For the experiment, participants submitted themselves for evaluation at various psychiatric institutions and feigned hallucinations in order to be accepted, but acted normally from then onward.
The study was arranged by psychologist David Rosenhan, a Stanford University professor, and published by the journal Science in 1973 with the title On Being Sane In Insane Places.
[6][7] While listening to a lecture by Ronald D. Laing, a psychiatrist associated with anti-psychiatry claims, Rosenhan conceived of the experiment as a way to test the reliability of psychiatric diagnoses.
Rosenhan himself and seven mentally healthy associates, termed "pseudopatients", attempted to gain admission to psychiatric hospitals by telephoning for an appointment and feigning auditory hallucinations.
Pseudopatients used pseudonyms, and those who were mental health professionals were given false jobs in a different sector to avoid invoking any special treatment or scrutiny.
During their initial psychiatric assessment, the pseudopatients claimed to be hearing voices of the same sex as the patient which were often unclear, but which seemed to pronounce the words "empty", "hollow", or "thud", and nothing else.
These words were chosen as they vaguely suggest some sort of existential crisis and for the lack of any published literature referencing them as psychotic symptoms.
No other psychiatric symptoms were claimed according to Rosenhan's publication, but medical records have indicated that, at least in the case of one pseudopatient, more were shared to the hospital such as not being able to sleep, feeling cold all over, being unable to work for six months, being sensitive to radio signals, having suicidal thoughts, etc.
Once admitted and diagnosed, the pseudopatients were not able to obtain their release until they agreed with the psychiatrists that they were mentally ill and began taking antipsychotic medications, which they flushed down a toilet.
A group of patients waiting outside the cafeteria half an hour before lunchtime were said by a doctor to his students to be experiencing "oral-acquisitive" psychiatric symptoms.
[9] For this experiment, Rosenhan used a well-known research and teaching hospital, the staff of which had learned of the results of the initial study but claimed that similar errors could not be made at their institution.
Rosenhan arranged with them that during a three-month period, one or more pseudopatients would attempt to gain admission and the staff would rate every incoming patient as to the likelihood they were an impostor.
Rosenhan published his findings in Science, in which he criticized the reliability of psychiatric diagnosis and the disempowering and demeaning nature of patient care experienced by the associates during the study.
Examining documents left by Rosenhan after his death, Cahalan finds apparent distortion in the Science article: inconsistent data, misleading descriptions, and inaccurate or fabricated quotations from psychiatric records.
[7][13] In February 2023, Andrew Scull of the University of California at San Diego published an article in the peer-reviewed journal History of Psychiatry in support of Cahalan's allegations.
[6] In 1887, American investigative journalist Nellie Bly feigned symptoms of mental illness to gain admission to a lunatic asylum and report on the terrible conditions therein.
[3] Slater wrote that she had presented herself at 9 psychiatric emergency rooms with auditory hallucinations, resulting in being diagnosed "almost every time" with psychotic depression.
Unlike the other experiments listed here, however, the purpose of this journalistic exercise was not to criticize the diagnostic process, but to minimize the stigmatization of the mentally ill.