In the article “On Being Sane in Insane Places” David L. Rosenhan discusses the social deviance of mental illness and the effects of labeling patients as sane or insane. The purpose of Rosenhan’s research and study was to determine the reliability of psychiatric diagnosis and mental illness labels in mental hospitals in the United States. In the article Rosenhan argued that psychiatrists couldn’t tell the difference between sane and insane patients and that their reasons and criteria for their diagnosis were invalid.
Rosenhan conducted a field experiment in which eight mentally healthy and sane individuals were purposefully admitted into various psychiatric hospitals in the United States. To start off the experiment the pseudo patients called the hospitals they planned to stay at for an appointment. After they arrived at the hospital and went to the admissions office and claimed to be hearing voices. They were instructed to explain to doctors that they heard the voices simply say the words “empty”, “hollow”, and “thud”. The pseudo patients falsely expressed these specific symptoms solely because they were common symptoms that real mentally ill patients had. In order to keep the study secrete and undetectable the people chosen for this study created a fake name and occupation so they wouldn’t be traced. Once they were admitted inside they stopped exhibiting any abnormal behaviors. During their stay at the hospital they were instructed to take observant notes about the patients, staff and hospital itself. At first the notes were written in secret, however it became clear that no one cared so they began to take their notes publicly. Rosenhan believed that normality and saneness would be so distinct and easy to detect that way the pseudo patients would be released nearly immediately. However they were hospitalized on an average of 19 days. Rosenhan made it clear that the patients were not carefully observed and that it was not the lack of time to observe that caused this issue instead it was the way in which the hospital went about observing them.
Surprisingly, Rosenhan’s research conveys that behaviors that are traditionally considered normal were seen by the hospital staff as being part of the pseudo patients’ pseudo condition. For example, it has been said that the pseudo patients were instructed to take notes. Although it was done secretly at first then publicly, many witnessing those taking notes may have wondered what they were writing about due to them constantly taking notes. However, in the hospitals, no nurse or staff member ever made remarks on the pseudo patients’ note-taking, due to them assuming that it was a nervous habit associated with their schizophrenia. In addition they felt and assumed that just because the pseudo patients were in the hospital, they had to be psychologically disturbed. And because this patient is disturbed, his or her nonstop writing has to be due to his condition. In fact it was said that, some real patients in the hospital became suspicious of them, and tried to bring it to the attention of the nurses. But these claims and accusations were continuously overlooked, since they were coming from someone labeled as “insane”. Rosenhan made it clear that the patients behaviors were misinterpreted by the staff. For instance, a patient may have gone “beserk” because he or she had been wittingly or unwittingly, been mistreated by and attendant. A nurse witnessing this would believe that the patient is acting this way due to his condition and not from the interaction he or she had with the attendant.
Psychiatrists and nurses have yet to realize the importance of labels on patients. Rosenhan expressed that psychiatric labels are highly influential. He conveys that once the schizophrenic label has been given to the patient, it is expected that the patient will continue this behavior. Patients start to act like and become the label assigned to them because it takes a toll on how they are portrayed by others. Even though after a period of time, if the patient has done nothing deviant they will be considered and allowed for discharge, the hospital still keeps them beyond their discharge date just to watch them and see if they patient will live up to their expectation of schizophrenic tendencies. This goes to show how influential illness labeling is.
Rosenhan’s experiment relates to this week’s chapter reading in that touches upon the theoretical perspectives of health and medicine. While conveying the functionalist perspective, the chapter discussed the Parsons who identified that a sick person has a specific role with both rights and responsibilities. However the rights the sick person is given is only merited through the fact that his or her illness is found legitimate by a physician. In Rosenhan’s case, he argues that the physicians were not able to give legitimate or valid diagnoses to patients. These illegitimate diagnoses caused patients to become the diagnoses instead of the patient to get rid of it.