Psychological Disorders: Crash Course Psychology #28

Way back in 1887, a journalist named Elizabeth Cochran assumed the alias Nellie Bly and feigned

a mental illness to report on the truly awful conditions inside psychiatric hospitals in

the US, which were known as asylums at the time. She found rotten food, cold showers,

prevalent rats, abusive nurses, and patients being tied down in her famous expose "Ten

Days in a Mad House". What she documented had been pretty standard mental health treatment

for centuries, but her work led the charge in mental health reform.

It's been a long battle.

Nearly a century later in 1975, American psychologist David Rosenhan published a paper called "On

Being Sane in Insane Places" detailing the experiment that he conducted on psychiatric

institutions themselves. The first part of his experiment involved sending pseudopatients

- a group of eight totally mentally sound associates, including David himself - to knock

on institution doors and falsely report that they'd been hearing voices. Once admitted,

the fake patients abandoned their fake symptoms and behaved as they normally did, waiting

for administrators to recognize them as mentally healthy.

Like Cochran, Rosenhan and his team learned that it's easy to get into a mental institution,

but it is much, much harder to get out. The participants were kept in the institution

for an average of 19 days, one of them for 52 days. They were forced to take psychotropic

medication (which they sneakily spit out) and were eventually discharged with a diagnosis

of paranoid schizophrenia in remission. Of course, being dubbed in remission isn't exactly

the same thing as being labeled sane, and that was just one of Rosenhan's criticisms

of the system. It viewed mental illness as an irreversible condition, almost like a personality

trait, rather than a curable illness.

Part two of his experiment came later when Rosenhan shared his results with a teaching

hospital and then told the staff that he'd be sending more pseudopatients their way in

the next few months, and challenged them to detect the imposters. With that in mind, out

of 193 new patients, 41 were ferreted out as likely or suspected pseudopatients. The

thing is, Rosenhan never actually sent in any pseudopatients. In the end Rosenhan concluded