Kiessel, Analysis 5

One of our questions to think about throughout the course is, “what role does the mental institution play in fictional representations of madness?”. I found this question to be extremely relevant to this week’s reading because of Bromden’s theory of “The Combine” and also the ward itself, especially the Big Nurse.

I typed into google, “current state of mental institutions” and found a great article that discusses not only the past horrors of mental institutions but the evolution of them and their role in the 21st Century, specifically State Hospitals. Interestingly, around the time the book was written and published, JFK made one last piece of legislation called the “Community Mental Health Act of 1963” where he expresses that “‘all but a small portion’ of those residing in large mental health institutions could be served in the community” (Fisher, et al.) The article then goes on to discuss the population of patients admitted to the State Hospitals and the types of characteristics associated with them, which are: “people with past criminal justice involvement, a growing “forensic” population, sexually dangerous persons, and, finally, what has been termed a “difficult-to-discharge” population” (Fisher, et al.). For clarification, the article gives descriptions of each characteristic type. A “forensic” population means someone who was deemed by the courts to be not competent to stand trial and was therefore sent to an institution.

The reason I found this interesting was relating it back the the novel. I think there are elements of all of these characteristics in the story. First, McMurphy fits the first two characteristic types: he has been prosecuted multiple times and continues to reoffend and is a known sex offender (even though he claims that the young girl came on to him). His sexual deviance has been conveyed throughout multiple points in the story including his prosecution and his admittance of having first been sexually active at 10-years-old with an 8 or 9-year-old. Lastly, I think the article’s mention of the patient who is “difficult-to-discharge” is fascinating when you link it to Bromden’s terms of “acute” and “chronic.” Chronic being the institutions form of patients who are “difficult-to-discharge.”

The question is whether these patients are actually acute or chronic because of their illness or because of the perpetuation by the institution. I think in One Flew Over the Cuckoo’s Nest it can be argued that the institution appears to be extremely corrupt and harmful and actually does perpetuate misery. For example,seemingly, McMurphy was not a chronic patient until the Big Nurse (potentially metaphorical of the power of institutions) wanted to control him and made him act out and rebel, which then ultimately forced him to become a chronic because of his lobotomy procedure. Furthermore, the “Combine” perpetuating Bromden’s invisibility and silence/deafness. In this novel, it is apparent that institutions are regarded as more harmful than benevolent.

If you want to check out more of the article, here is the link: institution link.


Works Cited

Fisher, William, et al. “The Changing Role of the State Psychiatric Hospital.” Health Affairs.      28.3 (2009). Web. 30 Oct. 2016.



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