On Growing Sane In Insane Places

About

The title of this exhibition draws inspiration from D.L. Rosenhan’s landmark study, “On Being Sane in Insane Places,” in which eight individuals pretended to hear voices at various hospitals across the U.S. All but one were hospitalised and spent an average of 19 days in psychiatric wards, diagnosed with schizophrenia, despite they stopped faking symptoms after their first visit. This experiment exposed significant flaws in the psychiatric diagnostic process, reflecting that the common was not detected as healthy.

Rosenhan suggests that doctors, erring on the side of caution, are more likely to label a healthy person as sick rather than a sick person as healthy. However, there is a key difference between medical and psychiatric diagnoses: the latter carries significant personal, legal, and social stigma. When someone is labeled with a psychiatric diagnosis, it can become a defining trait of their identity and impact many aspects of their life. The label is so powerful that many ordinary behaviors of these “pseudopatients” were overlooked or deeply misunderstood. After admission, the experiment also revealed a dehumanising attitude from the staff towards these “pseudopatients,” characterised by avoidance and detachment. The publication “On Being Sane in Insane Places” had a significant impact on the field of mental health, including the adoption of more objective diagnostic criteria, support for the deinstitutionalisation of many psychiatric hospitals, and increased efforts to promote humanised care.

To discern between normal and abnormal is a complex task, as dividing a spectrum into two categories always involves error. Norms shift from one place to another, and trends don’t repeat consistently over time. Each generation’s adolescence is therefore unique, and when comparing future generations with our own experiences, we must acknowledge the high risk of misjudging them.

In recent years, though, distress has become a defining part of many young people’s lives. The pandemic triggered  an exponential rise in psychiatric admissions, mental health waitlists, suicide attempts, self-harm, eating disorders, and more. Many young people today struggle with deflated self-esteem and self-image, and their motivation and drive often seem to drag along the ground, edging dangerously close to despair.

When looking for the roots of mental disorders, the word that most often comes up is multicausality. There are endogenous factors (genetic, hormonal, developmental) and exogenous ones (stress, substance use, trauma, social and cultural influences); the former are generally unlikely to change in a short period of time. Therefore, we could assume that the rapid shifts that have  shaped our current mental health landscape are largely rooted in our model of society.

This discussion doesn’t aim to draw conclusions but rather to open a space where we can explore some of the new and enduring factors affecting young people’s development and question how these influences—whether for better or worse—have taken hold. In a new paradigm where distress has become the norm, where do we draw the line between healthy and unhealthy? How can one grow sane in an environment that seems so ill-suited to fostering it?