Contrasting Portrayals of Mental Illness (One Flew Over the Cuckoo’s Nest and Girl, Interrupted)

girlAt first glance, Girl, Interrupted (1999) appears to be something of a female-centric retelling of One Flew Over the Cuckoo’s Nest (1975). Both take place in psychiatric hospitals; both portray main characters whose mental states are not always clear (are Susanna and McMurphy truly mentally ill, or is it an act?). Several plot points overlap–for instance, characters in both films are driven to suicide at similar points in the plot, each film contains a short escape into the outside world that ends in a return to the hospital, and both involve an illegal nighttime escapade that results in punishment (Susanna and Lisa singing outside Polly’s door, McMurphy’s party). However, the two films differ radically in their treatment of madness and the institution of the asylum.

In One Flew Over the Cuckoo’s Nest, the hospital is portrayed as a ruthless and authoritarian place, with little regard for the needs of its patients. Nurse Ratched, the film’s villain and a representation of the establishment as a whole, is merciless in her position of power and eventually orchestrates McMurphy’s lobotomy when he refuses to conform to the institution’s mould. By contrast, the staff member most prominently featured in Girl, Interrupted–Valerie–is portrayed as having Susanna’s best interests at heart, whether this is shown through tenderness or through the “tough love” that (according to the film) Susanna needs.

In One Flew Over the Cuckoo’s Nest, many of the inmates–whom the audience originally sees as insane–are eventually shown to be relatively ordinary people who have been driven to mental instability by the system’s victimization. Months of constant surveillance, manipulation, and being treated as identical cogs in the asylum machine with no individualization result in breakdown, and in one case, suicide. Into this place, McMurphy brings a whirlwind of chaos and freedom. His constant challenging of the rules, even in completely innocuous areas such as rearranging the day’s schedule in order to watch the World Series, can only last for so long in the stifling environment of the hospital. In the end, he is crushed by the power of the institution. As he lies in a vegetative state without free will or individuality, he is at last conformed to the asylum’s idea of an ideal inmate.

Girl, Interrupted portrays a very different picture of mental illness and mental hospitals. The outer trappings of the two hospitals are identical. Both are white and sterile. Both have a glass-enclosed nurse’s station through which mysterious (and mandatory) medication is handed to a line of patients. Both are isolated from the rest of the world but allow little privacy, including communal bathrooms. In One Flew Over the Cuckoo’s Nest patients are locked out of their rooms during the day, and in Girl, Interrupted the staff performs periodic, frequent “checks” to every bedroom.

But Claymoore is staffed, for the most part, by caring and competent workers. Even the hospital’s surveillance and other prisonlike attributes are not shown negatively, for, as Chouinard (2009) points out, it is when Susanna and others choose to leave the confines of the ward (Daisy’s apartment, the hospital basement) without permission from their authorities that violence and uncontrolled conflict occur. Lisa’s destructive behaviour is possible only outside the hospital’s limits. Though Susanna initially resists doctors’ attempts at therapy and medication, and tries to thwart the system by rebelling against the rules–due largely to Lisa’s influence–it is only when she decides to cooperate that she is able to conquer her borderline personality disorder. The film suggests that all she really had to do was decide that she wanted to defeat it and go home. This theme is paralleled with the movie’s references to The Wizard of Oz, in which Dorothy has had the power to go home all along without realizing it, and in order to leave Oz has only to make a conscious decision to return.

Both movies deal with suicide as well, but Daisy (Girl, Interrupted) and Billy (One Flew Over the Cuckoo’s Nest) commit suicide for very different reasons. While Billy is driven to despair by his environment–Nurse Ratched in particular, when she uses her power to manipulate him back into conformity and asexuality–Daisy commits suicide after Lisa, the hospital’s foremost rebel, sworn enemy of the system, and in many ways a classic revenge seeker, taunts her mercilessly about her past and her father, saying that Daisy cannot escape her problems even outside the hospital. In this Lisa is essentially undoing all of the hospital’s progress in Daisy’s life. Her actions in this scene, and the damage they cause, are a turning point for Susanna, who realizes that though Lisa’s rebellion and her devil-may-care attitude are attractive on the surface, her defiance is causing more harm than good for everyone involved. Lisa runs away to Florida, while Susanna chooses to return to Claymoore. (Throughout the film, Lisa–a sociopath–essentially fills the disabled-as-violent-and-criminal prototype; she is defined by her charisma but primarily by her “monstrously ‘other’ capacity for cruelty” (Chouinard, 2009)). Daisy’s death is caused by Lisa’s insistence on defying the institution, while Billy’s death is the direct result of the hospital’s brutal, dehumanizing authoritarianism.

As they travel deeper into the microcosm of their respective psychiatric wards, McMurphy moves toward insanity while Susanna moves toward a functional life in the outside world. One Flew Over the Cuckoo’s Nest blames social systems and brutal outside forces for the mental illness of many of its characters. When they are temporarily set free from the ward’s confines, whether mentally or physically, they are no different from–and certainly not inferior to–the people outside. By contrast, when the characters in Girl, Interrupted escape from their captivity, death and pain result. In Susanna and Lisa’s cases, at least, the film places the responsibility for mental illness squarely on the individuals involved instead of blaming environmental factors.  Stephen Holden, in his New York Times review of the film, describes its “hardheaded tough-love attitude toward lazy, self-indulgent little girls flirting with madness: You can drive yourself crazy, or you can get over it. The choice is yours” (Holden, 1999). Both the problem and the answer lie within Susanna, and that answer is found in her decision to cooperate with the hospital. And so, in the end, Susanna gives in, and the same system that is McMurphy’s death sentence is her salvation.


Chouinard, V. (2009). Placing the ‘Mad Woman’: Troubling Cultural Representations of Being a Woman with Mental Illness in Girl Interrupted. In, Social & Cultural Geography. Vol. 10, No. 7, November (pp.791-804).

Holden, S. “Get Over It, Little Girl. Stop Your Whining.” Review of Girl, Interrupted, Dir. James Mangold. New York Times 21 Dec. 1999.

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One Response to Contrasting Portrayals of Mental Illness (One Flew Over the Cuckoo’s Nest and Girl, Interrupted)

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