Rosenhan (1973) - On Being Sane in Insane Places
The “Medical Model”
This is based on the assumption that mental illness, like physical illness, has a basis in biology. The medical model of abnormality aims to treat psychological disorders as if they were physical illnesses ; diagnosing them in much the same way. The psychiatrist identifies a set of symptoms in the patient and uses these to identify a disorder.
In the 1960’s, psychiatrists launched the anti-psychiatry movement which challenged the fundamental claims and practices of mainstream psychiatry which believed that psychological disorders were physical illnesses.
Foucault :- Described the development of the concept of mental illness in the 17th and 18th centuries when “unreasonable” members of the population were locked away, institutionalised and subjected to inhumane treatment. He argued that the concept of sanity and insanity were social constructs.
Szasz :- Argued that the medical model is no more sophisticated than believing in demonology, and is unhelpful to our understanding of psychiatric conditions. He suggested that the concept of mental illness was simply a way of excluding non-conformists from society.
Normal vs. Abnormal
Psychiatrists may believe that they can tell the “normal” from the abnormal, but the evidence for this ability is not quite as compelling :-
· In murder trials, prosecution and defence may call their own psychiatrists who disagree on a defendant’s sanity.
· Disagreements about the meaning of terms e.g. “insane”.
· Conceptions of normality and abnormality are not universal – there are cultural differences.
Rosenhan did not suggest that there is no such thing as deviant or odd behaviours, nor that “mental illness” is not associated with personal anguish. However, there is an important question about whether diagnosis of insanity is based on characteristics of the patients themselves or the context in which the patient is seen.
Rosenhan aimed to investigate whether psychiatrists could distinguish between people who were genuinely mentally ill, and those who are not. He argued that the question of personality vs. situation can be investigated by getting “normal” people to seek to be admitted to a psychiatric hospital. There were two possible outcomes. If such pseudopatients were diagnosed as sane, this would show that the sane individual can be distinguished from the insane context in which he is found. However, if such pseudopatients were diagnosed as insane, this suggests that it is the context rather than the individual characteristics which determine the diagnosis.
The Pseudopatients :- Were 5 men and 3 women of various aged and occupations including Rosenhan himself. They attempted to gain admission to 12 different hospitals in 5 different states in the US. The hospitals represented a range of different kinds of psychiatric institutions e.g. private, old, well-staffed, modern etc.
Gaining Admission :- Each pseudopatient called a hospital asking for an appointment. On arrival, they told the admissions officer that they had been hearing…