The history of mental disorders and psychiatry is vast and undeniably tragic. Though methods of treating mental illness have evolved over the centuries, people suffering from mental disorders are often denied dignity and continue to endure social stigma. The origins of mental asylums could be traced back to the 5th century in the Middle East. In European nations, there have been such facilities since the 12th century. Yet mental health disorders in those times – and to an extent even now – are strictly viewed through the prism of morality and institutionalized religion.
The modern massive institutions to care and treat the mentally ill popped up in the early 19th century Britain. Psychiatric institutions in America rapidly grew around the same time. Rather than caring and treating the mentally ill, the institutions slowly transformed into a space of confinement. Mental health system did revolutionize psychiatry from ushering in different therapies to potent drugs. Yet the history of brutalities in mental asylums is well-documented and undeniable.
Mental health disorders have always been a subject of fascination in movies, or pop-culture in general. Movies are gradually evolving to understand the subject. In fact, works of art have repeatedly committed the mistake of grossly misrepresenting or glamorizing the mental health disorders. Nevertheless, as we are collectively learning about the fine line between sanity and insanity, we’re actively questioning such insensitive portrayals. Here are some of the best films set in mental asylums that portray the subject with sensitivity. They concisely convey the modern evolution of psychiatry, set in these sombre places.
1. Shutter Island (2010)
Scorsese’s Shutter Island is a dark, evocative, and ominous psychological thriller. Two US marshals Teddy Daniels (Leonardo DiCaprio) and Chuck (Mark Ruffalo) are sent to a remote Shutter Island where an asylum for the criminally insane is located. They are to investigate the disappearance of a patient. However, things are not as they seem and dark secrets are gradually uncovered.
Shutter Island is based on acclaimed American author Dennis Lehane’s novel. It deals with delusional disorder and PTSD within a mystery/thriller framework that’s presentable to mainstream audiences. In fact, unexpected twists and turns alongside DiCaprio’s powerhouse performance, keep us on the edge of the seat. The narrative tries to emulate the dark reality of the central character. At the same time, it also makes us reflect on the ethical aspects of psychological treatment. It does follow the American cinema staple of equating mentally ill with violence. Yet beneath the thrill and horror, it somehow attempts to comprehend the protagonist’s debilitating mental health.
2. One Flew Over the Cuckoo’s Nest (1975)
Czech expat Milos Forman directed this excellent adaptation of Ken Kesey’s novel. It is one of the iconic films set in a psychiatric institution. The remarkable thing is that the film isn’t truly about mental asylums or insanity as such. The setting and the mental afflictions function more on the metaphorical rather than the literal level. At its core, the film is a socio-political statement against the establishment.
When McMurphy (Jack Nicholson) feigns insanity to escape prison labour, he is sent to a mental asylum. Here, he’s pitted against the ice-cold and cruel Nurse Ratched (Louise Fletcher), who is in charge of the ward. While Ratched represents an enforcement of conformity, McMurphy represents the revolt against the same. Ratched’s sadistic treatment of her patients and her calculated methods of subjugating them is spine-chilling. Although it presents a caricature of mental institutions rather than an authentic picture, Cuckoo’s Nest is a satirical representation of power and authority.
3. The Snake Pit (1948)
Anatole Litvak’s powerful film was based on Mary Jane Ward’s semi-autobiographical novel of the same name. It’s considered to be one of the earliest films to genuinely depict the subject of mental illnesses and psychiatric institutions. As the title implies, mental institutions or psychiatric facilities of that era were referred to as ‘Snake Pits’ because of the chaos, indifference and inhumane treatment rampant in the places. It brought to focus the inhuman treatment given to mental patients and how such ‘cures’ hurt rather than help them. In fact, the film had an immense impact, pushing several states to change their laws regarding mental health institutions after it came out.
The film depicts a young schizophrenic woman’s nervous breakdown after being institutionalised. The Snake Pit was made during the Hays Code era, where a set of ‘moral guidelines’ needed to be followed by major studios. Therefore, it was an audacious attempt by both Litvak and producer Daryl Zanuck to tackle such a subject. Some might complain that it deals psychosis with light-touches. Yet, Olivia de Havilland’s heartrending central performance perfectly showcases what it means to lose control of one’s own mind.
4. Girl, Interrupted (1999)
Based on Susanna Kaysen’s memoir of the same name, this film depicts her stay at a mental institution. After a nervous breakdown and a suspected suicide attempt, Susanna (Winona Ryder) gets checked into an upscale, well-run mental institution. The narrative follows her 18-month stay in that place during 1967 and 1968. It discusses how social rigidities can stifle young women’s spirits and impair their minds.
Nevertheless, it has its share of mental asylum clichés, particularly in the presentation of Angelina Jolie’s character Lisa, a free-spirited sociopath. Jolie received a Golden Globe nomination for the role. But she also said in an interview that, “Lisa’s sometimes outrageous behaviour is unfairly vilified in the story.” On the other hand, Susanna’s evolution was handled with due sensitivity. Her interactions with the other girls in the ward shape her life and ideas more than her therapists do. Overall, the film is tad melodramatic, but generates real empathy for the central character.
5. Lunacy (2005)
Jan Svankmajer’s blood and guts horror film was loosely based on the works of Edgar Allan Poe and Marquis de Sade. But Svankmajer’s idiosyncratic signature is all over the film. The film revolves around an “ideological debate” about two different approaches to running a lunatic asylum. One is based on complete freedom, and the other on control and punishment. The young and naïve Jean Berlot (Pavel Liška) goes through a series of nightmarish experiences throughout the film.
Although the physical setting of the asylum appears relatively late in the film, the entire film feels like a projection of the place. Or maybe it’s a projection of the psychological world of the insane. The vision of the film makes the whole world seem like a madhouse and all of humanity its patients. The imagery is incredibly innovative, with animated tongues and eyeballs adding to the madness of the atmosphere. Though entirely different from Cuckoo’s Nest, Lunacy is also devised as a satire on authority and madness.
6. Angels of the Universe (2000)
Based on Einar Már Guðmundsson’s novel, this film is considered to be one of director Friðrik Þór Friðriksson’s finest. It poignantly tells the story of Guðmundsson’s mentally ill brother, represented by the fictional character, Páll (Ingvar Eggert Sigurðsson). Páll is an aspiring painter, who descends into madness after a romantic rejection. He is sent to a psychiatric institution, where he meets a number of colourful characters, each suffering from different mental health disorders.
One patient thinks he’s Hitler while another thinks he has telepathically written the Beatles’ songs. These characters are bit of caricatures, and they bring a light-hearted tone to this pensive narrative. In fact, the humour quotient has led to the work being called the Icelandic One Flew Over the Cuckoo’s Nest. Nevertheless, the comic elements aren’t exaggerated much, and it never dilutes Pall’s anguish. Though grounded in reality, surrealistic imagery is occasionally used to convey the protagonist’s otherwise caged thoughts. The intimidating and bleak landscape of Iceland also leaves a lasting impression on the viewer.
7. Brainstorm (2000)
Laís Bodanzky’s Brainstorm is based on an autobiographical work by Austregésilo Carrano Bueno. The book chronicled Carrano’s stay at a nightmarish mental asylum for a rehab program. The movie was filmed in the style of a documentary since Bodanzky felt it would have a greater impact on the viewers. Neto (Rodrigo Santoro) is a teenager who feels alienated from his family and has a substance abuse problem. The strict middle-class father decides to teach him a lesson by taking a drastic step of committing Neto to a psychiatric hospital.
At the hospital, Neto endures extreme abuse and horrific treatment protocols. Brainstorm could be critiqued for focusing more on the conditions of the hospital, and less on the psychology of the character. Or when it tries to explore Neto’s inner feelings, it takes a superficial route. Moreover, the significant father character comes across as one-dimensional. However, the meticulously constructed repulsive atmosphere of the hospital manages to keep us in a state of shock. The other biggest strength is Santoro’s heart wrenching performance. The actor is best known for playing Persian king Xerxes in Zack Snyder’s 300.
8. Nise: The Heart of Madness (2015)
Roberto Berliner’s wonderful docu-drama presents an important piece of history which revolutionised the practices of psychiatry. It is based on the true story of Brazilian psychiatrist Nise da Silveira, who began her career in 1944. She was shocked by the inhumane treatments given to the patients, and the appalling conditions they were forced to live in. Rather than taking a hard-line in treating patients with schizophrenia, she preferred and pioneered occupational therapy. She faced a lot of setbacks while trying to work this out within the system.
Nevertheless, Nise’s quest was eventually a success as she helped and supported her patients to create meaningful works of art. And art became a successful therapy for them. Nise’s heartfelt narrative tracks down this inspirational journey. Thankfully, it isn’t reduced into a stereotypical saviour story. It shows how treating mental health care seekers with compassion and offering them a creative outlet could have a positive impact. The film was a result of years of extensive research and almost accurately depicts Nise’s legacy.
9. David and Lisa (1962)
Frank Perry’s Davis and Lisa is based on a story by psychiatrist Theodore Isaac Rubin. It is refreshingly free of the clichés we often find in movies that deal with mental illness. The depiction of the mental issues are nuanced and understated, which makes the film feel authentic. David (Keir Dullea) is an intelligent young boy who develops a great fear of touch. When he is institutionalised, he meets Lisa (Janet Margolin), who has two personalities.
These two strike up a friendship which helps them both significantly. Remarkably, the film does not show them as pitiful victims as most films of that era would have. Instead, they are portrayed as flawed and difficult people. The other mentally ill characters also refuse to be viewed as victims. There’s a powerful scene in the film where they embrace their afflictions gleefully to drive home a point. The film doesn’t aim for unrealistic final resolutions, but is a gradual process and brings out the co-existence of opposing forces.
10. Shock Corridor (1963)
Samuel Fuller’s Shock Corridor is yet another American film that uses the atmosphere of mental asylum to offer a potent social commentary. In this case, Samuel Fuller depicts the fear and paranoia of the 1960s Cold War alongside the rampant xenophobia and racism. Johnny (Peter Breck) is a journalist who wishes to solve the mystery behind a murder which took place in a mental institution. He comes up with a trick and gets himself institutionalised there. But as he moves closer to achieving his target, he also begins to lose his sanity.
The film explores how an obsession can take over someone’s mind and drive them to madness. Shock Corridor is pulpy and lurid, and it’s full of energy. However, this doesn’t offer anything profound about mental health care or psychiatry. It features certain absurd scenes, like Johnny getting assaulted by sultry female patients in ‘nympho ward.’ The satirical tone and different characters in the mental asylum do make it compelling. It reinforces the fear and paranoia that prevailed in and consumed the 60s America.
11. The Ninth Configuration (1980)
William Peter Blatty, author of Exorcist, made his directorial debut with the idiosyncratic psychological drama, The Ninth Configuration. The film explored the blurry lines between rationality and insanity. The narrative is set in an abandoned castle which has been transformed into a mental asylum for traumatised war veterans. A new commanding officer, Kane (Stacy Keach), is appointed and meant to rehabilitate these soldiers. But this psychiatrist may not be all too psychologically stable himself.
Kane gets into frequent debates with one particular patient named Captain Billy Cutshaw (Scott Wilson) who argues with him about everything. Gradually, the confrontational interactions challenge their inherent values. Subsequently, Kane begins to lose his grip on sanity. Blatty uses the atmosphere to play with several interesting themes, the chief being the debate between science and religion. Moreover, in the cold, sterile and depressing environment of mental asylum Blatty perceives the loneliness and emptiness of the universe.
12. Man Facing Southeast (1986)
Eliseo Subiela directed this Argentine sci-fi drama. The film is set in a mental asylum, where psychiatrist Dr. Julio Denis (Lorenzo Quinteros) works. He has lost all motivation in life and seems to be clinically depressed. Then a mysterious man named Rantés (Hugo Soto) shows up at the asylum, claiming to be an extraterrestrial being sent to observe mankind’s stupidity. Denis is intrigued by Rantés, and begins to take interest in life again.
Rantés can be viewed as an extraterrestrial or a lunatic with delusions of grandeur or a Christ-like figure. Throughout the film, he ends up helping people more than the doctors do. Subiela raises deep philosophical questions about the boundaries of human reality which define rationality and irrationality. Most importantly, the narrative questions our rigid societal values which harshly judge those who are different. It makes us wonder if there is a definitive take on insanity in this mad world.
Movies dealing with mental health issues often question the traditional construct of rationality. They may question the establishment and its socio-cultural norms. Films set in mental asylums not only bring out the madness of the mentally ill people, but of society at large. There are more engaging and eye-opening works apart from the ones mentioned here. Short Term 12 is set in a group-home for troubled adolescents, which is unlike any of the draconian mental health institutions of the earlier decades. It vividly captures the trauma and struggles of at-risk teenagers. Frederick Wiseman’s Titicut Follies (1967) and Wang Bing’s ‘Til Madness Do Us Part (2013) are shocking interrogative documentaries that focus on the denial of dignity to those at mental health institutions.
(Additional writing by Arun Kumar)