How The Rosenhan Experiment Worked

particular study, a very famous psychology study. UM. And the whole thing is kind of rooted in context that you have to know, which is that UM. There was a time up until about the fifties when psychiatrists were considered like unquestionable, no matter how weird or brutal or potentially lie taking their methods were. If it was if it was a psychiatrist saying this is needed for mental health,

then society just went along with it, right. But then at some point in time there was kind of this backlash against that because people started questioning, like, are you sure you guys know what you're talking about? And if you don't, UM, what you're doing is even more horrific

than we thought before. And I was trying to think of a good analogy, Chuck, and the best I could come up with is, let's say you gave a group of church officials free, free reign to hunt witches, tortures suspected witches, violently exercised demons from from um people who are possessed, and then society figured out that not that those things don't exist, but that in this case, the

church officials themselves don't exist. Right, So, in this case, mental illness does exist, but the witch hunters don't aren't actually real, their methods don't mean anything. They're completely made up. And that was the crisis of confidence that psychiatry was going through in the middle of the twentieth century. People started doubting that it had any kind of veracity whatsoever, and that they were just torturing mentally ill people to

try to figure it out as they went along. Yeah, and I'm not going to get on some anti medication, anti psychiatry soapbox, but I will say this, and you know this about what's been going on in my private life. But I have seen a very sad situation of someone I love dearly in my own life over the past

few years deteriorate. Because while conditions in like let's just call them asylums what they call them back then, have certainly improved, Uh, there's still a lot of lines that can be drawn to doctors forgetting when it comes to mental illness, forgetting there as a human sitting there in front of them, uh, when medication is being thrown at them. And again the medication can be great, not going on some big tirade against uh uh antipsychotic meds and things

like that. But I've just seen it happen up close and impersonal, and it is a it is still a very broken system in many ways, and it's really really sad. Yeah, And what you just mentioned is it's a longstanding kind of tack that psychiatry has taken, which is they're battling the disease and the patient is just kind of an unfortunate casualty of that battle sometimes, you know what I mean. And so finally people stood up and said like wait, wait, wait, wait, wait,

we need to like rethink this psychiatry. Like you guys are giving people lobotomies, You're throwing powerful um like psychotropic medications at people that can rob them of their will. Um and rob them of their personalities, like we need to rethink this, And something called the anti psychiatry movement started to develop, um, both in the general public and amongst some psychiatrists and psychologists themselves, and in the Church

of scientology. Yes, scientologists hate this stuff, um, but they really are kind of vehemently opposed to the entire idea, it seems like, whereas this was more like the anti psychiatry movement, especially within the profession, was like, Okay, our goals are noble. What we're trying to do is worthwhile. We just don't know what we're talking about yet, and

we need to figure out a better strategy. Yeah, And as we'll see, certain things like if you listen to our episode on Titticut Follies, things like that popped up here and there throughout history to make people really pump the brakes and go, wait a minute, how how are we treating people with mental illness in this country? Like?

What the heck is going on? So there was a a person named R. D. Lange who was um didn't like to be like fully put in the box of like anti psychiatry, but was certainly criticized and questioning the fact that Hey, Um, we're observing these behaviors. It's a behavioral things that we're witnessing, and we're treating them biologically, and like, there's there's something missing here. There's a piece

that's missing. And R. D. Lange was giving a lecture one time that was seen by a gentleman that we're talking about today, David Rosenhand, who was a psychologist and rosen Han. I guess it. You know it touched a nerve with rosen Han or is it Rosenhand? You know I've always said hand, Okay, Rosenhand, that's what we'll go with. We definitely won't switch back and forth Overard. No, well, we definitely won't say I'm both in secession. But Rosenhand said, Hey,

this lecture spoke to me. Um, tagging someone is mentally ill quote unquote mentally ill is does humans a disservice because that's a tag that they live with, not only in the eyes of others, but to themselves, and it can calls real damage. Um, and some of these people aren't mentally ill. So we need to really take a look at this. And I have some ideas on how

to tackle it. Yeah, and we should say in this episode, we're going to use the word sane and insane a lot, and nowadays you would call that healthy or mentally ill um And the reason we're kind of using it like that's number one, that's the terms they used back then. But also it's different. It was a different understanding that back then that there there wasn't gradiations of mental wellness. There was you were sane or else you were insane. And once you were insane or labeled insane, you had

that label for life. You were in remission, but you still had that that label of you know, that you carried around for the rest of your life. Yeah, that's a good point. I'm glad you made that. Actually. Uh so. Rosen Han also at some point previous to this, underwent a experimental eight day in patient uh you know, and this was rosen and wasn't like a Rosenhand there I go. Wasn't saying, oh, I'm not feeling well, I'm gonna try this.

Rosenhand said all right, I'm completely saying I'm gonna check myself in for eight days as an impatient and see what happened. Because I want to maybe convince some of my students to do this. After he did it, he was like, well, that was intense. I definitely am not going to ask my students to do this. What I'm gonna do is design and experiment where we can have non students do this and then I can tell them what happened. Right, And the basis of it was just

one kind of very central question, right, right. So Um Rosine haine Um decided that he was going to design an experiment using those two experiences, and he wanted to see if psychiatrists could do the most basic part of their job, which is identify the difference between a sane person and an insane person. Yeah, and this, it really did make me wonder if he was influenced at all by One Flew Over the Cuckoo's Nest. I don't know. I saw that he started this in nineteen sixty nine.

When was that book published sixty two or sixty three. It's entirely possible and was the stage play, and the whole basis of One Flew with the Cuckoo's Nest was, Uh, if you haven't seen the movie or read the book, which is the both great Uh, it was it was a gentleman who was always in trouble with the law who basically saw a way around going to prison, and that was, um, let me try and convince them I'm insane and we'll be put in a cushy mental institution instead.

So the whole basis of that, it's a little different. But was put a sane person in an insane asylum? Again words they use back then, Uh, and let's see if I can fool them. Yeah. And that was written by Ken Kesey, who figures big time into the electric kool aid ASCID test. And he was actually on the ward of a state psychiatric facility in either Oregon or Washington and and he like witnessed this stuff and ended

up writing a book. And he was as we'll see, along with rosen Han man, Chuck, why did you do that to me? Along with rosen Hand and a bunch of other people along the years, he helped contribute to opening society's eyes to the ills of institutionalizing the mentally ill and how they were treated. Yeah. Absolutely. Um, So rosen Han gets in there, I'm gonna say on looks like Conomy go ahead and says, all right, here's what I'll do. And this is all in the in the

sort of pre study like planning part. I'm gonna call these people's pseudo patients. I'm gonna gather together people who are what I would call perfectly saying, they've never had any history of mental illness. They would go to a psychiatric hospital and they would say, hey, I'm hearing voices. Uh. If it was a man, they would say, I'm hearing

a man's voice. It was a woman, they would hear a woman's voice, and it's sort of unclear what they're saying, but I'm hearing the words uh, empty or thud or hollow um, And I figured I should talk to someone

about it and let's see what happens. Yeah. And so later people who came and have studied and analyzed this um believed that rosenhan Was was trying to simulate existential symptoms, possibly in existential psychosis, that where somebody has some serious concerns about the meaning of existence all of a sudden they're really concerned that they don't mean anything, that there's no purpose to life, and that he was trying to

kind of come up with that using those words. The thing is, after they presented themselves at the psychiatric facility and they gave this false initial complaint. They were also required to give a false name. They were also required to give a false occupation because a lot of these pseudo patients were actually psychologists and psychiatrists themselves, and that would have raised red flags for sure. But also he

was worried that they would have gotten special treatment. It would have altered the outcome of the data were collecting. But other than that, other than those three things, the deception ended there. They were supposed to behave exactly like they normally would uh as themselves from from that point on. Yeah, So like when they did interviews and stuff, whether it was intake or just as they went, although we'll see

that didn't happen a lot. As they went. Uh, they were to describe their lives as they were, uh, their personalities as they were, their relationships, their medical history. Everything was just straight up and on the straight and narrow. Um. This is very key. They did not take the medications. Uh. They would, you know, do the old trick where you hide them, uh misery style and then uh and then put them like under your mattress or something, or I

guess plush them down the toilet. Um. And they were uh. And of course rosen hand is saying that, uh, it's very natural how it happens. It's funny. Rosen And was saying, like, hey, anything, this thing is biased in the favor of these institutions, because like this is the very barest thing that they should be able to tell if someone is sane or insane, and these are completely sane people, so they should really be recognized as frauds. Like this shouldn't be too hard

for them. Yeah, I mean, like, if you're presented with somebody who has a perfectly normal, perfectly healthy life background history, um, like yeah, you should be able to recognize him as saint. So that was the premise of the whole thing. He also said that they while they were in there, if they were accepted into the facility, they were to become quote paragons of cooperation. That if they were given an instruction from somebody on the staff, they were supposed to

happily comply and follow it. Um, they were supposed to just kind of go along and get along, not cause any waves or any trouble. And that he noticed that there's like a built in mechanism to kind of support people from to to be uh cooperative, and that is that they presented themselves as psychiatric patients without anyone in these hospitals being informed that they were there, So they had no idea when they were going to get out. They needed to be on their best behavior and seem

as seen as possible so that they could eventually get out. Yeah, and this is where it really differs from Cuckoo's Nest because the main character there, McMurtry, was not cooperative at all, and that you know that led to the tragic ending. But man, yeah, what a movie. What a book. I've never read the book is that as as good as the movie is. It one of those rare things where the movies even better than they're both great. It's it's

like a great book, great movie. Yeah, really good stuff. Um. So, the other thing he had in his or claim to have in his hip pocket you can put a pin in. This is a writ of habeas corpus for each patient in case. Uh. They just were like I gotta get out of here, and the hospitals like, sorry, it doesn't work that way. Habeas rid of habeas corpus has to do with reporting unlawful detentions, and so rosen And said, I've got these on hand in case anybody has to

get out. Um. And I think he presented it to the pseudo patients that way too, right. Yeah, so don't worry like if it if it really, if push comes to shove, I can get you out of there through the courts basically. So um. And it is really important to know when you're voluntarily checking yourself into a mental facility for the purposes of a deceptive study, right, um.

And one of the things that Rosenhand needed for this study was for pseudo patients to take copious notes and observe everything um shot down, interactions, shot down, how they were treated, how other patients were treated, um, just basically everything they could document they were supposed to document, and Rosenhand was initially really worried that this is going to kind of show the pseudo patients hands. So they needed to take these notes secretly, and the pseudo patients figured

out very quickly. No one at the psychiatric facility who worked there could have cared less that they were taking notes the entire time, and in fact, they actually, in at least one case, attributed it to their um their psychological condition. Yeah, I mean this, um, I think it speaks to some of the results that we'll find, which was there a lot of time, was not a lot

of active participation from staff to patient. So they're like, I don't care, he's writing big whoop, right there was There was a note in one of their files patient engages in writing behavior, but that was it. They didn't think it was weird. They didn't think that whatever happened, those patients just took notes on everything. They were insane and so of course an insane person is going to do that. And so the pseudo patients were able to just take notes out in the open the entire time

during their stays. I think when you write engages in and tech behavior on the end, you can make anything like Josh and Chuck exhibited pie casting behavior right exactly when all of a sudden, someone's coming after us. All right, so the study is now designed. Um, he starts, Uh, he's collected these pseudo patients, these volunteers, I guess, and uh,

he wants to collect data in the end. Um, we should note that he did throw out the data from one participant because they, I think, kept making stuff up while they were in there and didn't didn't go with the reality of their life. Um. And then another and I have no idea why this person's data wasn't excluded. But another person tried, and this is very McMurtry esque. Although he hated Nurse Ratchet, but he tried to uh

to woo a nurse on the premises. Uh said that he was a psychologist, and UH actually provided psychotherapy to some other patients there. Yeah. I suspect that they didn't throw that data out because it was Rosenhan himself. Oh, that would be my guest. My data is still good. I didn't think of that because he was one of the eight pseudo patients at all who went to twelve different places in this study. Very interesting. I think it's a great place for a break. Ye. All right, I'm

gonna ponder that whole scene. Uh, and we'll be right back. Alright. So it's nineteen it's funny. It was published in Science in nineteen seventy three. But I didn't see I couldn't find anywhere when this happened. When did it actually happen? I saw seventy two. It's weird. I looked in a bunch of places and it all just dived right into the thing without saying what ear it was? Yeah, I said I noticed that too. I found it in one place.

All right, So seventy two The Summers of Love and eventually published in Science, which, of course we've talked about it a lot. It's one of, um, if not the most prestigious academic journal in US history. So it's not like it was published in Popular Mechanics or something like that. Hey, Popular Mechanics is pretty great, or BuzzFeed. Sorry, let's say Highlights Children. Oh, I love Highlights, which is the one I was on the cover of, like like Catholic Boy's

Life or something Catholic nuns like Expelled. It was spelled n O N E apostrophees. Uh so where were we? All right? It's nineteen seventy three. It's published in the journal Science. Uh. It was called on Being Sane and Insane Places. And it's a really great read. You sent me in the original article. It's awesome. You can still find it and read it. It's a really good read because it doesn't take the form of a regular scientific

academic journal. UM doesn't have a lot of data, not a lot of statistics, UM, not a lot of a lot of things UM methodology, like results. It's just sort of written out like this kind of uh challenge essay, which, as we'll see, ended up. You know, therere being a lot of problems with it, but it makes for a much better read than most things in science. Yeah. He starts a lot of paragraphs with oh here's another thing, right Yeah. So, Um, like I said, Rosenhan was one

of the eight pseudo patients. There were eight and all, um, five of them were men, the other three were women. Um, and five of the eight were somehow engaged in psychology or psychiatry plus him, are including him? Do you know? I think I think including him? Yeah, I think he's included all of those. And um. He sent them to twelve different facilities in five different states on the East coast and West coast. Um, and they were all different kinds.

He specifically tried to make his sample representative of the kind of facilities that you would find throughout the United States. Yeah. Um, one of them was a private hospital eleven where state run. Um, so not the biggest division there, but they did run the gamut from older kind of rundown places to newer places. Uh. Some places had um really good ratios of patient staff, some my really crutty ones uh and not nearly enough staff uh, somewhere research based and oriented, somewhere not at all.

So it seems at least that he had a pretty decent representation, right he so Um again, in the design of his study, he has set it up to make it as easy as possible for anyone in these psychiatric facilities staffs to notice that, you know, this person is actually not mentally ill at all. They're giving us all this information that's contrary to that. So he he, like he said before, Um, he biased it in favor of the psychiatric staff finding out that these people were saying.

And he said that there were some things that he considered and then dismissed about why they may have been admitted, because we haven't said it yet, but all eight were

admitted in all twelve instances, Um. And one of the reasons he considers they were possibly that possibly affected the diagnosis and their mission admission was that they were nervous, like the site of the pseudo patients were nervous about being found out they were They were nervous they were going to be embarrassed or shamed or maybe get into some sort of trouble Um. And so he said that might have contributed a little bit, but probably no, not

enough to be admitted into a psychiatric facility. So he he kind of dismisses that thought. But what he says is that they were all really surprised at how easily they were admitted. Yeah. I mean, I think in the late nineties sixties, when you show up say you're hearing voices in your head, they believe you and they say, all right, you're, uh schizophrenic, and welcome to the facility. Uh, here's your here's your outfit, and here's your room, and uh,

here's your pills. And that's basically what happened. I think they were all save one, diagnosed with schizophrenia UM. The one was at the private run Interestingly institution, and they were diagnosed as what would now be bipolar disorder. Back then they called it manic depressive psychosis. But they were all ushered in basically with open arms. Yeah. And I saw and I think a big Think article on this

UM study. They pointed out that, like this is the opposite of what it's like when you try to get mental health treatment today. It's really hard, it's really expensive. You don't just show up and they let you in and here's your gown and here's your pills kind of thing. So it's kind of interesting in that respect as well. But then once these pseudo patients were in the ward again,

they have diagnoses of schizophrenia. Now, um, there wasn't a single instance where any of their behavior was questioned by the staff, are considered suspicious, and um he got he obtained most of the reports from these visits and in the files, there's no questioning or suspicion whatsoever about the pseudo patients at all. No, I mean they would uh the reports were really good, and that all the people were like model patients and cooperating and friendly and engaging

and like. These things were noted, but no one ever said like, uh, and we'll see you know some of them, Well, we'll get to that point. Because I think that's one of the more remarkable parts of it is how they noted that. But what they didn't note was like, you know what, this person doesn't seem like there's anything going on with them at all. Uh. It was just sort of accepted, like they're here, so this is what is going on with them. It's really interesting. But that was

the staff, right, What about the other patients of the facility. Yeah, this I think is super fascinating. They were the only ones that were into it. The other patients they were basically were like, you're not one of us, and I and we can tell um and I trying to remember in Cuckoo's Nest, I think he basically told everyone right away, like the other patients like I don't belong here, um,

and he kind of became the de facto leader. But at uh these places with rosen Han, they've they basically said, hey, we don't think you're real. We think you're either a journalist um, trying to expose the facility, or maybe you're you work for the facility and you're you know, in there as a mole kind of checking on things. Yeah exactly, but either way, we don't believe you. And it seems

like in most cases they were uh. And I love that you actually put sniffed off the case and because you put this together, But they were sniffed off the case generally by just being reassured by the pseudo patients that no, I'm just feeling better, That's why I'm acting this way, right. Can't you just see Mr Martini saying, like, I know you're checking up on the hospital. So there's the thing that Rosenhand points out, and he just kind

of brushes past it, but it's kind of important. He says that while the other patients you know, found them out immediately, um, none of the pseudo patients were closely examined by the psychiatric staff, by the actual psychiatrists. They had plenty of interaction with the nurses, the order lads, you know, the people who interact with the patient's day today. But none of them, in all twelve instances, all twelve visits,

none of them were closely examined by a psychiatrist. And you can imagine that an inmate or a patient at one of these facilities is going to have the opportunity to really closely pay attention to you and interact with you and see your behavior. So it might have been easier for them just because they interacted with them more. But he defends this, you know, potential flaw in his design and saying like, these hospitals had plenty of opportunity

to closely examine pseudo patients and they didn't. So whether that was the reason they didn't find them out or not, it was still a huge failing of the psychiatric system and their process, and that they didn't even closely examine these people to see that, oh no, actually these people are faking. Yeah. And not to harp on Cuckoo's Nest, but it was written, you know, as a as a real thing that Kesy did, and it was that's what

happened in that book. He you had this initial meeting with a psychiatrist where they diagnosed him, and then it's like, all right, this is where you live now, and these are the orderlies and these are the nurses, and this is your life. There was no regular check ins to see if anybody was getting better, and that was the whole point of this experiment, and in a lot of ways was like it wasn't being done right. These people were just being sent to live away because they were

a hassle for their family. They were being sent to live somewhere else now, right. So one of the other themes of Um one flew over the Cuckoo's Nest is that, you know, Jack Nicholson is kind of slowly driven crazy, I guess you could say, from being institutionalized. It was one of the main themes um and Rosenhan Actually I don't maybe he did read that book because he accounted for this. Um. He didn't report it I think in the study, but um in a memoir that was found

after he died. Uh. He apparently had people visit, you know, friends visit the patients during their stay, and then would interview the friends to see if they noticed any actual change in the pseudo patients, and that none of them did. There was no major, you know, noticeable effect of institutionalization that could have accounted for people you know, mistaking them as as um, you know, having schizophrenia or something. Yeah. And this was over the course. What was the average stay?

How many weeks? I think nineteen days, almost three weeks for the average. Yeah. So it's it's long enough to where someone could have said to a visitor like, hey, this place is really wearing on me, starting to lose it a little bit. Uh, And apparently that didn't happen. Um. This is the part that I think really fascinated me was that, Uh, the more saying they were, which was to say, uh, saying appearing um, the more that was

looked at as a symptom of schizophrenia. So they would act completely normal, be super friendly, um and very cooperative and sort of like the writing behavior thing. When they looked at these notes, they would indicate this cooperation or just good sense sometimes to do things as part of their problem. Um, and we'll go over a few a

few of them. It's it's shocking. Um. There was one that lined up early for meals because I guess they were smart enough to know, like, hey, I get at the front of the line, I get whatever more food or the best food, you know, the best chicken breasts. I don't know. I saw, well, I saw it explained, is there's not a lot else to do or anticipation reward,

so like that's that's something to look forward to. Yeah, so they noted that as as an example of oral acquisitive psychotic behavior instead of just like being hungry and bored. Right exactly. That was that was a big recurring theme throughout right. Yeah. This next one was really kind of funny. Um, this one pseudo patient was talking about their marriage in their home life and they said, he, you know, my my life is pretty good. My wife and I get along.

We have occasional arguments. Um, very rarely. I spanked my kids, which was you know, something you did back then. So in that context, it was quote unquote normal family life. Uh. And they said that his attempts to control emotionality with his wife and children are punctuated by angry outbursts and in the case of UH, in the case of the children, spankings.

Instead of just saying in in marriage, they exhibited behaviors of being married, which is to say, occasionally arguing and again in those days, like I was spanked when I was a kid, we expect, yes I was, and now it's my choice. Good for you. What was the other one? What was the uh? Oh? So that same guy who was trying to control emotionality with his wife. Um, they

said that. So during his interview and take interview, he said that when he was a kid, he'd been close to his mom but kind of distant from his father, and then as he became an adult, he actually became close friends with his father and just not quite as close with his mom. Right, that turned into um, a considerable ambivalence and close relationships, and that his effective stability is absent, meaning he's emotionally unstable. Yeah, that's what they

gathered from that. You know, my brothers and sisters and me, we really fought a lot when we were young. But now that we're adults, we all get along really well. Right, right exactly, that is psychotic. So the rosenhand goes to um, he goes, he stops and points out, like this is a kind of a major section in the study. He's saying, like, this is the context of the hospital setting. This environment

shapes people's perceptions. And he was saying that the people's very sane, very normal personal histories didn't affect the diagnosis of schizophrenia. The diagnosis of schizophrenia altered everyone else's perception of their very sane and very normal personal histories. Yeah, and what really struck me was the Uh, and this is something I think you could, like I said, you can still see today in some cases, is the de personalization that happened. Uh, it was kind of constant. It

seems like these patients were generally ignored. Um, this is he Like I said, there wasn't a ton of raw data, but there was a little bit, And one of them was that they were close to fifteen hundred patient initiated contacts with the staff, like four hundred and sixty eight times. Uh. The eight pseudo patients went up and in aged the staff somehow, for some reason. And apparently less than three percent of those resulted in actual verbal engagement back to them.

So that tells me that they would just say something to them and be ignored at the time, right, Yeah, they would be ignored. They were powerless because they were stripped of rights, they were mistreated, sometimes violently by the staff. They were just treated like they weren't there, and they came to kind of question their self worth just as a part of the institutionalization process. Um. And that was a big, big point um from this study and one

of the lasting effects that had was pointing this out. Um. And like you said, I think the average length of stay was nineteen days, The shortest stay was seven days, the longest stay was fifty two days. Someone was digging it. And in eleven out of twelve of these visits, the patients, the pseudo patients were diagnosed with schizophrenia when they left, when they were determined to be able to return to society, they weren't labeled sane or cured or mentally healthy. They

were labeled as having schizophrenia in remission. And that is what Rosenhand was talking about, that once you're labeled insane in our society, especially in the middle of the twentieth century. You were insane for the rest of your life. It's

just you might not be actively insane at the moment. Yeah. Absolutely, So I say we take a break because, uh, we got a pretty good twist in the story coming up, and then we'll finish up about how this whole experiment is viewed these days right after this, Okay, chuck sie, So there's an extra twist coming. Um, Rosenhand is just showing off at this point. He's running circles around the field of psychiatry, juggling bowling pins that are on fire

for fun, right. Sure. Apparently somehow this word of the study got out before the publication of the study, and some hospital challenged Rosenhand. They said this could not possibly

happen at our hospital. So he actually worked with a research hospital, um and said, Okay, the staff was informed that over the next three months, one or more pseudo patients was going to be admitted, and they had the staff rate the patients that were admitted over those three months to see if they could figure out which one

was actually faking game on. That's right. Uh So of the one dred and ninety three patients that were admitted to this hospital over a three month period, um, there were forty one that were sniffed off the case as pseudo patients by at least one person on the nerving staffing. You know, they were nervous. It's the funnest staff. Uh.

Twenty three. Uh, we're sniffed off the case by at least one psychiatrists, and nineteen of them were suspected by at least a psychiatrist and at least one of the people on the nursing staff so uh, by at least one of the other Uh. Forty fifty sixty four of them were suspected as being pseudo patients. And how many pseudo patients did rosen Hans send their way? Zero? Not fair trick question. He's like Wallace Shawn and the Prince's

bride all of a sudden, that's right. So yeah, he didn't deploy any pseudo patients to the hospital and just basically let them chase shadows to prove that not only could they not detect false negatives, they couldn't detect false positives correctly either. So in psychology they call false positives and false negatives type one and type two errors. And he was basically showing like psychiatry is full of judging

type one and type two errors. Yeah. I wonder if there was one person on the staff that was trying to talk everyone into like he's not sending any I know it. I know this guy is just messing with us. They locked that guy up and gave him powerful anti psychotic medication. Yeah. So again, I'm sure he was very pleased with himself after this challenge. Uh. And this is

at a time and you know I mentioned Titticut Follies earlier. Uh, this is also a time when there was a, um, you know, a lot of sort of inside looks at what was going on in these hospitals. Thankfully because so many of them were exposed in the early seventies. Geraldo Rivera Uh kind of one of the first ways he made a name for himself was, uh, the work he did exposing the Willowbrook States School for the developmentally Disabled

on State in Island. Um. Uh, Titticut Follies. Frederick Reisman um did the same thing in the late sixties, and I think even in the eighteen hundreds, a journalist named Nellie Blye did sort of the same thing, going undercover to write a book called Ten Days in a Madhouse. And then of course Kenkisi, Yeah, there's ken Kizi. Two there was a life magazine spread from n called I

Think Bedlam forty. And all of these things like really shocked the conscience of society over and over and over again, and so together, including this wave of anti psychiatry, um, Rosenhand's experiment with all these other things helped kind of shape public perception and turn it against if not psychiatry itself, certainly the large state run um depersonalizing institutions that people

were typically placed in when they suffered from mental illness. Yeah, and you shouldn't be surprised to learn that John F. Kennedy was the first president to really kind of try and tackle this in a substantive way, um, because you know, he very famously had mental illness in his family. They had a lobotomy in his family, right, yeah, Rosemary. And so he got on it and said, let's put it into the guise of the federal government and get it

out of the hands of the state. That was more fat, that was more fat tony than jfk oh mayor Quimby. Come on, um, I know we're all frightened in Horney one of the greatest lines ever on the citizens totally uh yeah. So he said, let's let's put it under the hands of the federal government. The state run facilities are ignored and underfunded, and it's a it's a an S show in there. He coined that term to uh. So, he signed the Community Mental Health Act in nineteen sixty three,

but that was underfunded, and that was also an S show. Yeah. So, so the responsibility for treating the mentally ill went from the States to the Feds, but and the Feds never funded that bill. So the treatment of the mentally ill and who is responsible was basically in limbo for almost twenty years um. And then Reagan came along and said, how about this. We'll just push it back to the states and we'll give them a little bit of funding,

but not enough. And over the years, the kind of ping ponging between institutions and community based treatment, states responsibility and federal responsibility, all these state run beds were closing and closing, and there are fewer and fewer of them, and so we end up where we are today, which is a mixture of community based treatment, state run hospitals, they're definitely still there. And then private treatment and all

of them put together is just not enough. That's why it's so hard and so expensive to get treatment for mental health issues today in the United States. Yeah, and although you can't say this is the only reason, that's one of the reason why so many people, sadly in this country are unhoused today, including you know, veterans, military veterans of the United States. And it's just reprehensible the

blind dive that has been taken over the years. In the nineteen thirties, there was something called the Penrose hypothesis, which basically lays most of the blame on UH imprisonment of the mentally ill and the unhoused population that's mentally ill uh squarely the feet of D institute D instante. I can do this. You can't sound it out. D institutionalization hooked down fun It's worked for you, man. That is a when you look at that, that's a lot of letters it is. It's it's a real bone head word.

I just gave myself a pat on the back. You should you deserve it here you say it right now quick, D institutionalization. You show off you've been practicing for once. Anyway, it doesn't that doesn't mean anything. Anyone who listens to the podcast is that me practicing has zero effect on my pronunciation? Is true? Uh So the Penrose hypothesis lays the blame squarely on that uh word that you just said. That's very long and impressive, and you know their statistics

that helped back that up. Um. I think from eighteen eighty to two thousand five, the percentage of people with mental illness in prison rose from less than one percent. Yeah, and what else about the unhoused. There's a study from the mid nineties that found that the population of the unhoused in the United States was a hundred thousand and nineteen eighty and then in it was up to four

hundred thousand. Again, that is spans the entire um administration of Ronald Reagan, and a lot of people lay this at his feet. And again it's not that clear cut. The Penrose hypothesis is not cut and dried. But those are some pretty startling statistics. And the idea that if you shut down giant state run insto tuitions and you don't have enough treatment facilities elsewhere, what's going to happen

to those people? And it seems like a lot of them end up on the streets or in prison, and that's what America does with It's a large part of its mentally ill population today, especially ones that are people of color and other minorities. To absolutely. Um. As far as Rosenhan's experiment today, how it's viewed, it's, um, why is that funny? Anytime you say rosen Han, now, I'm just gonna crack up. Um, it's it's a little bit of a Stanford prison experiment view of it, which is, um, Hey,

this was interesting. We learned some things, but it was not rigorous scientifically. There was no randomization, there was no control, there was no sampling or blinding. Um, you didn't report how you train these participants. A lot of people have disregarded it, like you know, people that are well respected in the in the commune, in any psychiatric community and psychological community. Is nonsense and bunk um and just heavily criticized. Uh.

This one quote is I think pretty interesting. As a neuroscientist named Seymour Ketty that uh said, this is explanation if I were to drink a cord of blood and concealing what I had done, come to the emergency room of any hospital and vomited blood. That behavior of the staff would be quite predictable. Uh, they would label and treat me as having a bleeding peptic ulcer. And I doubt that I could argue convincingly that medical science doesn't

know how to diagnose that condition. This is taking a little far in a different direction, I think, but I get the point. I saw it put a little more succinctly by a writer in psychology today who said, the only thing the studies showed was that it is possible to deceive doctors by lying to them. So the study does have as detractors if you don't share your data like or your methodology like, it's not a scientific paper

at bait. But rosen Hands experiment has survived all these years because even as detractors say, well, it did a really good job of raising the issue of powerlessness and deep personalization in institutions, and that, in and of itself meat makes it a worthwhile study or paper at least for essay. I think it's super interesting and really interesting to read, and I think I agree. I think it did expose a lot of things, But I don't think you could, like point to it as proof of anything

necessarily except that the system was pretty messed up. Yeah, and the system is still messed up. I mean that's that that initial thing that already Lang hit on, that that psychiatry treats behaviors it observes with biological medicine is

still a problem. There's a guy who used to be the head of the National Institute of Mental Health, Thomas Insel, and he said, unlike our definitions of ischemic heart disease, lymphoma or AIDS, the D s M diagnoses are based on a consensus about clusters of clinical symptoms, not any

objective laboratory measure. So psychiatry still finds itself in the same place as ever, and it's now having to fend off kind of um a turf four that's been started by neuroscientists whore like all this stuff is brain based, and we're the ones who can look into the brain. We need to be taking over this stuff, and psychiatrists are like nine in the in the tradition of Freud. Uh. And also, by the way, if people listening, uh, you said r D the initials r D laying not already laying.

If you're wondering what Howard Sterns one time sidekick comedian already Lying had to do with any of this? Didn't he hang out with Norm McDonald a lot too. Yeah, I think they were pals, like already Lang. He had some bad troubles for a while. I think he's doing better now. Yeah. R I p Norm McDonald too. Yeah. So as far as Rosenhan himself, there was a book a few years ago and twenty nine team from Susannah Cahalan unless you misspelled Callahan, No, I really wish I had,

because that's a tough one. It's probably Kahalan. Uh. It was called The Great Pretender, And Susannah was not very kind to rosen Han and basically said, this guy is kind of a fraud, Like I found instances where Uh, first of all, he didn't have that rid of habeas corpus man. He said he did and told them he did, which is really not cool. Um Uh what else, Well, some of the data, some of the numbers that he

put out there don't match. Like she tracked one guy down, Bill Underwood, who was a pseudo patient, and that particular pseudo patient supposedly spent seven days in a hospital at eight thousand patients. He actually spent eight days in a hospital of fift patients, which matters if Rosenhand was saying, no, I'm really kind of getting a random sampler, good sampling of hospitals in America, big ones and small ones, etcetera.

If he didn't have an eight thousand patient hospital and d was the tops, maybe that wasn't as random as you'd think. Yeah, And she also, uh, didn't quite but came close to accusing him of flat out making up

about half the people. Um, I don't know this is because she only found three plus him uh and said, well, maybe he made up the rest or was there like actual evidence that he may have just made up the rest the former But she took out a an ad basically as an editorial in the Lancet, which is a British, very respective British medical journal, um saying like, hey, I'm looking for the other pseudo patients and got nothing, not a single bite, not not a lead or anything. So

she wonders if actually they didn't exist. Interesting. Yeah, And so the thing is, though it doesn't really matter, Like even if he did make up half the data and half the pseudo patients, it doesn't matter because this study isn't based on the data. It's all about the fact that it kind of shone this light on the way, you know, people are treated and how the mentally ill were treated in the United States at that time. You got anything else, no good stuff? Nice work, thanks me,

Nice work you. If you want to know more about Rosenhand, rosen Han, whoever, um, you can look up this article on being sane and insane places all over the Internet and I think you'll enjoy it tremendously. And since I said that it's time for listener mail listener mail, I'm gonna call this a couple of quick things on our Mediacci episode. I'm not gonna read this full email, but I did want to point this band out because listen

to it and they're awesome. This is from J Deptman sent in this band MARRYATCHI l bronx Uh and they were originally a punk band from l A And apparently they did an acoustic set for a TV show and they played it with a mariachi style just because it had that energy and then they were like, hey, this is awesome and that's kind of what they're known for now. And I played some of it and it's really awesome. And these guys, a lot of them are Caucasian and

they wear those outfits and they look awesome. Awesome. See. But the real email I'm gonna read is uh from Marlena Maynard. She her hers, who is a voice teacher, So I imagine Marlena from Nashville knows what she's talking about. Hey, guys, just listen to the episode about Mariaci music. I love how you highlighted issues of class and race in the

musical and academic world. I'm a classical singer and vocal coach, and as a professional in the field, we certainly have a long way to go in terms of equity and diversity. But Chuck, you mentioned that you love hearing many voices singing harmony. You weren't sure if five part harmony is a thing. Oh, I have great news, which is that there isn't really an upper limit at all. Five part

harmony is fairly common in choral music. If the composer wants to fill out a chord, they can simply write another note and the members of that section will know how to divide accordingly. You also will encounter a lot of pieces for eight voices i e. A double choir or two soprano parts to alto, to tenor and to bass parts. Uh, and then gives an example which I think people should check out. It's called the piece with

most parts. With the most parts that I'm aware of is spem in ali Um by Thomas Talise Is from the early sixteenth century. It's got forty vocal parts. Uh. So just go look that up s P E M I N A l I U M on YouTube. And then there's a couple of more um and also lists of bachuin um. And this is Marlena's favorite five part choral pieces, the second movement of Yezo Mina Freida by J. S. Bach. Very nice, So go check all those out. Check out Mariachi l Bronx. You've got a great Tiny Desk concert,

among other things. Those are always fun to watch. Do you ever see those? Yeah? I saw one when we did the Mariotti and the Flora. I can't remember the all all women um four piece Mariott band from New York. Yeah, that's off the NPR. The Tiny Desk concert is long been one of my favorite things. So Chuck. Since we're talking music, though, I want to just go ahead and give a shout out an announcement. You could say, are you ready for this? Did your niece write an album?

Not yet, she's working on it. Um. Instead, you asked for it and they're giving it to you. On November twenty second, Diarrhea Planet is reuniting in Nashville. What's this because of us? I probably I'm just gonna I assume everything is because of us. No, I don't think it is, but I want to go to that show. I bet you that place is going to go off because they haven't played together in three or four years now. They

broke up in two thousand eighteen. So they're going to be at the Exit Inn in Nashville November twenty seconde if you want to make a pilgrimage there. You know, I'm looking at my calendar when it that's it's a bad time a year Diarrhea Planet right at Thanksgiving, right around my wife's birthday. But I've been in more trouble in my marriage, so Nashville's pretty close. I'm going to the see Stevie Nicks. Really, I'm going to see Diaria

Planet there. Emily's like, you skip my birthday to see who? Yeah? Fantom Planet with Jason Swartzman oh Man so Chuck who was the the original the two people who wrote in Marlena is the vocal coach and Jay turned me onto Mariachi l Bronx. That's right, Thanks Marlena and Ja. If you want to point out some cool music we've never heard before, we love that kind of thing. You can send us an email to stuff podcast at iHeart radio dot com. Stuff you Should Know is a production of

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