From Hero of the Counterculture to Risk Assessment: A Consideration of Two Portrayals of the “Psychiatric Patient”

This article is based on a comparative thematic analysis of two novels that explore the experiences of institutional psychiatric care. Ken Kesey’s 1962 novel One Flew Over the Cuckoo’s Nest is a classic of modern U.S. literature. It is argued here that Kesey’s representation of the “psychiatric patient” as rebel was not only a reflection of some the changing societal attitudes in postwar America, but it also helped to shape them. The challenge to the asylum system was thus cast in terms of questions of the civil rights of a marginalized group. The main themes of the novel reflect those of protesters against the abuses of the asylum system—the poor physical conditions, the social isolation of the patients, poor physical care and abuse, and the use of ECT and psychosurgery. The rebellious spirit of Kesey’s work is contrasted with a recent novel—Nathan Filer’s 2012 award-winning The Shock of the Fall. In Filer’s work, the optimism and challenge to authority has dissipated to be replaced by a resigned fatalism reflecting the current crisis in mental health services