthy.

Why weren't the fake patients discovered?

According to Rosenhan, the failure to recognize the sanity of fake patients during the course of hospitalization may be due to the fact that:

  • sometimes doctors are influenced by a strong prejudice towards what in statistics is called “type 2 error”, that is, they are more likely to define a healthy person as sick than a sick person as healthy;
  • And socially deemed more dangerous make a misdiagnosis of mental illness than health.

The impact of Rosenhan's experiment on the scientific community

Rosenhan's research question was as simple as it was complex: If it is possible to distinguish between the sane and the insane, do the salient traits that lead to the diagnosis reside in the patients themselves or in the environments and contexts in which observers encounter them? Rosenhan's study has sparked quite a bit of discussion and debate, with some scientists rejecting it. Overall, Rosenhan's work represented a turning point in psychiatric studies, demonstrating how diagnostic labels can significantly influence the perception and care of patients in clinical environments.

Declaring a person “insane” and “schizophrenic” is extremely powerful and once a person is declared and considered abnormal, their every behavior is interpreted through this lens. This influenceor even prejudicecan significantly affect the way a patient is treated and the perception one has of him and should therefore be avoided as far as possible.

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