The winner of five Academy Awards, this movie stars Jack Nicholson as R.P. McMurphy, a lazy convict who fakes insanity in order to be transferred from the hard ways of prison to the "easy life" in a mental hospital. Filmed at Oregon State Hospital, actual patients were used as extras throughout the movie. The part of Dr. Spivey was played by the real hospital administrator.

We are given glimpses into the lives of many patients on Nurse Ratched’s ward. It is interesting to see how Nicholson’s character interacts with the others. He is resistant to the controlling nature of Nurse Ratched and tries to change things. Their world is haunting yet sometimes hilarious to us, the viewers.

Ultimately, all humor aside, this is a sad film with a tragic ending. We must ask ourselves, if this is an accurate portrayal of the time almost 40 years ago. The truth is conditions are much as they seem in the movie. New drug therapies promised hope for the chronically ill patients but also doubled as a means of controlling once uncontrollable patients. The symptoms may have been alleviated but at the cost of becoming a walking zombie.

If that’s not bad enough, then there’s Electro Convulsive Therapy or ECT. While watching the graphic scene in Cuckoo’s Nest where McMurphy is given shock treatment, we realize that this is done more as a means of punishment than actual therapy. It is hard to condemn those times; the new anti-psychotic drugs represented the first new approach in decades. The hope that they hinted at would ultimately come true twenty years later with the advent of newer medications with fewer disabling side effects. At the end of the movie we are asked to define the insanity defense for ourselves. Was R.P. McMurphy really insane when he entered the hospital? Or did he become this way only after suffering its effects as a nonconformist and trouble maker?

Many of you may be familiar with the story of Jimmy Piersall, the gifted baseball player who suffers a mental breakdown. The movie stars Anthony Perkins as Piersall and Karl Malden as his domineering father.

Jimmy has a bright future in baseball. His father won’t settle for anything less than the major leagues. His own dreams of success were frustrated somehow so he must relive them in the life of his son. Perfection is barely good enough. Jimmy obligingly pushes himself towards the top and one day finally makes it to the majors with the Boston Red Sox. Unfortunately, the pressure once he gets there is so intense that Piersall suffers a major mental breakdown and is hospitalized as a result.

During the ensuing treatment, helped by an understanding doctor, Jimmy realizes that he cannot live out his father’s dreams. He has to lead his life the way he chooses. Father and son eventually rebuild their shattered relationship. Jimmy makes it back to the major leagues and plays not to satisfy his father’s drive but to please himself.

Based upon the real life experiences of Mary Jane Ward in her book of the same title, this was one of the first Hollywood films to deal with mental illness in a realistic and insightful manner. Olivia de Havilland plays the lead character Virginia Cunningham, who finds herself in the idealistically named Jupiter Hill Hospital.

Once inside, she tries to remember the demons that put her there but with limited success at first. With the help of a caring psychiatrist, the pieces appear to her and she gradually completes the puzzle.

Stark and vivid in its portrayal of hospital life, The Snake Pit does represent an accurate if overly simplified picture of the time (1940's). There are chronic patients, compassionate staff members, and uncaring nurses who probably hardened over the years. One nurse even becomes a patient, and goes around the wards taking everyone’s temperature with an imaginary thermometer. The horrors we see are representative of a benevolent ignorance. Any treatment was tried if it promised the slightest hope. What seems cruel to us today was only a genuine attempt to help patients.

The saving grace for Virginia is made up of her own hard work and with the help of one caring doctor who sees hope and the possibility of improvement in her case. Out of the hundreds of patients, he selects a few who can be helped. Together, they confront the nightmares, one after the other, that contributed to her breakdown. They face them for what they are - awful yet insignificant memories. Any one of the memories, by itself, seems plain enough. But given her predisposition and the impact of these events, we see how she got into the snake pit.

Hard to find and even harder to watch, Titicut Follies is Frederick Wiseman’s documentary on life inside a mental institution. After being released, it was withdrawn from circulation and was not seen for decades.

Not for the feint of heart, this is still a very compelling movie. Wiseman films in the cinema verite style where we hop from scene to scene with no narration, just the voices of the staff and patients. The horrors become almost unbearable when one realizes these are actual people and events. What caused them to be hospitalized? What of their families, their hopes, their dreams and most importantly, their future. The overall effect of the film can be overwhelming. Patients walk around naked. Psychiatrists try therapy, all the while chain smoking away their own inner problems.

Empathy is a luxury for viewers. We must deal first with the fact that these horrible conditions existed up until the very recent past. Titicut Follies, however difficult to watch, should not be forgotten. It belongs in our collective consciousness much in the same way that films of the Holocaust do. We cannot forget the awful past especially when it could happen again.