Comment by ryandrake
2 years ago
Your comment reminds me of the Rosenhan Experiment[1]. "The first part involved the use of healthy associates or "pseudopatients" (three women and six men, including Rosenhan himself) who briefly feigned auditory hallucinations in an attempt to gain admission to 12 psychiatric hospitals in five states in the United States. All were admitted and diagnosed with psychiatric disorders. ... The second part of his study involved a hospital administration challenging Rosenhan to send pseudopatients to its facility, whose staff asserted that they would be able to detect the pseudopatients. Rosenhan agreed, and in the following weeks 41 out of 193 new patients were identified as potential pseudopatients, with 19 of these receiving suspicion from at least one psychiatrist and one other staff member. Rosenhan sent no pseudopatients to the hospital."
In fairness, psychiatry is totally different today than in 1973. The obvious change is that a huge reduction in the number of inpatient beds, combined with increasing demand, have created huge pressures to admit only the most obviously unwell patients and discharge them as quickly as possible. Most psychiatric inpatient stays are just a few days - just enough to get a patient through a crisis, revise their medication and (hopefully, but not always) arrange for appropriate outpatient care and support. The downtown of most US cities is a testament to the fact that, in 2023, under-treatment of severe mental illness is a far greater concern than over-treatment.
On an ontological level, psychiatry made a huge leap forward in 1980 with the publication of the DSM-III. One of the core goals of the DSM-III was to address the concerns raised in the Rosenhan experiment, making diagnostic criteria more robust and reliable. While there are still many controversies and shortcomings - most prominently regarding the over-diagnosis of less severe conditions - we now have a suite of reliable, validated diagnostic instruments for most serious conditions. For the most part, we aren't diagnosing or treating patients based on the gut instinct of an individual practitioner; we're using objective criteria with proven inter-relater reliability, guided by the over-arching principle that, regardless of symptomatology, no-one is mentally ill unless a) they're experiencing distress and/or b) they're causing significant harm to others. There are many shortcomings in how psychiatric medicine is practised today, but the era of locking people up just because they behave strangely is definitively over.
My favorite control experiment! Tell somebody you did something and ask them what the results were, but don't actually do the something.
"Honey, I doubled the salt in the pasta this time, how does it taste?" "Oh, it's really salty". "Ha-HA! I didn't actually add ANY salt!"
(do not actually do this to people you like or who like you)