What it means to be sane

“Guilty Except for Insanity,” along with being comprehensive and insightful, is a particularly special film because it hits close to home.

“Guilty Except for Insanity,” along with being comprehensive and insightful, is a particularly special film because it hits close to home. Not only does the documentary concentrate on the Oregon State Hospital, but director and clinical psychologist Jan Haaken is a member of the psychology department at Portland State. The film follows a structure of clips from the adaptation of Ken Kesey’s novel, “One Flew Over the Cuckoo’s Nest” (1975), documenting all the “maddening” junctures along the way for those who find themselves between criminal and mental institutions. 

Viewers meet several different patients on their journeys of guilt, confusion and coping, along with the staff that struggles to help them. Sharp scenes of restraints and medications are contrasted with soothing music, all produced by staff and patients themselves. The interviewees tell tales of displacement tinged with the hope of one day reentering the community.

For a release, the patients need to pass a point system set up by the hospital, but this is difficult in a social environment that is apt to cause conflict. Large metal-framed doors slam locked at every corner of the corridor. The razor-barbed fences resemble nothing of comforting suburban pickets. Can rehabilitation happen in a place that is so cold? And if it can’t, what should we do?

Whether or not it was intended as a call to action, the film does invoke serious questions about the efficiency of a system that, in the analogy of the film, is merely a net to catch someone already in trouble. What and where is the preventative protocol? One interviewee describes throwing rocks into windows to be sent to jail. After attempting voluntary admission to the Oregon State Hospital to no avail, crime was the last resort in this man’s desperate struggle to receive psychiatric attention. 

When crimes do happen, many people find themselves in the wrong place. It’s no surprise that the mass majority of people in jail are mentally ill, with a trial process as sticky as our own. To enter a “guilty except for insanity” plea, one must be approved by the district attorney. If unapproved, the person and his or her lawyer may try to convince a jury of “insanity.” However, the state is permitted to use psychiatrists of its own choosing in the prosecution, making the endeavor even more challenging than it already is.

The legal process is exasperating for just about anyone. However, for those who plead insanity, it is a particularly out-of-control situation resting on the shoulders of the district attorney. In addition, if one is accepted by the district attorney or found insane by a jury, the road continues to be littered with evaluations by board members. Some of the patients shown in the film are former chemistry majors, musicians and fishermen. In a sense, they are the people next door. Their stories are surreal by all means, but nonetheless very human.

Overall, “Guilty Except for Insanity” has only one downfall: It ends too soon. It would have been insightful to follow the characters for several more years to see how their goals were or were not attained through the Oregon State Hospital system. ?