One Flew Over the Cuckoo's Nest

This month's book 'One Flew Over the Cuckoo's Nest' is on one hand a book about mental health treatment and on the other about the abuse of power.

There was a report written in the 60's (Rand Report I think) for the American government about the affect on humans if alien life made contact. The conclusion was that the effects would be devastating and therefore any contact should be hidden. The evidence for this was that any aliens contacting us would be more advanced and if you looked at, for example, Native Americans you can see the effects of a more advanced culture upon a less advanced one.

It is useful to relate this to the book. Is the Chief mad because his culture has been destroyed and devalued? In the book the Chief talks about his dealings with the dominant (not necessarily more advanced!) culture. In many ways he is treated as invisible and irrelevant.

How would he, with his hallucinations, have been treated by his culture? Would he have been labelled as mad or a visionary?

It was fascinating at the reading group to listen to people's personal experiences of mental health problems. Many people have relatives who have suffered from such illnesses and I think it is interesting that something which affects many of us (my Grandma was schizophrenic) is so rarely spoken of - except the portrayal of mad axe wielding maniacs in the newspapers.

One thing that is very disturbing in the book is the treatments they undergo. I know that some, such as ECT, have been seen to work for some people. These treatments are not introduced out of cruelty but a desire to help. The experience of them though can be very different. My father told me that his mother had ECT, back before they used any anesthetic, and afterwards the doctor were so happy she was cured. Dad said that in fact she just became quiet - so instead of laughing all day she just sat in her chair and rocked. He thought she was still having her hallucinations but now was too scared to express them incase she was electrocuted again. I remember her like that from when I was a child - a very still, very quiet woman - in her own mental prison.

One thing the book doesn't really deal with is how to treat people with severe mental illness. Many of the people in the book aren't really mentally ill at all. Many just have low self esteem, which McMurphy increases with his antics, and have entered the asylum to hide.

The book, whilst timeless in some ways, is very much a product of its time - the rascism and misogyny demonstrates that. I found I could accept it, in that context, but I understand why others found it grating.

Throughout history different cultures have approached madness in different ways. Are hallucinations messages from the Gods or a sign of a diseased brain? Whereas one village might be happy to have one eccentric a city finds it hard to cope with a 1000!

Personally I do think we need safe places people can go if life gets too much for them - and secure places they can go if they are a danger to themselves or others. The question is what we do with them when they are there. The aimless days they endured in the book demonstrate one option - there are many others.

It depends really what has caused the illness - whether it is organic or emotional. There's no point in counselling if the problem is an imbalance in chemicals! I have to say though when I worked in a mental health unit I never met anyone who'd had a good life - they had all suffered violence or abuse. My grandmother was regularly locked in a cupboard as a child for hours on end by her abusive mother.

Whenever we have a period of economic slowdown, like now, the NHS has to decide what to spends its money on. Mental health is rarely top of the agenda but as something that affects many people it should be!

As a child I was fascinated by history and used to be amazed that where I lived used to be forest in the past. I would walk down the road thinking that underneath the tarmac and pavement was soil full of seeds just waiting to spring back into life once we are gone.

I remembered this thought when I was reading this book. Humanity's spirit is always there just waiting for someone, like McMurphy, to release it. We are naturally optimistic, enthusiastic people (how else would we have explored so far and advanced so much) but we forget sometimes. The book reminds us.