Revisiting 'One Flew Over the Cuckoo's Nest'

Over forty years after its initial release, One Flew Over The Cuckoo's Nest is back in cinemas courtesy of the BFI, with a lower age classification of 15. A defining film of its era, and one of the most iconic American films of all time, it has lost none of its power to shock, inspire, and provoke, remaining a fixture on many people's favourite movies lists.

Based on a novel by Ken Kesey, the story centres on Randal P. McMurphy, a long-time criminal who pleads insanity in order to avoid another spell in prison. Instead, he is sent to the state mental hospital, where he immediately shakes things up and challenges the authority of the wardens - butting heads with rigid disciplinarian Nurse Ratched in particular. Within the confines of the hospital walls, McMurphy's influence gradually takes hold over the other patients, encouraging them to stand up against what he sees as an oppressive system.

In Kesey's novel, the story is narrated by Chief Broden, an enormous Native American patient at the hospital. He has been a resident there since the end of World War Two, and is seemingly deaf and mute as a result of traumatic experiences on the battlefield (and perhaps more localised prejudice). The filmmakers, however - who included Czech director Miloš Foreman and a young Michael Douglas as producer - realised that depicting a film through the perspective of somebody who was mentally disturbed might be very challenging for audiences, and so focused on McMurphy's story instead. (Although the line between McMurphy's apparent sanity and the state-of-mind of the other patients is a blurry one at best, and a central focus of the film). Kesey was unhappy at this change, and claims to have never watched the film.

With McMurphy at the centre, it was clear that the role needed to be played by a bona-fide movie star. Other big names were considered for the role, including Marlon Brando and Gene Hackman, but eventually Jack Nicholson was cast in what would become one of the great screen roles. The cast also includes a young Danny De Vito, Back to the Future's Christopher Lloyd in his first screen appearance, and Brad Dourif as the tragic Billy Bibbet, the youngest man on the ward.

The film was shot in an actual hospital - a practice that would never be allowed to take place today. Furthermore, the hospital's director played the role of McMurphy's supervisor in the film, and many patients were incorporated into various crew departments. It was only much later that the producers realised that many of these individuals had been certified as criminally insane. The cast spent a great deal of time with the patients, with each allocated an individual to shadow in the hospital, and sometimes even sleeping on the ward. Patients' daily routines were also observed, including having actors sitting in on their daily therapy sessions. This observation extended to watching individuals undergo electroconvulsive shock therapy, a controversial practice in which seizures are electrically induced in patients to provide relief from mental disorders. 

During rehearsals, the actors were asked to participate in unscripted therapy sessions as part of the process of developing their characters. Unbeknownst to them, Foreman was filming these sequences - footage of which remains in the film - even when the actors were out of character; an ethically questionable technique that angered the actors.

At the heart of the film, though, is Nicholson. This film cemented the actor's star persona: oodles of dangerous-but-irresistible charm, a wide toothy smile, a daredevil rebellious spirit, and a droll tone of speaking, as if he had all the time in the world. The other patients are in awe of McMurphy; he becomes their leader and spokesman, even if he does not always act with their best interests at heart. With McMurphy's unhinged attitude, it's easy to see parallels with the monstrous character of Jack Torrance, a role Nicholson would play five years later in Stanley Kubrick's The Shining.

In charge of the ward, Nurse Ratched was a metaphor for the cold, bureaucratic authority that the entire story is raging against. One of the great screen villains, what makes her so interesting is her complexity. Whereas Hannibal Lecter has his diabolical charm and intellect, M (in Fritz Lang's M) is a vulnerable, child-like monster, and Psycho's Norman Bates clearly has profound psychological problems, Nurse Ratched intrigues because of her conviction that she is doing the right thing. Ruthless and icy her methods may be, but she would argue that they are in the best interests of her patients and their safety. But her techniques - withholding basic necessities from patients, humiliating them in group therapy - appear to induce nothing but compliant fear in those around her (including her colleagues). Fletcher's still, controlled performance as Ratched is one of the reasons why the film remains imprinted on the memory of everybody that sees it.

Depictions of mental health issues on screen have often been criticised for equating illness with extreme criminality; for using such conditions insensitively as a jumping off point for a gimmicky premise; or simply for being patronising. Whilst all of these following films deal with dramatically different conditions, and grouping them together can be problematic, other examples of sensitive depictions of mental illness on screen include Girl, Interrupted, Memento, A Streetcar Named Desire, What's Eating Gilbert Grape, and Little Miss Sunshine. Many of these films highlight - as One Flew Over The Cuckoo's Nest did - the dreadful stigma and mistreatment of individuals with particular conditions. They are also notable for their simple visibility when done correctly: the act of putting a character on screen with particular conditions can help to educate audiences about the realities behind the sensationalism.

But in many ways One Flew Over The Cuckoo's Nest is not a film about mental illness, and arguably its representation of afflictions is simplistic, or overly dramatised. The film is more of an anti-establishment story, encouraging its audience to stand up for themselves in the face of lumbering bureaucracy and restricted freedom. In that sense, it has more in common with the likes of Cool Hand Luke, V For Vendetta and Falling Down. 

This spirit of rebellion struck a chord with 1970s audiences in America, who were living through the controversies of the Nixon administration and the Vietnam War. American cinema was as daring during this period as it has ever been - with Nicholson at its centre - through films such as Five Easy Pieces, The Passenger and Chinatown. While One Flew Over... remains a product of its time, with elements of the storytelling and filmmaking process sitting uneasily in modern society, the film's defiant, inspirational attitude remains powerful, reminding audiences that we do not always have to accept things as they appear to be, even if standing up for what you think is right can have unforeseen consequences...