Food for thought A personally inflected history of psychiatric ideas with flashes of anarchic humour

In 1973, US psychologist David Rosenhan published the results of an experiment.

- By David Shariatmadari

Book of the week The Divided Mind By Edward Bullmore

He arranged for eight "pseudo-patients" to attend appointments at psychiatric institutions, where they complained to doctors about hearing voices. All were admitted, diagnosed with either schizophrenia or manic-depressive psychosis. They then stopped displaying any "symptoms" and started saying they felt fine. The first got out after seven days; the last after 52.

Psychiatrists at a major teaching hospital found it hard to believe that they had made the same mistake, so Rosenhan devised another experiment: over the next three months, he informed them, one or more pseudopatients would go undercover and, at the end, staff would be asked to decide who had been faking it. Of 193 patients admitted, 20% were deemed suspicious. It was then that Rosenhan revealed that no pseudopatients had been sent to the hospital at all.

Rosenhan's gambit seized the public imagination. Were the men in white suits just quacks? Was mental illness even real? Two years later, the film One Flew Over the Cuckoo's Nest added to the sense of reputational meltdown, and the psychiatric establishment responded by tightening up diagnostic criteria. A freewheeling challenge to psychiatry ended up provoking a kind of counter-reformation, making the profession more medicalised than it had been for decades.