
Troubling discrepancies in Rosenhan's “On Being Sane in Insane Places”? - Anon84
https://nypost.com/2019/11/02/stanford-professor-who-changed-america-with-just-one-study-was-also-a-liar/
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mlthoughts2018
This feels honestly like a pretty weak criticism of the original paper. First
there are all kinds of red herring details about Rosenhan’s “life of the
party” demeanor and a book deal, very much as if to set you up to believe he
was a manipulator on these accounts alone.

After that there is literally just one fact that possibly indicates
manipulating the original study data, which is allegedly omitting one
participant’s experiences which were “positive” (as self-reported decades
later).

Even if true, the overall study only included some tiny sample size, and if
even only 1-2 had harrowing or abusive experiences, which Rosenhan himself had
in his own faked hospital stay, wouldn’t that be enough to prove the general
point that abuse was shockingly common and patient treatment in these
facilities at that time was seriously troubled?

Meanwhile this article itself is also pushing various book ads for the
author’s own book.

My takeaway is that Rosenhan may have selectively excluded data, but the point
of his paper was much more qualitative and directional in a direction that
turned out to be true and led to a huge overhaul of mental health facilities
for the better.

If we can prove Rosenhan manipulated data, we should acknowledge that, and it
should not be treated lightly. But it also doesn’t seem to invite sweeping
reassessment of the original paper at all.

This piece just seems like somewhat of a publicity grab.

~~~
dang
Thanks. That seems like enough to add a question mark to the title above.

------
ScottBurson
NYT piece on the same book:
[https://www.nytimes.com/2019/11/02/books/susannah-cahalan-
gr...](https://www.nytimes.com/2019/11/02/books/susannah-cahalan-great-
pretender.html)

~~~
dang
Thanks, that's interesting. I've pilfered the phrase "troubling discrepancies"
to replace the baity title above.

------
tcj_phx
The United States' mental health system feeds itself with its palliative
approach. As bad as the system might have been 50 years ago, in Rosenhan's
time, I'm sure it's much worse today, on account of 50 years of development of
non-helpful drugs. For example, one of my sources says that each generation of
anti-depressants was less effective than the generation that preceded it. The
MAOI's were reasonably-effective for short-term use [2], but fell from favor
as their patents expired. Their replacements were less effective, but patent
profits paid for drug companies to promote them to doctors. The SSRI's are the
least-effective of all. Second-generation "atypical antipsychotics" aren't
appreciably better than first generation antipsychotics, and in some cases are
actually much worse (some of the latest and greatest antipsychotics, which are
actually anti-serotonin drugs, might be worth using on a very-short-term
basis).

Robert Whitaker says that 20th century psychiatric medications take what would
have been an episodic condition, and make it chronic [0][1].

There are now vastly more people who need help than capacity to help them.
I've recently come to appreciate that we have a bifurcated approach. People
who have no one to advocate for them get a catch-and-release treatment,
because the holding tanks can only hold people for a few days before they have
to be transferred for involuntary evaluation or released to the street. Those
with an advocate are given priority.

In my state, the process for helping people who don't realize they need help
goes 48-hour hold -> involuntary evaluation (3 days max) -> filing of petition
for court-ordered treatment (weeks and weeks).

My friend got the catch-and-release treatment once. She'd escaped from her
involuntary treatment program, where her ability to control her alcohol intake
(the actual cause of her condition) was not helped by the palliative
psychiatric drugs she was forced to take. She did well for a month, then
resumed drinking.

After a few weeks of drinking she disappeared. Maybe two days later she called
and asked me to pick her up from "big city", but didn't give a specific
location. A few days later I got a call from a mental hospital. She said she
was being transferred for involuntary evaluation, then she stopped calling.
Her father said she'd been released.

I suggested to her father that we should file a missing person report. He
concurred. When I called the police, the officer said they'd prefer I come
down to the main station or a precinct to file the missing person report in
person, so the officer would know I wasn't harassing someone. I was also told
it'd help to get her family involved too.

So her father and I went down to the main station. The officer working the
desk was skeptical, but after a few minutes he agreed to look up my friend.
When he came back and said my friend wasn't missing, because they'd taken her
back to the crazy-tank the day before.

Her father had already hired a lawyer. The social worker said they have dozens
of petitions for court-ordered evaluation expire every week, on account of not
having room to transfer the patients for their evaluations. I think the social
worker greased the wheels to make sure my friend wasn't released to the street
again.

From the fine article:

> But the problem is that scientific research needs to be sound. We cannot
> build progress on a rotten foundation.

The 'rotten foundation' in our mental health system is treating people's
symptoms without concern for their cause. Scientists have actually figured out
most of the causes behind patients' symptoms, so we don't actually have to
treat them palliatively anymore. It's just conveniently profitable for the
system to play make-believe that our current selection of FDA-approved patent
medicines are the best we can do.

[0]
[https://news.ycombinator.com/item?id=15353109](https://news.ycombinator.com/item?id=15353109)
[1]
[https://news.ycombinator.com/item?id=12068958](https://news.ycombinator.com/item?id=12068958)

[2]
[https://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor](https://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor)
\- "New research into MAOIs indicates that much of the concern over their
supposed dangerous dietary side effects stems from misconceptions and
misinformation, and that it is still underutilized despite demonstrated
efficacy. ..."

~~~
seibelj
I wish people would stop saying online that SSRIs are a scam. My life was
saved by Lexapro, an SSRI. I have taken it for almost 8 years now and the
difference within 2 weeks of starting treatment was night and day. Literally
stopped years of anxiety and depression that made life unbearable and turned
them into a manageable condition. I tried many other “cures” - diet, exercise,
mindfulness, therapy, and on and on - and nothing helped like Lexapro did.

If you need help don’t get spooked by the parent commentator. Help exists.

~~~
tcj_phx
> I wish people would stop saying online that SSRIs are a scam.

Some people like their SSRI's, some people kill themselves soon after starting
that class of drug [0] (presumably due to the serotonin syndrome [1]).

> My life was saved by Lexapro, an SSRI.

My friend told me about how Lexapro seemed to help her. But it also didn't
keep her from relapsing on cocaine, a pro-dopamine drug. The MAOIs are much
more useful for a cocaine-like boost that doesn't make them crash after 20
minutes than the SSRIs, which take weeks/months before most people notice any
benefit, and which help some people by helping them "not care" about their
life situation.

20 years ago teh scientists figured out that it's not extra serotonin that
helps people, but the SSRI's effects on neurosteroids:
[https://www.ucsf.edu/news/1999/11/5059/scientists-
identify-n...](https://www.ucsf.edu/news/1999/11/5059/scientists-identify-new-
pathway-antidepressant-action)

> If you need help don’t get spooked by the parent commentator. Help exists.

My observation is that some people don't actually get the help they need, and
deteriorate from defective prescriptions. My friend needed help getting her
drinking under control, but all she got was medically assaulted with anti-
dopamine drugs (so-called "antipsychotics").

The tragedy is that we actually know how to help people. Some of the MAOIs are
much better drugs to use temporarily while helping people deal with "stress".

[0] [https://www.madinamerica.com/2016/10/11-9-million-paxil-
suic...](https://www.madinamerica.com/2016/10/11-9-million-paxil-suicide-
verdict-inside-story/) \- I think the damages were overturned on appeal.

[1]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370302/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370302/)

