The Corner

Health Care

The Rosenhan Study Was Bunk

(Unsplash)

As Hilaire Belloc stated in an essay buried deep in 1941’s The Silence of the Sea, “Statistics are the triumph of the quantitative method, and the quantitative method is the victory of sterility and death.” One wonders just how many “deaths” have been caused by junk social science and bungled statistics. Consider:

David Rosenhan — Stanford professor of psychology, influential scholar, the rest — published his famous study “On Being Sane in Insane Places” in 1973. It came at the apex of the “first wave” of deinstitutionalization in the United States — John Kennedy’s last act as president was the Community Mental Health Act of 1963, a federal boondoggle which usurped state power and tried to deinstitutionalize the mentally ill via national mandate. He created a network of “community mental health centers” with federal funds, centers that he hoped would replace the state hospital as the locus of psychiatric care. The results were mixed; on one hand, plenty of individuals were mistreated in state hospitals, and still others never belonged there in the first place. Yet for the most seriously ill, the results were disastrous — the new “community mental health centers” Kennedy initiated had becomes hotbeds of political activism and had little time or interest for the violently disturbed. By 1973, many of those who were unnecessarily hospitalized in the past had already been discharged. But anti-institutional sentiment had reached a fever pitch among progressive academics; Mike Gorman, one of the architects of deinstitutionalization, admitted later in life that his “hidden agenda was to break the back of the state mental hospital.”

Rosenhan, caught in the spirit of revolution, instructed eight so-called “pseudo-patients” to play-act as schizophrenics and seek admission to mental hospitals. The subjects allegedly returned with a litany of horror stories — neglect, overmedication, squalor, uncaring staff — and Rosenhan further asserted that, if psychiatric professionals considered these fake patients insane when they were perfectly lucid, then the institutional psychiatry must itself be a sham. The study was cited time and again by activists eager to close “the asylums.” Today, with scores of drug-addled, mentally ill persons toiling on our streets, the fruits of this effort couldn’t be clearer.

Susannah Cahalan, author of the new book The Great Pretender, raises significant questions about Rosenhan’s study. She discovered, for instance, that one of the subjects contradicted the study’s findings outright — he told Cahalan that his experience at the institution was much different than Rosenhan let on. From her account in the New York Post:

Harry Lando had a vastly different take. Lando had summed up his 19-day hospitalization at the US Public Health Service Hospital in San Francisco in one word: “positive.”

Even though he too was misdiagnosed with schizophrenia, Lando felt it was a healing environment that helped people get better.

“The hospital seemed to have a calming effect. Someone might come in agitated and then fairly quickly they would tend to calm down. It was a benign environment,” Lando, now a psychology professor at the University of Minnesota, recalled in an interview.

But instead of incorporating Lando into the study, Rosenhan dropped him from it.

Lando felt it was pretty obvious what had happened, and I agree: His data — the overall positive experience of his hospitalization — didn’t match Rosenhan’s thesis that institutions are uncaring, ineffective and even harmful places, and so they were discarded.

Cahalan alleges that, in addition to discounting Lando’s testimony, Rosenhan’s pseudo-patients presented symptoms “far more severe” than the ones he recorded in the study. She even goes so far as to claim that “some of the other pseudopatients [Rosenhan] mentioned in his study never existed at all.” Rosenhan, despite receiving a lucrative deal to publish a book on his research, never published his manuscripts, and went to his grave with the data that radically changed domestic mental health policy.

Perhaps — perhaps! — we should be less credulous of the academic hokum we deploy in our public policy disputes.

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