Do you think it's possible to accurately predict who has a history of mental health issues, and who doesn't?
Between 1969 to 1972, the American psychiatrist David Rosenhan and seven other researchers posed as patients to carry out an experiment to test just how accurate a mental illness diagnosis could be. Together, they faked hallucinations and tricked a dozen psychiatric institutions across five US states into admitting and diagnosing them with mental illnesses they didn’t have.
Rosenhan, in what came to be known as the Rosenhan Experiment, was trying to prove how easy it could be to misdiagnose someone with a mental illness on observation alone. He also wanted to expose the problematic nature of unconscious bias influencing a diagnosis.
Several decades later, inspired by the ground-breaking Rosenhan Experiment, a new two-part documentary How 'Mad' Are You? wants to find out whether Australia has progressed in its perception and diagnosis of mental illness.
Three experts – clinical nurse Jan MacIntire and Professors Jayashri Kulkarni and Tim Carey – rely on observation alone to diagnose which five out of ten participants in the documentary have a history of mental illness. Along the way, several myths about mental illness are challenged. Here are six of them...
Myth 1: Someone’s appearance can indicate a history of mental illness
The choices we make about our appearance – or anything that makes us look ‘different' – can lead to assumptions about mental ill health. Throughout the documentary, the experts try their best not to judge anyone’s appearance as being representative of certain symptoms of mental illness. However, one participant’s facial hair and clothing choice do trip them up as they briefly consider whether he might be a member of a group (like war veterans) that may be likely to have suffered from mental illness.
Myth 2: People who live with a mental illness are more likely to come from a particular socio-political group
Some groups may show a higher rate of mental illness - but should that be a factor in diagnosis? In the program, the experts deliberate on how to diagnose people from different social groups, considering that those people may be affected by the experience of belonging to said social groups.
Veterans, refugees, LGBTQI+ people, Indigenous Australians and people from ethnic minorities often are unfairly associated with mental illnesses, which often leads to broad generalisations and dangerous stereotyping.
Myth 3: People who live with a mental illness cannot function
This is addressed from the very start. Not only do the participants live with each other but they also participate in a series of tests set out for them during the week. The format challenges the idea that a person living with mental illness cannot contribute to or participate in wider society, and reminds us how mental health issues can be invisible, and can go undetected by even our closest friends and family.
Myth 4: Personality traits and behaviour can reveal a mental illness
Character traits and behaviour can be misleading when looking for a history of mental illness. As the psychiatrists eventually discover, it can be hard to tell whether someone is just anxious in their immediate situation – surrounded by a camera crew while being filmed for a documentary – or if they live with an anxiety disorder.
Myth 5: Past incidents from someone’s life can indicate a mental illness
The show's experts consider past personal history when diagnosing people in both their normal day-to-day medical practices and during the documentary but this can lead them into murky territory.
The assumption that experiencing trauma will always lead to mental illness ignores that some people can be resilient, work through their trauma with professional help and not feel impacted in the long-term.
Myth 6: People can never recover from mental illnesses or their associated symptoms
By the end, the documentary reveals who actually has a history of living with mental ill health. Viewers learn that some people can recover from mental illness. Others learn to manage symptoms and cope with them well enough to function on a day-to-day basis.
However, both these outcomes require strong support networks, a good match between the practitioner and the patient as well as the right kind of treatments.
How ‘Mad’ Are You? airs over two weeks, starting Thursday 11 October at 8.30pm on SBS and SBS On Demand:
If you or someone you know is in need of assistance, contact Lifeline 13 11 14 , Beyond Blue 1300 224 636 or Kids Helpline 1800 55 1800.