Patrick” (1978)
A weird, Aussie “Carrie” knock-off, boasting a lower budget and a rather bland visual style (especially when compared to de Palma’s lurid classic), “Patrick” is still a pretty decent little B-movie, mainly thanks to a genuinely unsettling turn by the Marty Feldman-esque Robert Thompson as the titular bedridden maniac. (Note to self: if ever you need to cast a character who sits and stares unblinkingly for the majority of the film, make sure to cast someone who resembles Marty Feldman as closely as possible). After killing his promiscuous mother by electrocuting her in the bath, Patrick slips into a catatonic state for three years, from which it is thought that he’ll never recover, though the head doctor at the hospital where he stays keeps him alive at great expense and trouble, for his own, glory-seeking purposes. When attractive nurse Kathie (Susan Penhaligon) arrives, she discovers that not only can Patrick communicate, he has the power of telekinesis which he uses to rid himself of potential rivals for Kathie’s affection. The film’s pacing slacks off far too much to justify its two-hour running time, and too many precious minutes are eaten up with long expository telephone calls, but the scenes with Patrick present, whether spitting, hurling creepy doctors across the room with his mind, or talking to Kathie via an electronic typewriter are pretty good. Aussie director Richard Franklin subsequently dallied briefly with Hollywood, directing the sequels to both “Psycho” and “F/X: Murder by Illusion,” before attaining the ultimate accolade and being namechecked by Quentin Tarantino as a genre influence, particularly for the film that came after “Patrick,” serial killer flick “Road Games.”

Girl Interrupted

"Girl, Interrupted" (1999)
Leaving even "Gothika" in the dust in terms of the pulchritude of its inmates, the girls, interrupted of "Girl, Interrupted," led by Winona Ryder, Angelina Jolie, Elizabeth Moss, Brittany Murphy and Clea DuVall do their best to inject some life into a film that's ultimately too smoothed down and too comfortably directed (by James Mangold) to really punch its point home. If, indeed, it has much of a point at all. In what should be a far more jagged and jarring story (and by all accounts is much more so in the source autobiographical novel) Ryder plays Susannah, a Gauloise-smoking, pixie-cut-sporting Jean Seberg-esque young woman, confused by onrushing adulthood, distracted parenting and the social upheavals of the 60s (so we're told) into a kind of existential fugue serious enough to lead her to make a potential suicide attempt and then commit herself to an institution. Once there, it seems clear that as troubled as she may be, she's a lot less so than most of her fellow inmates, and over time she forms bonds with many of them, especially the volatile, potentially sociopathic Lisa (Jolie), whose amorality may trouble Susannah but not as much as her wildness attracts her. But the film's over-earnest insistence that Susannah is the central character and the central focus of our attention becomes a major flaw as we realize that of all of the women there (including Whoopi Goldberg as the head nurse and Vanessa Redgrave as a shrink), she's probably the least interesting (Jolie is definitely the film's MVP), and the most obviously destined-to-be-fixed of them anyway.So the potentially strong supporting cast are reduced to ciphers, mere waystations on Susannah's route to inevitable rehabilitation, characters designed and presented solely to teach our heroine a series of lessons. That fact is as much as Ryder dresses, looks and smokes the part of the thoughtful, writerly outsider in denial over the depth of her pain, and as much as Jolie snarls and slaps her way to a Best Supporting Actress Oscar, the film doesn't have a great deal of importance or insight to say about mental illness, the turbulent period in which it's set, or even the pros and cons of institutionalization. As an entertaining, well-acted yarn, it's likeable enough; it's just a shame it's had all its sharp edges removed.

Even Dwarfs Started Small

"Even Dwarfs Started Small” (1970)
There’s so much to be appalled by and so much to be transfixed by, in Werner Herzog’s 1970 film “Even Dwarves Started Small” that it’s difficult to know where to begin, but it’s clear that already in his second film, Herzog was a director of singular vision and utter fearlessness when it came to bringing that vision to life. Set in some sort of an institution housed within an isolated compound, it’s the narratively sketchy story of an inmate rebellion against the authorities, during which buildings are destroyed, plants are burned, animals tortured (including the crucifixion of a monkey) and whatever few boundaries of civilization that ever existed inside the walls are broken down. Oh and did we mention that every member of the cast is a dwarf? Yet somehow, despite Herzog’s trademark disgust with humanity and his recognition of the essential brutality of nature (even the chickens turn cannibalistic toward each other) there’s an even-handed objectivity to the way the film is presented that makes direct judgment difficult and accusations of mere exploitation impossible. Indeed, even the moments in which our attention is explicitly called, by Herzog’s fascinated camera, to the deprivations of his small-statured cast in the simple terms of having to stretch to use a door handle or to struggle clumsily to hold a telephone receiver, are robbed of any hint of schadenfreude by the overtly allegorical, surreal tone he establishes so brilliantly. At the time, many critiques of the film were offered in terms of its social commentary on the issues of the day—Vietnam, political protest (one of the inmates is even held prisoner by the besieged “warden” for use as a bargaining chip)—but looking at it now it seems its themes are more timeless and much less specific. We are all, suggests Herzog, as ill-suited to our environment as the small cast are to theirs, and all that stands between any of us and complete social breakdown is an intangible adherence to rules and obedience to authority which, under even the slightest of tests can be found to be illusory. Then again, what the nearly three-minute scene of the dwarf laughing at the kneeling camel signifies is anyone's guess, though we'd imagine Herzog is delighted at its new life as an internet meme. It’s certainly among the most thought-provoking and unsettling asylum-set films we’ve ever seen, and pretty much a must-view for anyone in danger of forgetting, in light of recent documentaries about cave painting and roles in Tom Cruise movies, just how thoroughly Herzog earned his provocateur reputation. He claimed the film occurred to him in a nightmare and its striking imagery and creepy tone of abandon certainly haunt ours to this day.

One Flew Over The Cuckoo's Nest

Honorable mention: One Flew Over the Cuckoo’s Nest” (1975)
Yes, Milos Forman’s unassailable 1975 classic doth bestride this list like a colossus, but we felt enough has been written about the multi-Oscar-winning masterpiece to make it hardly necessary for us to add our two cents. But rest assured, the film, one of only three ever to win the Big 5 Oscars (Picture, Director, Actor, Actress and Screenplay) is one of the most heartbreaking and yet scathing portrayals of a mental hospital that you’ll ever see, and features a peerless Jack Nicholson in one of his absolutely essential performances. It’s simply brilliant and if by some odd stroke of fate you haven’t yet seen it, you should seek it out immediately.

Dishonorable mention:Sucker Punch
As much as we’re vocal in our adoration of ‘Cuckoo’s Nest’ we’re equally so in our condemnation of the shitshow that was Zack Snyder’s ungodly mess “Sucker Punch,” and so ironically it’s left off the list for the same reason (we think we’ve made our opinions known on it elsewhere, repeatedly). Suffice to say that if we left off ‘Cuckoo’s Nest’ to make room for a less lauded film, we left off “Sucker Punch” because no one could bear to write about it any more and our store of vitriol is running low.

Elsewhere, there were plenty of films that could have been included like “The Jacket,” the stylish but oddly forgettable Adrien Brody/Keira Knightley vehicle from director John Maybury; “Don Juan de Marco” with Marlon Brando and Johnny Depp; “Lost Angels” which stars Beastie Boy Adam Horowitz alongside Donald Sutherland; the remake of “House on Haunted Hill” which is truly frightening for the first half and then unbelievably stupid in the second; Ashton Kutcher vehicle “The Butterfly Effect” which is stupid all the way through; the rather sappy “Awakenings” with Robin Williams and Robert de Niro; and the rather good Alan Parker-directed, Nicolas Cage  and Matthew Modine-starrer “Birdy.” A fair few comedies have also taken psychiatric institutions as their setting, like “Crazy People,” Mel Brooks’ “High Anxiety” and more recently “It’s Kind Of a Funny Story,” while there are also plenty of titles in which a mental hospital may feature in a few scenes but is not the main location of the action. However in a few of those cases, those scenes are among the most memorable in the films overall, so worth a mention at least: Brad Pitt’s quirk-laden turn in Terry Gilliam’s “Twelve Monkeys” (Gilliam featured a similarly dystopian loony bin in “The Fisher King” too); Christopher Nolan’s "Batman Begins" features a portrait of Arkham Asylum; while Renfield’s cell in various Dracula movies through the years, (especially Coppola’s take, but mainly because that Renfield is played by Tom Waits) is also one that’s come to define our idea of cinematic insanity. Shout out your favorites, or the ones we should be locked away for neglecting to mention, below.