JULY 2025 PICKS: INSTITUTIONALIZED
This month's recommendations explore the beneficial and harmful effects of psychiatric institutions.
In her beautiful and gradual memoir Committed: On Meaning and Madwomen, writer Suzanne Scanlon considers the years she spent as an inpatient at New York State Psychiatric Institute and Hospital in the early ‘90s. It was shortly before long-term stays were phased out, before it was recognized that they make it more difficult for a person to integrate themselves back into society upon release. Scanlon recalls a time when the biomedical approach to psychiatrics was in the process of usurping the analytical one. She, along with other patients, became unfettered as her doctors experimented with various new drugs, finding steady ground – her aching, stripped feelings mirrored – in art, in books by women writers before her who felt too much and not the proper way. As this memoir meanders through the works and ideas of everyone from Virginia Woolf to Janet Frame, Scanlon shows us how these madwomen before her quite literally survived the black sun of despair through the creation of art, by articulating pain through writing; she thereby skewers medical institutions, which she shows quash women’s, especially marginalized women’s, creativity, ignore their cry to be understood.
It’s both a tender and blistering book in which Scanlon wonders, “Can you love a life in a carceral space, a space of surveillance?” The institution was both incredibly dehumanizing, and home. As a patient she, along with others, found she had to perform mental illness to receive care and attention — she found ways to survive the system that generates its own kind of being. In halting and various ways, it helped her to get better than she was before being committed, even as it broke her, altered her thinking irrevocably. “You can become used to care and attention,” Scanlon writes. You become used to being a patient, because that’s the dynamic — a play between patient and doctor — on which the institution turns.
Psychiatric institutions are like little worlds unto themselves, and as such they can be good even as they are bad. They are brutal and uncompromising, sometimes violent, but always overwhelmingly paternal and infantilizing, always and endemically predatory. They have for years targeted and done violence to the more disenfranchised and marginalized, the most vulnerable, people within society, under the guise of administering care.
Here are a handful of films that explore the beneficial and harmful effects of psychiatric institutions.
The Snake Pit (1948), dir. Anatole Litvak
This film is a marvel for many reasons: its keen understanding and visual depiction of mental distress; its sober documentation, often interrogation, of contemporary psychiatric treatments (like shock therapy); Olivia de Havilland’s jaw-dropping performance of a woman in the throes of psychosis. But tallest among all of its successes stands Litvak’s ability to humanize those with mental illness. The film, based on a semi-autobiographical novel of the same name by Mary Jane Ward, follows de Havilland’s Virginia Cunningham, a novelist who is committed to Juniper Hill State Hospital by her husband after a nervous breakdown. The film follows Virginia as she moves up and down through the wards, through the intensity of her mental illness and diagnoses, as she gets better and worse, and ultimately better again, under the Freudian analysis of her therapist Dr. Kik (Leo Genn).
Now, this film isn’t perfect — it has been criticized for suggesting that there is an ultimate cure for Virginia’s schizophrenia, and that cure looks like being a good and submissive, undifficult and tame, wife to her husband. This is absolutely a valid criticism (though not entirely sound, for the lesson Virginia learns is that she can manage her mental illness, not that it has been absolutely solved and eradicated), but I do believe that the film can still be viewed for its strengths. This film, while certainly privileging and championing Freudian analysis as “the right way” to treat mental illness, also considers the psychiatric institution without glamorizing it. In fact, at times it seems almost to criticize the institution for its inability to treat the immense number of patients it interns for a lack of proper funding. Patients get lost within the facility’s many wards, and sometimes nurses become patients themselves. Litvak’s gaze (of necessity subtle, working as it was within the studio system, itself paternalistic) shrewdly acknowledges the formidable power a mental health facility wields over its patients, a power that is tough and impossible to resist, a power that is kin to, an extension of, capitalist patriarchy. This is a brave film for its tackling of an unwieldy and fraught topic.
It is by no means without fault, nor is it anarchic, for it finds health within the system it delicately criticizes, but throughout its complex being, two things remain constant: an empathetic gaze for the patients, who exhibit a wide array of mental illnesses and visions of what it looks like to be well and happy, and de Havilland’s careful performance, which gracefully depicts Virginia’s raw confusion, fear, and stress in the face of a powerful institution that subjugates and has the potential to violently suppress, even as it facilitates wellness.
Frances (1982), dir. Graeme Clifford
Frances is like The Snake Pit in that it represents the psychiatric facility at around the same in history (the 1940s) and that my recommendation comes with many caveats. Clifford’s film, produced by Mel Brooks’ Brooksfilms, is based on the infamous Shadowland: Search for Frances Farmer, a biography of the Old Hollywood actress written by film critic William Arnold that has largely been discredited for its fictionalization of Farmer’s life. Arnold, without any factual substantiation, says in his book that Farmer received a transorbital lobotomy when she was institutionalized, a claim that writer Jeffrey Kauffman has thoroughly debunked. This film is a distortion of a distortion and should not be taken as fact. It really is only worth considering for Jessica Lange’s sensitive portrayal of Farmer.
In Lange’s hands, Farmer is not so much a woman whose career is derailed because of her mental illness, as much as she is a woman used and abused by the predatory and vampiric system of Hollywood first and patriarchy second. Lange carries Farmer’s mental illness with an awareness that while it beleaguers the woman, it is not responsible for her ruin so much as it is something others use as reason to exploit, disempower, disenfranchise, and victimize her and so many other people like her. Farmer is given back her humanity by Lange, a humanity that Hollywood tabloids stole from her, sensationalizing or reframing her acts of resistance to a brutal system as unhinged or ungrateful, as insanity. This film is unrelenting in its depiction of the violence done to Lange’s Farmer, and at times it feels too focused on the vulnerable woman’s pain in the way that Old Hollywood was, but it is Lange’s performance that makes any of it meaningful, that saves Frances from feeling totally exploitative. Through Lange’s Farmer we see just how powerless patients are in their attempts for self-advocacy in the face of psychiatric institutions, we see what it looks like for a person to give up, to get lost. Lange joins de Havilland’s ranks in her ability to put a face to madness.
Elizabeth Blue (2017), dir. Vincent Sabella
Anna Schafer is Elizabeth, a woman who has just been released from a psychiatric facility armed with an arsenal of medications. The film follows her as she works to rebuild her life with the help of outpatient therapy to assist in managing her schizophrenia. Elizabeth is about to get married to Grant (Ryan Vincent), who has just moved in with her, and as she prepares for her wedding, she finds that her hallucinations have returned with strident force. This film is careful and tender, soft and kind as it explores Elizabeth’s attempt to manage a life and her diagnosis. Oftentimes the film is painfully beautiful for its depiction of the stabilizing force love, if it is guaranteed and safe, can have in guiding us back to ourselves; it at the same time, in negative relief, shows how lovelessness can destroy us. Elizabeth Blue is heartbreaking for how real it feels in its depiction of loneliness and the desire for safety from one’s own mind. Psychiatric institutions here are more benign than terrible, but they are still underfunded with employees overworked and unable to meaningfully care for every patient. Sometimes patients fall through the cracks, this film suggests, sometimes they are released before they are ready, because sometimes nobody has the time to see their hurt. Obliquely, this film reveals institutions to be airless, carceral spaces that are unable to teach patients how to build lives of community and love.
Unsane (2018), dir. Steven Soderbergh
Claire Foy plays Sawyer Valentini, a woman who has relocated her life in an effort to escape her stalker David Strine. As she begins rebuilding, she realizes she might not be able to make it without professional help — she sees Strine’s face everywhere. She turns to a counsellor at Highland Creek Behavioral for support, and though she has a good session, things turn sour and then dire when the counselor tricks Sawyer into signing a form that commits her into the facility for 24 hours. It’s a scam that the facility, along with others across the country, run: they trick people into voluntarily committing themselves and keep them confined until their insurance claims pays out. Sawyer rails against her confinement, oftentimes violently lashing out at orderlies; she just wanted some support as she navigated her life after being stalked. But when Strine shows up at the facility as an orderly under another name, Sawyer is, understandably, horrified. People refuse to believe Sawyer when she explains to them that her life is in danger. They think she is just insane, why else would she be in the facility? Unsane, with its tight frames and veering gaze (the film was shot entirely on an iPhone), is agitating and frustrating, anxiety and squirm inducing. As Sawyer lashes out against the system around her, begging for help, Soderbergh reveals not only the insidious ways in which psychiatric institutions still continue to victimize people looking for help, but also how the power imbalances are so stark between patient and employee that it’s tough to hold onto your humanity through peaceful means once you’ve been labelled a patient.