Rosenhan's study of diagnostic reliability in psychiatric hospitals

ON BEING SANE IN INSANE PLACES

In this dated but intriguing article, D.L. Rosenhan, professor of psychology at Stanford University, poses a very interesting question, one that is still relevant in today's world-"If sanity and insanity exist, how shall we know them?" (1973, 250), meaning that under certain conditions, it may be impossible to recognize the differences between the two. This is supported by Rosenhan's comment that "What is viewed as normal (i.e., sane) in one culture may be seen as quite aberrant in another" (i.e, insane). From a medical perspective, Rosenhan states that determining whether someone or something (i.e, an action) is either sane or insane is "a simple matter" by posing the question "do the salient characteristics that lead to diagnosis reside in the patients. . . or in the environments and contexts in which observers find themselves"? (1973, 251). In order to explore the main question on recognizing sanity and insanity, Rosenhan describes an experiment in which eight "pseudopatients" or those of normal sanity, posed as mentally-ill patients and once admitted to a psychiatric hospital, acted totally normal or unsane. The results were that these patients "were never detected" by the psychiatrists as faking insanity. The overall diagnosis was "schizophrenia in remission" which indicates that "any diagnostic process" on the part of psychiatrists to determine sanity or insanity "lends itself so readily to massive errors that this. . . cannot be a very reliable" process (1973, 252).