Makayla Rippy

Catherine Phillips

English 101

April 10, 2016

One Flew Over the Cuckoo's Nest Gives Insight to the Horrors of the American Asylum

Based off of an award-winning novel by Ken Kesey, Forman's film, One Flew Over the Cuckoo's Nest, received multiple academy awards and sparked a further awareness and attention to the asylum epidemic in America during the late 19th and early 20th century. "In 1904 almost 40% of patients were hospitalized for five years or longer; and by 1923, this had increased to 54%" (Dean). Because of this increase, more and more attention was paid to the facilities, which seemed to become worse with the increase of popularity. The film gave a new perspective on the debate -- allowing the audience to first relate to the main character, Randle McMurphy, who is clearly not mentally ill, in order to show the inhumane side of mental facilities from a perfectly sane person's perspective. Despite its initial comedic effect, the story slowly becomes darker as the viewer is able to dive beneath the surface of mental facilities, into the more grotesque and uncivil side of them. The movie purposefully highlights the problematic treatment of patients in American mental asylums, most specifically: the tyrannical and dominating tendencies of ward employees, the grouping of the mentally disabled and the mentally ill together, and the radical forms of therapy. 

From the very opening scene of the movie, the audience is introduced to Nurse Ratched, who seems to be the iconic symbol of all American asylum employees who mistreated their patients. She enters the psychiatric ward wearing all black from head to toe, an outfit that represents her true self. The seemingly miniscule scenes of Nurse Ratched entering the hospital with no dialogue must be purposely done to showcase the color symbolism of her all-black attire, a sort of foreshadowing of the employees being the "bad guy". She also wears her hair in the same fashion with every scene, no matter how much time has passed. It is done up in a way that almost resembles devil horns, another purposeful move by the producers to emphasize her as being the villain, especially considering she is the only woman in the film with such a hairstyle. This causes the audience to immediately subconsciously dislike Nurse Ratched from the get-go, before she has even spoken. When she is actually working, however, she is always seen wearing white, the complete opposite of her personality, giving an almost appealing look to her (along with her faux-friendly personality). This could be a reference to the fact that many American asylums often advertised to be beautiful, with lovely landscapes, giving "[significantly impressive] reputations of these institutions [ ... ], leading parents and friends of patients to have increased confidence in their patient's care, thus helping in small part to lessen the stigmatism associated with the mentally ill" (Leupo). It was because of this misrepresentation that people weren't very aware of maltreatment during the prime of asylums. 

The most common type of scene that she plays a part in is during the group therapy sessions, where all of the patients sit in a circle and discuss their problems. It is in the first scene of this kind that the audience gets a first glimpse into the unnecessary treatment towards the patients, when Bancini (an isolated patient) wants to stand up and look out of the window, but is refused this privilege. The workers shove him back down into the chair, but when he gets up again and walks into the circle of other patients, Nurse Ratched calls the guards to come and they drag him out, screaming "Get on his legs!" (Forman).  This is all heard in the background while the audience can also hear him hollering out in pain, implying that the guards used unnecessary force and roughness with him, all because he desired to simply stand up for a change. During a later group session, McMurphy brings up the idea of taking a few hours out of their normal schedule to watch the World Series. Nurse Ratched is obviously against this, but decides to let the men vote, only if a majority of them do. However, she knows that half of the room is incapable of comprehending the simple task of raising their hands, so it is in this manipulative way that she disallows them from changing the schedule. She defends her theory, stating that many men in the ward would become upset by a change in the schedule. This idea of having a filled schedule comes from many Asylums across America at the time due to concern in how to occupy patients' time, in which "work programs and recreational activities were devised for patients [ ... ], significantly moving to bridge the gap between society and the hospital" (Leupo). The schedule was highlighted many times in the film, with certain things such as "medication time," and time given for them to play cards, as well as work detail. McMurphy comments on this directly, saying that "she likes a rigged game" (Forman). This is yet another way that the employees exercised unnecessary dominance and control over the patients, creating a sense of imprisonment rather than a place of healing.

Due to McMurphy's constant hassling of Nurse Ratched, because of his hatred for her, he ends up being forced to stay in the institution for longer. Nurse Ratched's very own words were, "You're going to stay with us until WE let you go," which was basically a threat from her that she had all of the control over him, simply because he was presumed "mentally ill" (Forman). Because of her threat, McMurphy is immediately distraught, especially when she reveals that almost every man sitting in the circle had come to the hospital voluntarily. The problem arises when asked this question: if they had come there on their own will, why were they not able to do things on their own will, also? For example, Cheswick, who is one of the voluntary patients, is subjected to horrible punishment, just for asking for his cigarettes from Nurse Ratched, who refuses and causes him to get upset, ending with him, McMurphy, and Chief being sent to another part of the ward, where it is implied that they are all sedated and/or administered electroshock therapy. Because of this, it seems like although these men have entered free men, they have been stripped of their rights and considered less than human once diagnosed with a mental illness, no matter in what way they were considered to be "sick".

An extremely important aspect of the film that highlights the way that all "sick" people were treated in the same way is the involvement of a particular character named Martini. His character is obviously very different than any of the other patients, meant to imply him being a mentally disabled individual and is an example of the common practice of mentally disabled patients being confused as mentally ill patients, when in fact, there is a fine line between the two. Someone who is mentally disabled is "limited by cognitive ability [that] is lifelong and will not dissipate, [and] cannot [be] restored by medication." Mental illness, on the other hand, is defined as "disturbances in thought processes and perceptions, [which may include] hallucinations and delusions. [The illness] may be temporary, cyclical or episodic and can occur at any stage of life." This type of illness is one that "can be prescribed [medication] to control the symptoms" (Intellectual Disability and Mental Illness). It is in this way that many mentally disabled patients, such as Martini, would not benefit from any treatments given to them by American mental asylums, because it is not an illness that can be cured or treated at all. Although Martini is never seen being abused in such a way, it is certainly implied that he does not belong in this sort of mental word, especially in comparison McMurphy, who has no disability or illness. The film may have been speaking out on the fact that mentally disabled individuals did not belong in such a place at all, because they could be administered torturous treatment that other patients received, such as electroshock, ice baths, or a lobotomy. 

In most ways, these treatments were not helpful to a majority of people, considering that "at best the odds were one in three that [some radical procedures] would actually lead to an improvement in the patient's health" (Leupo). The two radical treatments that were highlighted in the film were electroshock therapy and "the notorious lobotomy, [which was] introduced into American medical culture" in the early 1930s. Forman comments on the unnecessary use of electroshock therapy after McMurphy is first administered it after fighting with a guard. Afterwards, he enters the ward almost like a zombie, as if the electrocution had fried his brain, until he winks and bursts into comedic movement, showing the audience how ineffective and ridiculous the technique was. However, he wasn't so lucky with the other radical practice of Lobotomy. It was a "medical procedure where the neural passages from the front of the brain are surgically separated from those in the back of the brain, [resulting in] the patient forgetting their depressing or discouraging feelings or tendencies" (Leupo). It was after this method of "fixing" McMurphy's angry tendencies that he entered the ward once again like a zombie, only this time he was not faking it. "Due to the number of complications and deaths that resulted from the procedure, [the Lobotomy] was referred to as 'psychic mercy killing' and 'euthanasia of the mind'", which seemed to be exactly what happened to McMurphy(Leupo). The morbid and emotional scene allowed the audience to realize just how horrid things had gotten in mental asylums across the country, forced to watch as Chief mercifully ends McMurphy's life by smothering him with a pillow, because he knows otherwise he will live a miserable rest of his existence in the mental ward. 

As the scene of Chief finally escaping and running towards the Canadian border plays on the screen, one can only imagine the reactions of the audience. There is an almost sick feeling left in the gut of those who realize the full meaning behind the movie, because the audience is forced to see first-hand the horrors and nightmarish depths of the American mental asylums during the 20th century. Without this book and movie, many people today still wouldn't know the full effect of psychiatric treatment to patients in mental words, or at least wouldn't leave with such a deep and long-lasting feeling of disgust and remorse for the way that these patients were treated. It was such a hard-hitting topic like this that perhaps is the reason for more people desiring a strong amount of change in the asylums, leading to the near extinction of them. 

Works Cited

Dean, Charles E. "The Death of Specificity in Psychiatry: Cheers or Tears?" Perspectives in              Biology and Medicine 55.3 (2012): 443-60. Web. 10 Apr. 2016.

"Intellectual Disability and Mental Illness." IDRS-s32. S32 Step By Step Guide. Web. 10 Apr.             2016. <http://www.idrs.org.au/s32/_guide/p040_4_2_IDandMI.php#.VwqTbqQrLIU>.

Leupo, Kimberly. Toddler Time Network. "The History of Mental Illness". http://www.toddlertime.com/advocacy/hospitals/Asylum/index.htm. 11/22/11.

One Flew over the Cuckoo's Nest. Dir. Milos  Forman. Perf. Jack Nicholson. United Artists,

            1975. 
