ID R O S E N H AN ' S S T U D Y ”
DAV
TITLED "ON B E IN G S A N E IN
INS A N E P L A C E S
BACKGROUND INFORMATION
• DAVID ROSENHAN'S STUDY, TITLED "ON BEING SANE IN INSANE PLACES," WAS PUBLISHED IN 1973
IN THE JOURNAL SCIENCE. THE STUDY AIMED TO INVESTIGATE THE RELIABILITY OF PSYCHIATRIC
DIAGNOSES AND THE EXPERIENCES OF INDIVIDUALS LABELED AS MENTALLY ILL WITHIN PSYCHIATRIC
HOSPITALS. ROSENHAN CONDUCTED A FIELD EXPERIMENT INVOLVING PSEUDOPATIENTS—PEOPLE
WHO WERE NOT ACTUALLY MENTALLY ILL BUT FEIGNED SYMPTOMS TO GAIN ADMISSION TO
PSYCHIATRIC HOSPITALS.
METHODOLOGY
• PSEUDOPATIENTS: ROSENHAN AND SEVEN OTHER "PSEUDOPATIENTS," WHO WERE MENTALLY HEALTHY, PRESENTED
THEMSELVES TO VARIOUS PSYCHIATRIC HOSPITALS ACROSS THE UNITED STATES. NONE OF THEM HAD A HISTORY OF
PSYCHIATRIC DISORDERS.
• FEIGNED SYMPTOMS: THE PSEUDOPATIENTS COMPLAINED OF HEARING VOICES SAYING EMPTY, HOLLOW, OR THUD, BUT
THEY DID NOT SIMULATE ANY OTHER SYMPTOMS OF A PSYCHIATRIC DISORDER. THEY GAVE ACCURATE PERSONAL HISTORIES,
APART FROM THE FALSE SYMPTOMS.
• ADMISSION TO HOSPITALS: ALL THE PSEUDOPATIENTS WERE ADMITTED TO PSYCHIATRIC HOSPITALS, WITH THE INITIAL
DIAGNOSIS BEING SCHIZOPHRENIA IN REMISSION.
• BEHAVIOR IN HOSPITALS: ONCE ADMITTED, THE PSEUDOPATIENTS BEHAVED NORMALLY AND REPORTED THAT THE
HALLUCINATIONS HAD CEASED. THEY PARTICIPATED IN HOSPITAL ACTIVITIES AND INTERACTED WITH STAFF AND OTHER
PATIENTS.
METHODOLOGY
• LENGTH OF HOSPITALIZATION: THE PSEUDOPATIENTS WERE NOT RELEASED QUICKLY. THE AVERAGE LENGTH
OF HOSPITALIZATION WAS 19 DAYS, WITH A RANGE FROM 7 TO 52 DAYS.
• DISCHARGE DIAGNOSES: UPON DISCHARGE, THE PSEUDOPATIENTS WERE DIAGNOSED WITH CONDITIONS
SUCH AS SCHIZOPHRENIA "IN REMISSION." THE ABSENCE OF FURTHER SYMPTOMS WAS NOT RECOGNIZED.
• REACTIVE LABELING: ROSENHAN OBSERVED THAT THE PSEUDOPATIENTS WERE OFTEN VIEWED THROUGH THE
LENS OF THEIR PSYCHIATRIC LABEL. NORMAL BEHAVIORS WERE SOMETIMES INTERPRETED AS SYMPTOMATIC.
• FOLLOW-UP STUDY: ROSENHAN CONDUCTED A FOLLOW-UP STUDY WHERE HE INFORMED THE HOSPITALS
THAT HE WOULD BE SENDING ONE OR MORE PSEUDOPATIENTS TO THEM OVER A SPECIFIC PERIOD. DESPITE
THIS WARNING, THE HOSPITALS STILL REPORTED RECEIVING PSEUDOPATIENTS, EVEN THOUGH ROSENHAN
HAD NOT ACTUALLY SENT ANY.
FOLLOW-UP STUDY
ROSENHAN CONDUCTED A FOLLOW-UP STUDY WHERE HE INFORMED THE HOSPITALS THAT HE WOULD BE
SENDING ONE OR MORE PSEUDOPATIENTS TO THEM OVER A SPECIFIC PERIOD. DESPITE THIS WARNING, THE
HOSPITALS STILL REPORTED RECEIVING PSEUDOPATIENTS, EVEN THOUGH ROSENHAN HAD NOT ACTUALLY
SENT ANY.
PRINCIPLES MIGHT HAVE BEEN
IMPLICATED:
• PRINCIPLE A: BENEFICENCE AND NONMALEFICENCE:
THE PSEUDOPATIENTS MAY HAVE EXPERIENCED PSYCHOLOGICAL HARM AND DISTRESS AS A RESULT OF
BEING LABELED AS MENTALLY ILL AND SUBJECTED TO THE CONDITIONS WITHIN PSYCHIATRIC HOSPITALS.
• PRINCIPLE B: FIDELITY AND RESPONSIBILITY:
THE STUDY INVOLVED DECEPTION AND POTENTIAL HARM TO PARTICIPANTS (PSEUDOPATIENTS) AND THE
INSTITUTIONS WHERE THE RESEARCH WAS CONDUCTED.
• PRINCIPLE E: RESPECT FOR PEOPLE’S RIGHTS AND DIGNITY:
POTENTIAL VIOLATION: THE PSEUDOPATIENTS' RIGHTS AND DIGNITY MAY HAVE BEEN COMPROMISED
THROUGH THEIR INVOLUNTARY PARTICIPATION AND THE PSYCHOLOGICAL IMPACT OF BEING TREATED AS
MENTALLY ILL.
APA ETHICAL STANDARD
INFORMED CONSENT (3.10):
THE STUDY INVOLVED PSEUDOPATIENTS BEING ADMITTED TO PSYCHIATRIC HOSPITALS WITHOUT THE
KNOWLEDGE OR CONSENT OF THE STAFF, OTHER PATIENTS, OR THE INSTITUTIONS THEMSELVES.
AVOIDING HARM (3.04):
THE PSEUDOPATIENTS EXPERIENCED POTENTIAL PSYCHOLOGICAL HARM AS THEY WERE LABELED AS
MENTALLY ILL AND TREATED ACCORDINGLY, WHICH COULD HAVE LED TO STRESS OR DISTRESS
APA ETHICAL STANDARD
DECEPTION IN RESEARCH (8.07):
THE STUDY INVOLVED SUBSTANTIAL DECEPTION, AS THE PSEUDOPATIENTS CONCEALED THEIR
TRUE IDENTITY AND PURPOSE FROM THE HOSPITAL STAFF.
DEBRIEFING (8.08):
THERE IS NO EVIDENCE THAT ROSENHAN DEBRIEFED THE HOSPITALS OR STAFF INVOLVED IN THE
STUDY, LEAVING THEM UNAWARE OF THE TRUE NATURE OF THE RESEARCH.
