Author: Scotty Hendricks / Source: Big Think
- In 1973, eight experimenters faked insanity to see how easy it was to get into a mental hospital. The hard part was getting out.
- Their findings sparked a great debate over how psychiatry treated patients and how accurate diagnostic procedures were.
- In an age marked by a lack of proper mental health care, the finding that it was too easy to get a doctor’s attention seems shocking.
In the United States, mental health care can be difficult to come by. One-third of Americans live in a “mental health professional shortage area” and lack access to mental health facilities; this probably explains why less than half of the people who need treatment get it. It can almost seem like you have to be at the end of your rope to get help sometimes.
It didn’t use to be this way though; there was that one time that a psychologist found it was easier to fake your way into a mental hospital than it was to get out.
The Rosenhan experiment
In 1973, after hearing a lecture from the anti-psychiatry figure R.D. Laing the psychologist David Rosenhan decided to test how rigorous psychiatric diagnoses were at modern hospitals by first trying to get into them with fake symptoms and then trying to get out by acting normally.
Eight experimenters participated, including Dr. Rosenhan. All but two of them were somehow involved in medicine, so fake names and occupations were created to both avoid the enhanced scrutiny they expected members of their field to be given when claiming insanity and to prevent the test subjects from facing the stigmas of mental illness after the experiment ended.
The pseudopatients all reported the same symptoms, an auditory hallucination saying the words “empty,” “hollow,” and “thud.” These words were chosen to invoke the idea of an existential crisis. They were also chosen because at the time there was no literature on an “existential psychosis.”
Much to the pseudopatients’ surprise, they were all admitted to all 12 hospitals they went to with little difficulty. In all but one case, they were given a diagnosis of schizophrenia. In the outlier, a private hospital gave them a slightly more optimistic diagnosis of “manic-depressive psychosis.”
Once admitted to the hospital, the patients were instructed to act normally and do what they could to be released. This led them all to be “paragons of cooperation” and to fully participate in ward life. They attended therapy, socialized with others, and even accepted their medications which they then disposed of. If asked, they were to say their symptoms had disappeared entirely.
Shockingly, the staff had no idea any of them were faking. Their normal behavior was medicalized into symptoms of their schizophrenia. All of the pseudopatients were taking notes on the hospital, so naturally one of them had the note “patient engages in writing behavior” added to their file. Lining up early to get food was cited as an example of “oral-acquisitive” psychotic behavior.
The life details of the subjects, all fairly typical for the time, were suddenly signs of pathological behavior. One pseudopatient reported that he had a happy marriage though he occasionally fought with his wife and that he did spank his children on rare occasions. While this might seem like a standard 1960s life, his file read:
“His attempts to control emotionality with his wife and children are punctuated by angry outbursts and, in the case of the children, spankings.”
Schizophrenia’s Identity Crisis
Amusingly, while the staff at the hospitals had no idea they had fakers in the ward, the real patients often caught on very quickly. The participants reported dozens of cases of their wardmates coming up to them and accusing them of being either a journalist or professor playing sick in order to take notes about the hospital.
Disturbingly, the fakers also reported that the staff was dehumanizing and often brutal. Conversations with staff were limited by their frequent absence. When the staff did have time to talk, they were often curt and dismissive. Orderlies would often be both physically and verbally abusive when other workers were absent. The pseudopatients reported they often felt invisible, as the staff would act like they weren’t even there. These details were made worse by the powerlessness felt by…
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