In 1973, Rosenhan conducted a field study to expose the effects and validity of labelling, in particular through professional diagnosis of psychological disorders. Although his results were greatly praised and have been highly influential in the field of clinical psychology, we mustn’t take Rosenhan’s research at face value, as alike every study his work has flaws.
Firstly however we must consider the implications of his research. Although it has led to stricter, better defined diagnosis of those with psychological disorders, the study was extremely unethical. The deception and misleading of the professionals breaches many of the ethical guidelines, and the participants themselves were put in extremely uncomfortable positions. An experiment such as this would not be accepted by the BPS today, however we must consider, does the insight this study provided into the problems of diagnosis and labelling overrule the embarrassment to the professionals and distress to the participants? This question is debatable.
Although to the eye Rosenhan‘s methods appear sound, through reading his research paper it is easy to identify flaws. Anthony Clare stated that Rosenhan was “theorising in the absence of sufficient data”. He used an extremely small sample size of eight volunteers, therefore how can we know that perhaps the apparent hasty diagnosis for all the participants was not by chance? Another question that arises is the number of hospitals in the sample, as Rosenhan states there was twelve. Does this mean that four of these hospitals did not diagnose the volunteers with schizophrenia?
Rosenhan refused to identify the hospitals, as he believed it was a breach of their confidentiality. However this disallows anyone to back-up or challenge Rosenhan’s account at the hospitals, which in-turn prevents his research from gaining reliability and falsifiability. It appears through this that his research is not quite as valid as first meets the eye.
Hunter believed that one of the issues with the study was Rosenhan’s use of the word “normal”. “The pseudopatients did not behave normally in the hospital. Had their behaviour been normal, they would have talked to the nurses’ station and said ‘Look, I am a normal person who tried to see if I could get into the hospital by behaving in a crazy way or saying crazy things. It worked and I was admitted to the hospital but now I would like to be discharged from the hospital’”. Rosenhan in his own research paper complained of the conflicting meanings of terms such as “sane”, yet evidently he uses words himself in inaccurate contexts.
A programme created by the BBC named “How mad are you?” (2008) investigated the problems with diagnosis. In it, three mental health experts were challenged to see if they could make the distinction between “illness” and “health” in ten participants, five of which had various psychological disorders. They were filmed during a week of activities, and the experts surprisingly found diagnosis difficult! As said by Ian Hulatt, “the public need to realise that you cannot just look at someone and make assumptions. When someone has been labelled with a disorder or episode of mental illness it’s very unhelpful to interpret everything they do through a poorly understood label.” This highlights the criticisms of Rosenhan’s study, as although it is common for one to blame the staff for not recognising the patients were completely sane, diagnosis of a disorder is a difficult process that inevitably can be subjectively influenced.
“If I were to drink a quart of blood and, concealing what I had done, come to the emergency room of any hospital vomiting blood, the behavior of the staff would be quite predictable. If they labelled and treated me as having a bleeding peptic ulcer, I doubt that I could argue convincingly that medical science does not know how to diagnose that condition”. As suggested by Kety (1975), The expert’s job is to diagnose; they do not expect an ‘actor’ as such to test them, therefore in my opinion Rosenhan’s study cannot be seen as detrimental to mental health experts’ reputation, rather the vicious, yet inevitable effect of expectations and labelling. However despite the criticisms, we cannot deny its influential grasp on psychology.