08/08/2025
Here is the next installment of The Psych Geek's Guide to People Don't Behave Just to Behave
Another Chapter from the Psych Geek’s Guide to People Don’t Behave Just to Behave by Morry Edwards, PhD
Morry Edwards, Phd
3 min read
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Chapter 2
On Being Sane in Insane Places-
The Rosenhan Experiment
Identifying “crazy” behavior many times varies from place to place and society to society. Some traditions or customs in one country may seem quite bizarre to someone from a different background. Having a monkey’s skull opened at your dinner table and eating the brain is a delicacy in China or Vietnam and serves as just one example.
As recently as the early 1960’s large mental hospitals were not necessarily treatment oriented as more for custodial care. These were not necessarily very healing places to be.
In 1963, the Community Mental Health Act of 1963 (CMHA) (also known as the Community Mental Health Centers Construction Act, Mental Retardation Facilities and Construction Act Public Law 88–164 was passed. The purpose of the legislation was to transfer people from those large mental hospitals to facilities or families in the community. This ended up very shortsighted as far fewer of the proposed centers were built, many were never fully funded, and little money was provided for long term. The trouble with that was instead of having other transitional residential programs, people often ended up on the street and it dramatically increased our homeless population.
In the midst of emptying out the mental hospitals, there was another controversy brewing: a criticism of psychiatric diagnoses. Dr. David Rosenhan, a professor of psychiatry at Stanford University devised an experiment to test the arbitrary nature of psychiatric diagnoses.
Rosenhan and seven mentally healthy associates feigned mental illness by claiming they were hearing same s*x voices pronouncing words such as “empty” or “hollow.” No other psychiatric symptoms were reported and once they were admitted, the patients reported feeling “fine” and no longer had any hallucinations. They were still forced to admit to having mental illness and to take medications. They flushed the pills down the toilet and even some of the other patients could tell they were “normal.”
All but one of them were diagnosed with schizophrenia in remission. They were forced to admit that they had mental illness and agree top take antipsychotic medication before they were released. They were institutionalized in 12 different hospitals in five states for an average of 19 days. A more detailed description can be found elsewhere especially in Rosenhan’s original article entitled, “On Being Sane in Insane Places” published in the journal, Science, in 1973. He describes the dehumanization and invasion of privacy. While many of the staff were well meaning, some were verbally and physically abusive.
As one can imagine, this was a huge embarrassment to the psychiatric establishment. A well-known teaching hospital claimed that similar errors could not happen at their hospital. Rosenhan told them that during a three-month period, pseudopatients would attempt admission and had the staff rate new admissions as the likelihood of being an imposter. During that time, 193 patients were admitted and 42 were considered imposters, while another 42 were considered suspect. The truth was that Rosenhan had not sent a single “imposter.”
Another psychiatrist who questioned labels was Thomas Szasz who wrote The Myth of Mental Illness: Foundations of a Theory of Personal Conduct.
This stirred the pot even more, but much reform has taken place and we have succeeded in deinstitutionizing as many as possible. While psychiatric diagnosis has developed more empirical validation in the Diagnostic and Statistical Manual of Mental Disorders — 5 (DSM-5TR)), it remains an evolving process.
Another community mental health problem that has developed is the growing use of jails as a mental health facility. Many people who should be receiving treatment through community mental health agencies end up committing minor and sometimes major crimes end up in jails rather than mental health facilities. As an example, Cook County Jail in the Chicago area reports as many as one-third of their 6,500 prisoners are mentally ill. It is to the credit of Sheriff Tom Dart and his staff that some innovative programs are helping his prisoners get jobs and hopefully stay in society. For a slightly light-hearted look at this grim situation, see John Oliver’s segment a few years ago (https://www.youtube.com/watch?v=NGY6DqB1HX8 ).
A further point to consider is focusing less on labels and more how the aberrant behavior functions. Let’s look further into how a behavior functions with many of the people in this book. While many have severe problems, several are super role models such as the man who starts us off in the next column.
Written by Morry Edwards, Phd
