Rosenhan (1973) Sane in Insane places On being sane in insane places Science psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places introduction difficulty of judging what is 'normal' varies over time / between societies Rosenhan asked "If sanity and insanity exist, how shall we know them?" p250 research Q: if 'normal' people attempt admission will they be detected? / how? psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places the study: researchers (NOT participants!) 8 sane people attempted admission graduate student; 3 psychologists; a paediatrician; a painter; a 'housewife' telephoned for an appointment 12 hospitals; 5 US states gave false names/addresses; otherwise correct details psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places the study: pseudo-symptoms pseudo-patients (PPs) reported unfamiliar, same sex 'voices' unclear but said 'empty'; 'hollow'; 'thud' simulated 'existential crisis' (who am I?; why am I here?) NB no mention of 'existential crisis' in theories in psychosis psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places the study: after admission stopped reporting symptoms... but may have looked anxious! took part in ward activities kept notes each had to get out by their own devices! psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places Results: hospitals' responses NB hospital staff were the subjects (participants) of this experiment none of the PPs were detected all but one diagnosed as schizophrenic NB not one clear symptom of this! some other patients were suspicious (35/118 said so) psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places results: getting out all pseudo-patients (PPs) wanted to get out ASAP! remained in hospital days (av 19) discharged with 'schizophrenia in remission' psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places results: follow up study a teaching and research hospital aware of study told one or more pseudo-patients would seek admission in next 3m c 1/10 suspected by 1 psychiatrist + one staff member none had been sent psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places Results: general observations (1) normal behaviour of PPs ignored or misinterpreted note taking recorded as pathological in 3 medical records e.g. 'Patient engages in writing behaviour' [please engage in this behaviour in my lessons!] psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places results: general observations (2) Rosenhan noted: sane/insane behaviour overlap (such as depressed moods or anger) in the study a psychiatrist was observed to note early queuing for lunch told registrars [trainees] this was 'oral- acquisitive' syndrome another interpretation: boredom in hospital! psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places results: PP observations PPs approached staff with polite requests e.g. 'Pardon me Dr X, could you tell me when I will be presented at the staff meeting? 71% psychiatrists; 88% nurses totally ignored PP's Qs! [comparative study U students - U staff virtually 100% responses] nurses stayed in offices c90% of time therapist-patient contact = < 7 mins per day psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places results: evidence of depersonalisation no privacy, even in toilet (doors often removed) medical records open to all staff, regardless of therapeutic responsibility ward orderlies brutal in front of other patients; stop when other staff seen = patients’ views valueless psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places results: medication PPs given 2,100 tablets only 2 swallowed when some were flushed PPs spotted other patients' medication! = cooperative patients' behaviour ignored psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places discussion (1) Rosenhan claimed "It is clear we cannot distinguish the sane from the insane in psychiatric hospitals" (p257) seems to be overstating BUT failure to detect sanity follow up questionable detection of insanity psychlotron.org.ukMark Souter

Rosenhan (1973) Sane in Insane places discussion (2) depersonalisation and powerlessness R said behaviours interpreted via expectations R said better to discuss behaviours and causes R noted real patients did not have PPs' comfort of false diagnosis psychlotron.org.ukMark Souter