ON BEING SANE IN INSANE PLACES

From People's Almanac 1975

In an experiment later written up as “On Being Sane in Insane Places,” D. L. Rosenhan, of Stanford University, and 8 associates (3 women, 5 men) voluntarily entered 12 mental institutions. They complained to staff psychiatrists of hearing voices which said “hollow,” empty,” or “thud.” They reported no other symptoms.

The “patients” were chosen for the experiment on the basis of being normal every-day people and they represented a wide range of occupations, from housewife to artist to pediatrician. After being admitted to the hospitals, all pseudo-patients told the staff that their symptoms had disappeared, and all acted normally.

In trials in 12 different hospitals, it took pseudo-patients between 7 to 52 days to be released. In almost all cases, they were discharged with diagnoses of “schizophrenia in remission”; not once were they discharged as being sane.

Upon reading these astounding facts, one might assume that the experiments were conducted in hospitals chosen for inadequate or incompetent staff or overcrowding. This was not the case. Most of the hospitals tested were funded by the local. State, or Federal Government, and several were considered excellent. They varied as to newness and number of staff, though one well-staffed, expensive, and modern hospital was included in the test. Results were no different there.

Once the pseudo-patients were in the mental hospitals, they observed many enlightening facts about what happens to a person when people think he is crazy. They found that patients were considered less than human and were treated as though they were invisible. Often they would address staff with simple questions such as asking when a given doctor would be in, and they would be totally ignored, with the staff member walking straight past them, or would receive a curt non-reply like “Hello, how do you feel today?”

There was little privacy or activity allowed the patients, but when disorders arose from these stultifying conditions they were attributed to the patient’s “disease.” Many pseudo-patients took notes of their observations, first secretly and then openly when they found that nobody cared. One nurse, commenting on her patient’s “psychosis,” mentioned his “compulsive note-taking behavior.” Another pseudo-patient overheard a staff psychiatrist complaining about patients “oral acquisitiveness” in lining up in the cafeteria lounge a half hour before lunch. The good doctor overlooked the fact that in the hospital there was nothing else to do.

Treatment was minimal. Drugs replaced a doctor’s time. All pseudo-patients combined were given 2,100 pills, which they, like many real patients, discarded.

An interesting sidelight to the experiment was the fact that although not one psychiatrist, nurse, or attendant suspected the hoax, 35 patients of the 118 residing in admittance wards with the experimenters suspected they were faking. “You’re not crazy, you’re some journalist (or professor) checking up on conditions here,” was heard over and over again.

To verify these disturbing findings, the researchers notified a leading teaching hospital that in a given 5-month period, one or 2 pseudo-patients would attempt to gain admission to their hospital. The hospital staff was well acquainted with the experiment. Of 193 patients admitted during the 3-month period, 41 were alleged to be pseudo-patients by staff members, including 23 by psychiatrists with the greatest amount of training.

Actually, not one pseudo-patient presented himself during that period.