It is worth starting with the fact that Rosenhan’s article presents a particular critical study aimed at substantiating the problems of psychiatric diagnosis. The direct support of the study was the question of the difference between sanity and insanity. Rosenhan’s central claim is that there is a certain amount of inconsistency regarding the validity and applicability of concepts defining mental health. In addition, it is argued that the causes of psychopathology may depend on culture under certain circumstances. Accordingly, the main problem the researcher highlights are the causality of making a diagnosis.
The article claims that the definition of a mental state based on the catalog of symptoms is not sufficiently reliable. This is manifested precisely in the fact that the person directly making the diagnosis plays a huge role in determining the disease.
Thus, Rosenhan developed and conducted two experiments that would help prove the statement. In the first case, eight candidates were selected, including the researcher himself, who was also completely healthy from mental illness.
Twelve different psychiatric clinics were selected, which were not notified about the experiment in advance. The process consisted of the fact that all the pseudopatients claimed that they were hearing auditory hallucinations. It should be noted that the names and symptoms were fictitious, but all the experimenters presented a genuine biography, which helped in the implementation of authenticity. After pseudopatients came directly under the supervision of doctors, they stopped pretending. In addition, the main task was to cooperate with doctors to prove their sanity. All this was confirmed in the reports of nurses who demonstrated the absence of unnatural behavior.
The first experimental results were that all the patients who took part spent a different number of days in medical institutions. The article says that all of them were discharged with a diagnosis of schizophrenia in remission, except for one person. In addition, it is noted that there were no signs of doubt about the diagnosis among the staff. However, the real patient managed to quickly identify the falsity of the behavior of those who participated in the experiment. Thus, Rosenhan argues that doctors tend to adhere to the version that a person may be sick in order not to make a mistake. However, such a trend can lead to people being exposed to danger due to various social circumstances.
Then, after studying the results made by Rosenhan, hospitals began to suspect that they were not reliable. Therefore, it was necessary to conduct a second experiment that would demonstrate the consistency of the results. This time, the researcher notified several organizations in advance that a pseudopatient would contact them within a particular time. In addition, all staff was asked to assess the likelihood that a particular patient is not real. Thus, out of all 193 people who applied to the institution, 41 were identified as fake. However, the bottom line was that, during this time, not a single pseudopatient referred by Rosenhan addressed the hospital.
An essential significance of the experiments was that a tendency revealed that if a person is defined as mentally ill, then all actions will be strictly determined within this category. The danger lies in the fact that normal behavior can often simply be ignored by defining the patient in this way. In more severe cases, it may be misinterpreted, which will force doctors to identify such behavior as one of the symptoms of the diagnosis. In such cases, various facts from the biography may be incorrectly adjusted to the framework of the disease. In addition to this problem, the study also noted negative ill-treatment of patients subjected to violations of their rights.
Thus, the question is raised – how many people are recognized as mentally ill when this is not the case in reality? After all, by making a diagnosis in this way, people can drive themselves into the framework of a particular style of behavior corresponding to the disease.