The way that the United States took care of the mentally ill changed dramatically during the second half of the 20th Century.
In 1960, over half a million people resided in state-run Insane Asylums.
This was not a good system. At its best, residents led comfortable, unfulfilling, shameful lives. Just as often, the mentally ill faced abuse, neglect, and draconian treatments.
As a society, we had concluded that euthanizing people who couldn’t behave or take care of themselves was barbaric and unacceptable. However, shackling people’s hands and feet to their bed, force-feeding people pacification pills, and giving them lobotomies was perfectly normal.
As more Americans learned about what was really happening inside government asylums, the demand for systematic change became unstoppable. As the 20th Century came to a close, so did the era of state Insane Asylums.
The 1962 Ken Kesey novel “One Flew Over the Cuckoo’s Nest” and the Best Picture-winning 1975 film shined an unforgettable spotlight on the cruelty of our public asylums.
The movie begins with convicted statutory rapist Randle McMurphy (Jack Nicholson) giving a shout of joyful victory. He has convinced the prison that he may be crazy so he has been transferred to the Oregon State Hospital of Mental Health. “Good-bye, work duty,” McMurphy imagines, “hello, easy street.”
Things do not work out so well for him.
McMurphy is horrified to discover that the asylum inmates lead brutally regimented lives that are devoid of humanity and fun. Instinctively, McMurphy begins to rebel against the system by introducing gambling, sports, and girls to his timid pals.
This does not sit well with head nurse Mildred Ratched (Louise Fletcher). Nurse Ratched wants order and control. “Cuckoo’s Nest” becomes a war of wills between Ratched and McMurphy.
To his credit, director Milos Foreman does not turn the film into a simple story of good vs. evil. McMurphy is not that good. He is violent, disrespectful, and rebellious to a fault.
And Nurse Ratched is not that evil. Ratched has concluded that she must maintain order and rigid control or the inmates will begin running the asylum, which is literally true in this case.
Nurse Ratched wasn’t the problem; she was the inevitable result of a hopelessly broken system. Hospitals like hers were shuttered by the dozens in the next few decades.
Sadly, the victory of “One Flew Over the Cuckoo’s Nest” hasn’t necessarily been a triumph for America’s mentally ill. Now that the asylums are closed, countless unwell people are housed in actual prisons. And thousands more live on the street.
Our old asylum system was horrible. I don’t know if the current system is any better.
It might be time to learn what other countries do with their mentally ill citizens and copy one of them. Because we have failed.