How might we interpret Shutter Island’s (2010) portrayal of a 1950s psychiatric institution?
**Spoiler warning**
Set in 1954, Martin Scorsese’s Shutter Island (2010) follows the journey of US Marshal Teddy as he investigates a psychiatric institution on “Shutter Island” with his partner Chuck, aimed at finding a patient who mysteriously disappeared. As the investigation unfolds, the audience is led to discover several new pieces of information. For example, we find out that Teddy’s motive to investigate Shutter Island is to find the man who murdered his wife, Andrew Laeddis. We also witness some of the inhumane ways in which patients are treated, such as with lobotomies, an archaic form of neurosurgery that involves severing nerve pathways in the frontal lobe of the brain1.
In what is often cited as one of the best plot twists in cinema2, it is revealed that Teddy is Andrew Laeddis and was incarcerated after murdering his wife. Andrew is experiencing delusions, and “US Marshal Teddy” is a delusion he created as a result of his guilt. Chuck, his partner, is revealed to be Andrew’s primary psychiatrist who sought to treat Andrew through a role-play “investigation” for him to come to terms with reality.
The film ends with Andrew leading his doctors to believe that the treatment failed, due to which he is committed to undergo a lobotomy.
Shutter Island is a prominent example of psychiatric treatment being depicted in film. It portrays some of the hostile and dehumanising ways in which patients were treated in the past, with scenes showing the imprisonment of patients and lobotomies being routine procedure. The role-playing treatment Teddy receives also presents ethical concerns3 regarding the delivery of treatment without a patient’s knowledge or consent. Such representations may result in misperceptions about how psychiatric treatment is delivered today, particularly if the historical context of the film is overlooked4.
Related to this, the film is set during a time in history when mental health problems were heavily stigmatised, and procedures like lobotomies were still being conducted. As such, Shutter Island sheds light on the uncomfortable realities of psychiatric treatment in history4. The film also highlights the emerging use of alternative, more humane treatment approaches, with senior psychiatrist Dr. Crawley proposing: “I have this radical idea that if you treat a patient with respect, listen to him, try and understand, you just might reach him.” Perhaps then, Shutter Island can be viewed as a commentary on the evolution of psychiatric treatment.
The first time I watched this movie, I was a teenager. Back then, my understanding of psychiatric treatment came mostly from popular media. Because of that, what came to mind when I thought of psychiatric hospitals was this aura of fear and mystery shaped by these portrayals. Another example that reinforces this image is the Supernatural episode ‘Asylum’ (2005), where the villain is the ghost of a psychiatrist who tortured patients. I watched it ages ago and still remember it clearly, which shows how strongly the idea of the psychiatric hospital as an unknown, haunting institution lingers in people’s imagination.
I think psychiatric hospitals are portrayed this way not only because of their dark past but also because they provide a powerful setting to explore what it means to be human and what we consider a ‘monster’: that thin line between sanity and insanity. That’s why they appear so often in thrillers and horror films. While Shutter Island, in my opinion, critiques past treatment practices, it also raises questions about who the ‘real monster’ is: the doctors performing lobotomies, the patients, or Andrew, who killed his wife. The film invites the audience to reflect on these moral dilemmas, even as the hospital setting still carries a certain ‘shock factor’ tied to the enduring connection between ‘madness’ and fear.
Now that I’ve studied mental illness and treatment, I know that psychiatric hospitals are not like that anymore. Treatment and research today follow strong ethical standards, and patients are treated as humans, not as ‘monsters’. Still, films like Shutter Island remind us of psychiatry’s dark history.
I agree – there are many examples of psychiatric treatment in the media, particularly representing inpatient settings. Off the top of my head, the examples you shared sound similar to Arkham Asylum in the Batman franchise, and the American Horror Story series “Asylum”, although I haven’t seen the latter. They all seem to present mental health support happening in these creepy, sinister places, where patients are very often villainised. I do wonder what it is about this topic that seems so captivating to an audience…?