On “Being sane in insane places”

Rosenhan’s 1973 study was a powerful indictment of psychiatry of the early 1970s. It is a classic study relevant to discussions of contending definitions of abnormality and the validity and reliability of diagnosis. In evaluating the study methodological, ethical, cultural and gender considerations should be discussed.

Methodological

Strengths: The use of covert participant observation meant that the pseudo patients could experience and comment on their treatment within hospitals as it occurred. Thus, there was a high level of ecological validity. Different kinds of hospitals were used on the East and West coasts of the US, so the results can be generalised. The pseudo patients were both men and women of different ages and from different occupational groups.

Limitations: The sample of hospitals was small. The pseudo patients may have behaved differently because they knew they could get out of the hospital.

Ethical Considerations

Psychological stress may have been caused to the real patients, but also to the researchers.

As the follow-up study showed, people in real emotional distress were turned away from hospitals, suspected of being pseudo-patients. Therefore, this caused additional psychological stress.

Time and space was taken up in the hospital by the pseudo patients; it may have been that this prevented others from being admitted.

Deception was involved, both staff and of the real patients, which is unethical.

Gender and Cultural Considerations

Three women and five men of different ages were the researchers. The staff and patients were of both genders. The cultural mix of either researchers or staff and patients is not given but the study was carried out in the USA.