Defining how one should be counted as sane is a troubling matter. In situations involving mental health diagnoses, concern over the reliability in distinguishing sane from insane arises. With such a troubling situation, instances of its misuse are deemed unreliable and inconsistent. Author David L. Rosenhan addresses this dilemma in his classical piece “ On Being Sane In Insane Places.” By arguing upon the notion of insanity and sanity not being as accurate as it may seem, he emphasizes the effects this poses on patients within hospitals who may be wrongly diagnosed for psychological disorders, specifically schizophrenia; and these effects precede due to the use of labeling theory.
Rosenhan conducts a field experiment involving pseudo-patients to verify the validity of psychiatric diagnoses in mental health institutions. The pseudopatients were asked to display fake and abnormal behaviors to gain admission to mental health institutions. Gathering eight sane individuals who were admitted to 12 different hospitals, it was found that each pseudopatient was misdiagnosed with Schizophrenia. But when they were released, their “condition” was labeled in “remission.” This supports Rosenhan’s observation involving the misuse of mental health labels. Displaying no abnormal symptoms after being admitted into the psychiatric ward, their sanity was under suspicion by physicians who held a strong bias, referred to as the type 2 error. Physicians are more likely to call a healthy individual sick rather than calling a sick individual healthy, to stay on the side of caution. However, this hasty decision can significantly inhibit patients.
Being labeled as having schizophrenia in remission made the patients remain viewed as schizophrenic. There is nothing that patients can do to relinquish this label placed on them; even attempting to be sane will still be seen as insane. Rosenhan includes the use of Labeling theory to demonstrate that the psychiatric diagnoses of patients are based on inaccurate assessments of their characteristics. Patients not only are misdiagnosed but are also faced with the harmful effects of being labeled as mentally ill. By debating upon the idea of normality, he finds that its implications are solely determined by the circumstance and the individual observing the patient. Furthermore, the effects of this label serve to“filter” everything in the pseudopatients personal life that is affiliated with their schizophrenic illness. One example is of a pseudopatient whose personal history was altered from a case summary processed for their discharge. The staff had unintentionally changed the information in order to attain consistency with the popular theory of the dynamics of schizophrenic reaction. This relates to the textbook idea of social stigmatization, everything the patient said or did was disregarded because of the stigma that came from being labeled as schizophrenic. To reverse these detrimental effects of labeling theory and stigmatization, Rosenhan proposes that we should focus on the individual problems that provoke patients.
In conclusion, Rosenhan’s study calls for change in clarifying how one is determined to be normal. If change does not occur, not only will these misdiagnoses affect the lives of patients who do not possess actual mental illnesses, but prevent actual patients from receiving the treatment they need. Moreover, the effects of labeling exhibit the idea of stigmatization as patients are discriminated against in everything they say and do. Overall, Rosenhan’s idea that normality is socially constructed is supported through this experiment as observers were not able to identify the sane from the insane. From personal experience of observing the effects of the stigmatization of illness, I agree upon the notion for change. Being the cousin of a mentally ill individual, I observed the discrimination these individuals are faced with first-hand. Everything they would do was associated with their mental illness. Although understandable for certain situations, discriminating against his every action is not justified.
