As Joker: Folie à Deux transfers to a Gotham mental-health facility, Victoria Luxford explores how American films have presented such institutions over the years, from One Flew Over the Cuckoo’s Nest to Girl, Interrupted.
Todd Phillips brings his dark vision of the world of DC Comics back to our screens with Joker: Folie à Deux. A sequel to 2019’s Joker, it builds on that film’s audacious interpretation of its titular character. Phillips’ vision of the Joker is a man not born from a fall into a vat of toxic waste, as with previous incarnations; nor is he shrouded in mystery like Heath Ledger’s version in The Dark Knight (2008). Partly inspired by Martin Scorsese’s Taxi Driver (1976), Joker shows Joaquin Phoenix’s Arthur Fleck (the failed comedian who becomes the Clown Prince of Crime) to be a villain created by a system that allows him to fall through the cracks.
In the first film, his decline is punctuated by meetings with an indifferent social worker (Sharon Washington), who informs him of the budget cuts that exacerbate his spiral into crime. Like the Joker, Arkham Asylum is also reimagined from the comic books, becoming ‘recast’ as a mental-health institution unfit for purpose. It’s part of the system that accelerates his descent into darkness, rather than rehabilitating him. Joker: Folie à Deux is the latest film to look at mental-health facilities with scepticism, where clean white halls of healing are overcast with shadows of abuse.
The Joker sequel finds Arthur contained by the very system that didn’t help him, starting as a patient in Arkham State Hospital awaiting trial for his murders in the first film. Admitted to a music-therapy group, he meets Lee (Lady Gaga), a fellow patient who professes to be infatuated with him. From Arthur’s point of view, Lee is the human connection he has longed for all his life. From the audience’s point of view, Lee is the catalyst for Arthur’s deeper descent into madness, as she is enamoured with the Joker persona and his actions rather than the human beneath them.
In one meeting, in a dark, gloomy cell, she paints Arthur’s face into the Joker with her make-up. In another, she whispers through his cell, ‘You can do anything you want. You’re Joker’, prompting Arthur to physically transform into his alter-ego, grinning and arching his back as he drags from his cigarette in a pose familiar from the first film. Far from being a source of rehabilitation, Arkham has allowed Arthur to meet other unquiet minds who worsen his issues. It’s a theme that runs through many Hollywood films, which question whether psychiatric institutions are there to help their patients, or simply subdue them.
Joker: Folie à Deux (2024)
The 1999 drama Girl, Interrupted moved scrutiny away from those being treated, instead asking whether the medical professionals had their patients’ welfare at heart. When teenager Susanna (Winona Ryder) is admitted to local psychiatric hospital Claymoore following an overdose, the women she lives with are broadly non-violent, with trauma shown to be connected to their conditions. There’s nuance to their situations, but director James Mangold portrays a system where a diagnosis robs you of agency. The patients are never sure just what drugs they are being given, nor are they asked how the pills make them feel. They are subject to a process, and Susanna, whose judgement is never shown to be impaired, continually questions her confinement. ‘I signed myself in, I should be able to sign myself out,’ she protests to the hospital’s psychiatrist (Vanessa Redgrave).
Girl, Interrupted (1999)
Leaning over a large wooden desk, head on her chin as if looking down on her, the psychiatrist replies, ‘You signed yourself into our care, we decide when you leave.’ Valerie (Whoopi Goldberg), the head nurse of the institution, treats Susanna’s depression as a nuisance. Dunking her in a bath when she refuses to get out of bed, the nurse judgementally bears over her and challenges Susanna’s protests by calling her a ‘lazy, self-indulgent little girl who is driving herself crazy’.
Here, the hospital is shown to view mental illness as at least partly a pattern of behaviour to be controlled, or punished. This is particularly clear in the case of fellow patient Lisa (Angelina Jolie), an unpredictable woman who delights in rebellion. The twinkle of delight in her eyes as she breaks free of the hospital is placed in stark contrast following her punishment, electroshock treatment, after which Susanna watches in horror as Lisa returns with a docile demeanour and a vacant, haunted stare. Girl, Interrupted sums up its analysis of Susanna’s experience with one of her final lines: ‘Was I ever crazy? Maybe. Or maybe life is.’
Girl, Interrupted (1999)
Miloš Forman offered a more draconian look at mental-health facilities in his 1975 classic One Flew Over The Cuckoo’s Nest, leaving you in doubt as to the intentions of those in charge. Jack Nicholson stars as Randall McMurphy, a convicted criminal who has feigned insanity in order to be transferred to a psychiatric hospital, thus avoiding a labour camp. The free-spirited McMurphy’s attempts to bring levity to his fellow patients are opposed by the domineering Nurse Ratched (Louise Fletcher), who intimidates those in her charge into obedience, and values schedule over wellbeing.
In one sequence, the two engage in a battle of wills when McMurphy calls for a vote to watch a baseball game. Ratched, who remains still compared to the animated pleadings of McMurphy, rigs the vote, requiring a majority that would include non-responsive patients. Frustrated, McMurphy begins commentating on an imaginary game, evoking a boisterous reaction from the patients. The scene, previously without music, is suddenly greeted with a hopeful flourish from Jack Nitzsche’s score. Foreman’s camera focuses on the excited expressions of the patients, as well as the fury of Ratched. In that moment, the filmmakers make it clear that it is not disorder being suppressed, but the human spirit.
One Flew Over the Cuckoo's Nest (1975)
What links these films and others is the reflection of how we have, and still, view treatment of mental-health disorders in society. The novel that One Flew Over The Cuckoo’s Nest is based on was published as a criticism of mental-health institutions in the 1960s by author Ken Kesey, whose story was inspired by his experiences as an orderly at a facility in California. Girl, Interrupted is set in a similar period, and adapted from Susanna Kaysen’s memoir.
Joker: Folie à Deux is a heightened, fictional narrative, but perhaps its power comes from its reflection of the world around us. Arthur Fleck waits two years for trial in Arkham, held in place with abusive guards, with only his lawyer (Catherine Keener) arguing that his crimes are the result of external trauma. Joker’s actions may be unimaginable, but a system that simply forgets him may be easier to believe – a 2024 Mental Health America report stated nearly 60 million Americans experienced mental illness in the past year, but due to costs and access shortage, only a fraction were being treated. Add to this a justice system with one of the highest reoffending rates in the world, and Arthur’s further descent into darkness seems chillingly plausible. Joker: Folie à Deux may continue the story of an infamous villain, but Phillips shows that the walls of a psychiatric hospital can provide a perfect new accomplice.
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