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Friday, August 12, 2022

How Can You Tell?

One of the longstanding criticisms of psychiatry is the claim that doctors could not reliably diagnose mental illness.  11/2/19 New York Post:

His research work was also groundbreaking. In 1973, Rosenhan published the paper “On Being Sane in Insane Places” in the prestigious journal Science, and it was a sensation. The study, in which eight healthy volunteers went undercover as “pseudopatients” in 12 psychiatric hospitals across the country, discovered harrowing conditions that led to national outrage. His findings helped expedite the widespread closure of psychiatric institutions across the country, changing mental health care in the US forever....

Rosenhan’s eight healthy pseudopatients allegedly each followed the same script to gain admittance to psychiatric hospitals around the country. They each told doctors that they heard voices that said, “Thud, empty, hollow.” Based on this one symptom alone, the study claimed, all of the pseudopatients were diagnosed with a mental illness — mostly schizophrenia.

And once they were labeled with a mental illness, it became impossible to prove otherwise. All eight were kept hospitalized for an average of 19 days — with the longest staying an unimaginable 52. They each left “against medical advice,” meaning the doctors believed that they were too sick to leave. A total of 2,100 pills — serious psychiatric drugs — reportedly were prescribed to these otherwise healthy individuals.

Now, this is a worrisome problem, but why would a sane people seldom pretend insanity?  If a sane person was involuntarily committed on the claim of another tha would be a serious problem.  But what about the reverse: can psychiatrists tell when a person is no longer dangerous?  I have run into a number of mass murders where the patient was released.  You may recall the sword murders on the Staten Island Ferry some years ago.  Admittedly, that was the 1980s when pressure to empty mental hospitals was very high.  But this?

New York, N.Y. (1950)

03/06/1950: Just released “from a hospital for the criminally insane,” the murderer stabbed to death four and wounded three others on the street.

Category: public

Suicide: no

Cause: mental illness

Weapon: knife[1]

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