By Keith Murfee-DeConcini 

DSAB 626: Disability Law and Policy, Fall 2014


In comparing the movie Shutter Island (2010) to that of the Willowbrook State School (1947-1987), one can see both a before picture and an after shot in the same view. On one hand, Ashecliffe (where the movie takes place) is a snapshot of Willowbrook before the consent decree and on the other hand, had Willowbrook been left unchecked, Ashecliffe could very well have been its future. There is nothing in the movie Shutter Island that is fantastical. The plot takes place in the middle of 1950s which is also when the drug lithium is introduced and the lobotomy is at its height of popularity.

The opening view of Ashecliffe at the beginning of Shutter Island calls to mind that of Alcatraz, according to this author. Both are on islands and are prisons of maximum security. The former is fictional and only doubled as a prison, primarily in Ward C, where the most dangerous patients are kept. The movie spends a brief time in that ward, but the atmosphere displayed is stark: bars on the windows, locked doors and gates, long, dark and unkept hallways. The Ward is a visual metaphor of mental illness and the chains and cages that go with it.

Willowbrook is not a far shutter from that. The Consent Decree of 1975 was written to address the hideous conditions at the school, as well as the numerous abuses against patients there. The Decree goes into meticulous detail (from living environment to community placement) of how Willowbrook should operate from then until its closing in 1987. One section (N) is on “Restraints and Abuses” which dictates the use of restraints as when only “absolutely necessary to prevent a resident from seriously injuring himself or others…never as punishment [or] for convenience of staff…” Dr. Naehring (played by Max von Sydow) in Shutter Island clearly would not agree with that section of the decree if he was presented with it. In the movie, he clashes with his counterpart, Dr. Cawley, when he makes the claim that he would like to shackle the patients at all times, much to Dr. Cawley’s dismay. It is highly doubtful that Dr. Naehring would agree with any part of the Consent Decree, based on his “tough as nails” persona and rigid medical beliefs.

Some of the patients on Ward C are not clothed and wander around in dungeon-like cells, and it is not hard to imagine them left in their own waste. Often the residents of Willowbrook were confined to similar conditions. The hospital setting of Ashecliffe (everywhere else except Ward C) offers a chilling look into the past atmosphere of institutions, apart from the fact that Ashecliffe is cleaner in the movie than Willowbrook probably ever was kept. While the Consent Decree goes into updating heavily Willowbrook’s standard of care and its décor, the implementation of such detail is hindered by the inability to follow through as promised. This is seen by the formation of a Willowbrook Advisory Council which has little effect, other than arguing among themselves about the best way to enact the guidelines set forth in the decree.

The premise of Shutter Island is an elaborate role play thought up and conducted by one of the head doctors at Ashecliffe, Dr. Cawley, in an attempt to help the most dangerous patient there, Andrew Laeddis, wake up from his delusions and accept the reality of where he is and what he has done. Failing that, he will be lobotomized. While there were no Lobotomies performed at Willowbrook, it is certainly not hard to fathom that it could have happened there. All it would have taken is a subject’s extreme violent outbursts and a doctor crazy enough to think and say that he could “cure” mental illness or feeblemindedness with a lobotomy.  With the amount of public fear and guilt in the air, people would have believed anything, even the most influential. It did happen with the Kennedys after all.