Number of patients judged 193
Number of patients assumed as pseudo patients by at least 1 staff member 41
Number of patients doubted by 1 psychiatrist 23
Number of patients suspected by1 psychiatrist &1other staff member 19
Psychiatrists will hardly expect someone to carry out a deception in order to be admitted to a psychiatric hospital. In other words, the study is far away from realism.” Schizophrenia – may actually indicate reliability – present the same symptoms, get the same diagnosis!”(Kety1974). ‘Schizophrenia-in-Remission’ was either never used or used only for few patients each year shows in 12 hospitals and 11 other cases .Therefore, the psychiatrists’ discharge diagnosis was, in fact, due to how the pseudo patients behaved and not to the fact the psychiatrists could not tell they were normal(Spitzer 1975).
According to Rosenhan (1973) in relation to 23 patients doctors and staff might have made a type 1 error in diagnosis and labelled a normal person insane and insane person as normal by type 2 errors and being failed to give accurate judgement. It is not easy to differentiate between sane and insane in psychiatric hospitals as of the hospital’s environment manipulate the observer‘s thinking and create misunderstanding so that patients has to suffer the consequences of being in such an environment once being hospitalized , those who being labelled with psychotic illness lose their respect , left alone ,humiliated ,and seems to have no existence or power in society, there is no doubt that “psychiatric diagnosis are rarely found to be in error and once the label is sticks, it leaves a long lasting impact ”(Rosenhan 1973).
Barnard (1975) Objects that, in mental hospitals, psychiatrist are not able to distinguished between abnormal or normal person, Rosenhan ignored the relationship between diagnosis and effect of treatment and that psychiatric diagnosis are not different then other medical diagnosis and just patients behaviour is not the solution of a problem raised by him. Psychiatrists should not necessarily be suspicious about a patient is pretending to have mental illness, therefore the study lacked realism. Rosenhan “called this the “experimenter effect” or “expectation bias” and so that he discard the data which conflicts with his methodology. (Kety in 1974)
There are significant ethical problems with the study, its being carried out in real life hospitals and in the presence of real staff members who were unaware of the investigations, wide range of hospitals are being used and hospital staff were deceived about the patients’ symptoms. They could neither give their consent nor exercise their right to withdraw. However, Rosenhan did protect confidentiality – no staff or hospitals were named, to minimise the risk of their credibility, he used both quantitative e.g. number of days and responses, and qualitative data e.g. recorded notes by pseudo patients, which might have influenced by their emotions. This study caused instability in public confidence in the American mental health system – which may have prevented people from seeking help who genuinely needed it. Psychiatrists also point out that the DSM has been revised several times since Rosenhan’s experiment, and that diagnostic criteria have been tightened considerably, to provide better care and treatment to mental health patients. It is much not possible to fooled psychiatrists by hallucinating it is now required to be repeated several times. In DSM-IV (1994) hearing voices must be experienced for over a month before a diagnosis of Schizophrenia can be made. (Michael W. Eysenck 1994)