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How on-screen portrayals of mental illness have changed since One Flew Over the Cuckoo's Nest

SCOTT DETROW, HOST:

Nearly 50 years ago, theatergoers were introduced to Milos Forman's film "One Flew Over The Cuckoo's Nest." It was based on Ken Kesey's best-selling novel, and it starred Jack Nicholson as a new patient at a state psychiatric hospital.

(SOUNDBITE OF FILM, "ONE FLEW OVER THE CUCKOO'S NEST")

JACK NICHOLSON: (As Randle Patrick McMurphy) If that's what being crazy is, then I'm senseless, out-of-it, gone-down-the-road wacko.

DETROW: "One Flew Over The Cuckoo's Nest" won multiple Oscars, including best picture, at the 1976 Academy Awards. As NPR's Mandalit del Barco reports, a restored version will be screening at theaters tomorrow and on Wednesday, July 16.

(SOUNDBITE OF FILM, "ONE FLEW OVER THE CUCKOO'S NEST")

NICHOLSON: (As Randle Patrick McMurphy, laughter) Whoo. Hoo-hoo-hoo (ph).

MANDALIT DEL BARCO, BYLINE: In "One Flew Over The Cuckoo's Nest," Jack Nicholson's character, R.P. McMurphy, has been convicted of rape, but he avoids time on a prison work farm by faking mental illness. He's portrayed as a charismatic rebel, butting heads with the controlling Nurse Ratched, and he inspires a rebellion by the other patients who, unlike him, are in the institution voluntarily.

(SOUNDBITE OF FILM, "ONE FLEW OVER THE CUCKOO'S NEST")

NICHOLSON: (As Randle Patrick McMurphy) How about it, you creeps, you lunatics, mental defectives?

DEL BARCO: Actor Danny DeVito played a patient named Martini.

DANNY DEVITO: Real harmless, really sweet guy.

DEL BARCO: DeVito first played the character in an off-Broadway production. He says to prepare for that role, he and the stage cast visited the state-run psychiatric institution on Wards Island in New York. The film was shot on location at a mental health facility in Salem, Oregon. And he says the casting was perfect.

DEVITO: They found this guy to play McMurphy - ha, ha, ha - this brilliant guy, Jack Nicholson. He was, like, just a trip, man. He was, like, the best.

DEL BARCO: In the film, Nicholson's character is held down to undergo electroshock therapy.

(SOUNDBITE OF FILM, "ONE FLEW OVER THE CUCKOO'S NEST")

UNIDENTIFIED ACTOR #1: (As character) Here we go.

(SOUNDBITE OF ELECTRICITY)

NICHOLSON: (As Randle Patrick McMurphy, groaning).

DEL BARCO: He ends up with a lobotomy.

KEN DUCKWORTH: The meta message that you could be punished, lobotomized, held down against your will isn't a great message for help-seeking in terms of the mental health field.

DEL BARCO: Ken Duckworth is a psychiatrist and the chief medical officer for the National Alliance on Mental Illness. He remembers seeing "One Flew Over The Cuckoo's Nest" at a theater in 1975 when he was 17.

DUCKWORTH: And believe it or not, my father was in and out of a state hospital for very bad bipolar disorder. When I visited him, the industrial, institutional coldness of it all felt familiar to me in the film.

DEL BARCO: Duckworth says it's a brilliant film with kernels of truth about the overcrowded institutions of the 1960s, when the story was set. But he says it left a lasting impression.

DUCKWORTH: You talk to somebody with major depression. They'd be on multiple meds. You say, were you ever exposed to electroconvulsive therapy or shock therapy? Oh, no. I saw what happened to Jack Nicholson. I'm not letting them do that.

(SOUNDBITE OF FILM, "THE SNAKE PIT")

UNIDENTIFIED ACTOR #2: (As character) Don't be afraid, Mrs. Cunningham.

DEL BARCO: Before "Cuckoo's Nest," the 1948 film "The Snake Pit" was set in a psych ward. Olivia de Havilland earned an Oscar nomination for portraying a woman who has a nervous breakdown and undergoes shock therapy.

(SOUNDBITE OF FILM, "THE SNAKE PIT")

OLIVIA DE HAVILLAND: (As Virginia Cunningham, groaning).

DEL BARCO: These days, electroconvulsive therapy happens under anesthesia, lobotomies are almost never performed and patients are no longer being warehoused in large mental institutions. Duckworth says, increasingly, films and TV shows offer more humanistic and empathetic portrayals.

(SOUNDBITE OF FILM, "SILVER LININGS PLAYBOOK")

BRADLEY COOPER: (As Patrizio Solitano) I used to be on lithium and Seroquel and Abilify, but I don't take them anymore, no.

DEL BARCO: In the 2012 film "Silver Linings Playbook," Bradley Cooper's and Jennifer Lawrence's characters compare meds.

(SOUNDBITE OF FILM, "SILVER LININGS PLAYBOOK")

COOPER: (As Patrizio Solitano) You ever take Klonopin?

JENNIFER LAWRENCE: (As Tiffany Maxwell) Klonopin? Yeah.

COOPER: (As Patrizio Solitano) Right?

LAWRENCE: (As Tiffany Maxwell) Jesus.

COOPER: (As Patrizio Solitano) Like, I said what?

LAWRENCE: (As Tiffany Maxwell) Yeah (laughter).

COOPER: (As Patrizio Solitano) What day is it?

DEL BARCO: Series like "Shrinking" feature caring therapists with their own vulnerabilities. And even "The Sopranos" showed everyone could use talk therapy, says DeVito.

DEVITO: Yeah. Like, Tony Soprano's not going to lay down for a lobotomy, right? Nah.

DEL BARCO: Like that HBO classic, "One Flew Over The Cuckoo's Nest" remains a cultural touchstone. Mandalit del Barco, NPR News. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

As an arts correspondent based at NPR West, Mandalit del Barco reports and produces stories about film, television, music, visual arts, dance and other topics. Over the years, she has also covered everything from street gangs to Hollywood, police and prisons, marijuana, immigration, race relations, natural disasters, Latino arts and urban street culture (including hip hop dance, music, and art). Every year, she covers the Oscars and the Grammy awards for NPR, as well as the Sundance Film Festival and other events. Her news reports, feature stories and photos, filed from Los Angeles and abroad, can be heard on All Things Considered, Morning Edition, Weekend Edition, Alt.latino, and npr.org.