[HN Gopher] On being sane in insane places (1973) [pdf]
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On being sane in insane places (1973) [pdf]
Author : dbgrman
Score : 57 points
Date : 2026-02-02 17:43 UTC (5 hours ago)
(HTM) web link (www.weber.edu)
(TXT) w3m dump (www.weber.edu)
| dbgrman wrote:
| An experiment where they sent normal people to mental institutes
| to see if professionals would be able to identify them.
| lostlogin wrote:
| And interestingly, how often the patients in the ward could
| spot these normal people while the medical staff did not.
| tines wrote:
| This is from the seventies. I wonder if things would be different
| fifty years later.
| EtienneDeLyon wrote:
| Nope!
|
| https://archive.is/tH0il
| tines wrote:
| This isn't really the same situation.
| cwmoore wrote:
| That one is a case of mistaken identity, but the same
| process, same players, and same system.
| tines wrote:
| The fact that we're hearing about it means that the
| process worked, doesn't it?
| cheeseomlit wrote:
| Yeah, after he was forcibly injected with drugs against
| his will.
|
| >Mr. Wright said the hospital later apologized to him and
| gave him a $50 gift card for a restaurant. The crisis
| center also apologized and gave him a $25 Walmart gift
| card.
|
| That alone would be enough to drive me clinically insane
| tines wrote:
| Sure, that was the first responders on the scene. The
| question isn't about whether mistakes are made, it's that
| once they're made, will they be recognized and fixed? The
| commenters article doesn't show what they claim (if not
| proving the opposite).
| clort wrote:
| I'd say yes. I have a book by Lauren Slater, called 'Opening
| Skinners Box' in which she researched many psychological
| experiments of the past, and subjected herself to similar
| conditions where she could, in an effort to understand better.
|
| The chapter on 'Thud' ended with her visiting a psychiatric
| hospital of good reputation with an emergency room, she
| basically said the same things as the researchers in the paper.
| She was given some anti-psychotics and sent away.
|
| https://en.wikipedia.org/wiki/Opening_Skinner%27s_Box
| blast wrote:
| > She was given some anti-psychotics and sent away
|
| But that confirms the main point of the experiment, which was
| that people who didn't need psychiatric treatment were given
| it anyway.
|
| It's only of secondary importance that the prescribed
| treatment changed from hospitalization in 1973 to drugs in
| 2004. The primary point is that there was no objective way to
| determine who genuinely needed treatment. She didn't, but was
| diagnosed anyway.
|
| This objection is so obvious that she must have addressed it
| in the book. Do you remember if she did?
| hamdingers wrote:
| I happen to have the book handy.
|
| > HERE'S WHAT'S DIFFERENT: I was not admitted. This is a
| very significant difference. No one even thought about
| admitting me. I was mislabeled but not locked up. Here's
| another thing that's different: every single medical
| professional was nice to me. Rosenhan and his confederates
| felt diminished by their diagnoses; I, for whatever reason,
| was treated with palpable kindness.
|
| Seems she would disagree with your assessment that being
| prescribed some likely-harmless pills is the same as losing
| your freedom.
|
| There's also a section earlier where she presents an
| argument the actual finding of the study is that mental
| healthcare is not set up to handle adversarial or dishonest
| patients, which is still a problem and a tough one to
| solve.
| dbgrman wrote:
| I wonder the same. Have been reading up on literature related
| to ADD/ADHD diagnosis and prescription stimulants. It seems
| like there is little to no friction in getting a legit positive
| diagnosis. One can pretend to have issues securing a medication
| that is only meant for strong ADHD patients. I know someone who
| was able to get their hand on a lot of such stimulants, got
| addicted, went over the typical dosage, and is now suffering
| from psychosis.
| ossicones wrote:
| If you've ever taken a depression screener at a wellness visit,
| that's a consequence of this work. This paper describes how
| unreliable psychiatric diagnosis used to be. There were
| standards, but they ultimately came down to physician judgment.
| This created demand for more objective standards, which resulted
| in the "checklist" approach that we have now.
| dillydogg wrote:
| It's true. You wouldn't believe how many people I've SIGECAPS'd
| during my medical training. I didn't realize this article was
| the beginning of this approach, but it certainly helped get
| care to people who previously wouldn't have received it. Though
| I'm sure there are also many who may require intervention that
| aren't captured by a SIGECAPS exam. The double edged sword of
| the checklist manifesto, though I overall think it has been
| beneficial.
|
| SIGECAPS is an acronym taught in US medicine for the diagnosis
| of major depressive disorder: Sleep disturbance, Interest loss,
| Guilt, Energy loss, Concentration loss, Appetite changes,
| Psychomotor agitation, Suicidality. And must have Depressed
| mood or Anhedonia (inability to enjoy things previously
| enjoyable).
|
| The history of the SIG E CAPS acronym is also interesting, I've
| heard it was short for SIG (old shorthand for "to be
| prescribed") Energy CAPsules.
| RodgerTheGreat wrote:
| Is "energy capsules" a euphemism for amphetamines?
| dillydogg wrote:
| I was taught that it was more a memory device for
| recognizing major depressive disorder as a state of sadness
| and low energy. The treatment, I presume was still SSRIs
| first line.
| post_break wrote:
| I had to look up SIGECAPS before I read the rest of your
| comment. Big oof when I did. Never heard of Anhedonia, but I
| sure have it.
| dbgrman wrote:
| I wonder what's the false negative rate for these checklists.
| throwway120385 wrote:
| The awful thing is that with at least some of those screeners
| you can still get people on the other side who make whatever
| you're self-reporting worse. When my spouse answered honestly
| on a postpartum survey about how she was feeling the social
| worker they sent in picked at my infant son's mismatching socks
| and suggested that she was so old she was "set in her ways" and
| that having a child might be too big of an adjustment for her.
| It set her back in a huge way and knowing what I know now I'd
| go to all of those appointments with her and never answer any
| of that stuff honestly.
|
| It doesn't really matter how "objective" your standard is if
| you're still relying on individuals to try to "address"
| whatever the patient is reporting. People still form a negative
| opinion and label you really quickly no matter how hard the
| profession fights that perception.
| 12_throw_away wrote:
| This is one of those "important research with unbelievably flawed
| methods" sort of situations. Psych research before IRBs was
| _crazy_.
| TZubiri wrote:
| Nowadays there's a lot of FUTON bias in research. There's so
| much power in just hitting the streets or reaching out to your
| circle.
|
| For the most part, you care the most about your circle, so if
| that isn't representative of the whole of society, it sounds
| like somebody else's problem. Who said all research needed to
| be perfect.
| ameliaquining wrote:
| This study was a fraud: https://doi.org/10.1177/0957154x221150878
| sddfgvdsvsdfas wrote:
| [flagged]
| dang wrote:
| Could you please stop posting unsubstantive comments and
| flamebait? You've unfortunately been doing it repeatedly. It's
| not what this site is for, and destroys what it is for. Please
| don't create accounts to do this with.
|
| If you wouldn't mind reviewing
| https://news.ycombinator.com/newsguidelines.html and taking the
| intended spirit of the site more to heart, we'd be grateful.
|
| (We detached this subthread from
| https://news.ycombinator.com/item?id=46860103.)
| cm2012 wrote:
| This experiment is now widely debated, the author may have made
| up or exaggerated details.
| ggreer wrote:
| It's unclear if this experiment actually happened the way
| Rosenhan claimed. A journalist went through Rosenhan's archives
| and tried to verify his story. She managed to track down one of
| the pseudopatients, who disputed some of Rosenhan's claims such
| as the amount of preparation, and whether Rosenhan had worked out
| a legal backup plan in case the institution refused to release
| the patient.[1] She also noted large discrepancies in various
| numbers. Apparently she wrote a book about the whole thing, but I
| haven't had the chance to read it.[2][3]
|
| 1. https://sci-hub.red/10.1038/d41586-019-03268-y
|
| 2. https://www.npr.org/2019/11/13/777172316/the-great-
| pretender...
|
| 3. https://www.susannahcahalan.com/the-great-pretender
| dbgrman wrote:
| Thanks for sharing, will read these.
| wumms wrote:
| Reminds me of: Man's Search for Meaning (1946)
| https://en.wikipedia.org/wiki/Man%27s_Search_for_Meaning
| nephihaha wrote:
| Was rereading that last year. Recommend it to anyone who
| hasn't.
| dang wrote:
| Related. Others?
|
| _The Rosenhan Experiment: On Being Sane in Insane Places_ -
| https://news.ycombinator.com/item?id=45785783 - Nov 2025 (1
| comment)
|
| _On Being Sane in Insane Places (1973)_ -
| https://news.ycombinator.com/item?id=32686098 - Sept 2022 (2
| comments)
|
| _David Rosenhan's fraudulent Thud experiment set back psychiatry
| for decades_ - https://news.ycombinator.com/item?id=22155529 -
| Jan 2020 (119 comments)
|
| _Troubling discrepancies in Rosenhan 's "On Being Sane in Insane
| Places"?_ - https://news.ycombinator.com/item?id=21437852 - Nov
| 2019 (16 comments)
|
| _On being sane in insane places_ -
| https://news.ycombinator.com/item?id=10885181 - Jan 2016 (1
| comment)
|
| _On being sane in insane places_ -
| https://news.ycombinator.com/item?id=4371212 - Aug 2012 (2
| comments)
|
| _Rosenhan experiment (1973)_ -
| https://news.ycombinator.com/item?id=1469370 - June 2010 (2
| comments)
| nibles_and_bits wrote:
| Hello from a wildcat alumnus class 2006, never thought I would
| see a weber state link in HN top 20.
| dbgrman wrote:
| lol, that's the first pdf link i could find of this article.
| nephihaha wrote:
| We are trained to be scared of lone individuals and rural
| environments, when in fact most abuses occur within a hierarchy
| and urban settings. I feel the fatal flaw in human nature is so
| many are obedient to power without question, especially when
| power has some kind of uniform, but also within gangs etc.
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