Out of all of the works of literature we have studied in this class, I feel that this one is the one that I am the most interested in. I felt particularly connected to this book because of the experience that I have had with mental health facilities in my lifetime.
While I have never been admitted to a mental health facility myself, I have family members and friends who have, and I have seen first hand what occurs inside them and the effects that they can have on people due to their experiences there.
In One Flew Over the Cuckoo’s Nest, we are introduced to the character Miz Ratched, who is the head nurse in this particular facility. It is apparent to the readers that she is not a very warm caregiver, nor is she particularly invested in her patients. Near the beginning of chapter one, there is a scene, which I felt captured the essence of how Miz Ratched felt about her patients and the type of care they received. In this passage, she has an interaction with some of her patients which the narrator describes as, “She stops and nods at some of the patients which come to stand around and stare out of eyes all red and puffy with sleep. She nods once to each. Precise, automatic gesture” (Kesey 6).
This passage demonstrates the cold, mechanical approach that Miz Ratched took to running the facility. Rather than embrace each person as a human being and treat them as such, she treated the patients with a cold and mechanical demeanor. This was also demonstrated on page 25, where the narrator states, “The big nurse tends to get real put out if something keeps her outfit from running like a smooth, accurate, precision-made machine” (Kesey 25).
This description was actually quite similar to the experience I have had with mental health facilities. On the occasions I have gone in to visit my friends and family who were admitted to them, I was shocked at how bleak and depressing they seemed. Many of the staff seemed to be “checked out”, and focused on staying on schedule and meeting quotas at the loss of forming relationships with the patients.
An article published by the BMC health services analyzes this exact situation. In the study conducted by the BMC, patients who had spent time in a psychiatric hospital were interviewed. They were asked questions about their experiences in the hospital, if their stay had been beneficial, and their relationships with the staff in the hospital. The study found that, “Relationships with an individual which comprised effective communication, cultural sensitivity, and the absence of coercion resulted in that person being attributed with a sense of trust. This resulted in the patient experiencing the hospital as a place of safety in terms of risk from other patients and staff” (Gilburt, Rose & Slade 1).
It is apparent that an icy approach to patients with no relational bonds whatsoever is not beneficial to these patients, as demonstrated in both fiction and non-fiction. When we stop looking at these facilities as machines to be maintained, maybe we will be able to move forward into providing the best care possible in all psychiatric hospitals.
Gilburt, H., Rose, D., & Slade, M. (2008, April 25). The importance of relationships in mental health care: A qualitative study of service users’ experiences of psychiatric hospital admission in the UK. In BMC Health Services Research. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-8-92
Kesey, K. (1962). One Flew Over the Cuckoo’s Nest. N.p.: Penguin Books.