'Bedlam': Film Review | Sundance 2019
Psychiatrist-turned-filmmaker Kenneth Paul Rosenberg explores the American mental health crisis in his first feature-length film.
Eloquently combining intimate personal viewpoints, including the filmmaker's own, with an incisive historical perspective, Kenneth Paul Rosenberg's Bedlam is a haunting and trenchant look at failed public policy. The potent film traces what one expert calls a "150-year-old disaster": how little true progress American society has made when it comes to treating people with severe mental illness. Once warehoused in nightmarish institutions, over the past decades they've been relegated instead to hospital emergency rooms, prisons and the streets — places that Rosenberg's documentary explores over a five-year period.
The picture that emerges as he follows ER doctors and nurses and a handful of mental health patients, zeroing in on Los Angeles as "the epicenter of today's crisis," is heart-wrenching for everyone involved. The director and his editor, Jim Cricchi, have deftly orchestrated the new interviews and footage — astute camerawork from a team led by DP Joan Churchill — with affecting archival material, and a few well-deployed title cards offer clear and concise definitions of such conditions as schizophrenia and bipolar disorder.
At the core of the endless cycles of incarceration and homelessness for many mentally ill people is the policy of deinstitutionalization — well-meaning at first, but carried out over the decades without a plan for patients' continued care or integration into society. Rosenberg includes one of the infamous clips of a disoriented patient wandering L.A.'s Skid Row in a hospital gown after being dumped on the street by the hospital.
He shows how one benighted policy has replaced another. John Kennedy (whose sister Rosemary was institutionalized most of her life) called for more enlightened and humane community-based treatment instead of crowded "custodial" institutions. Down came the edifices — places whose vast, eerie ruins have become some of the most photographed derelict sites in the country. (There are now only five state psychiatric hospitals in all of California.) But for people who need ongoing medical attention, nothing really replaced them. And then Ronald Reagan cut off federal funds to community programs, putting a greater burden on the states and municipalities.
The struggles of patients, their families and health care professionals are illustrated with gripping specificity in a handful of profiles as Rosenberg tracks patients' setbacks and their halting, hard-won progress. The film's three key subjects are first seen in the ER, in the midst of full-fledged episodes of mania or depression or, in one case, a combination of the two. Heartrending to witness, these scenes are also profoundly enlightening, pulsing with compassion as they bring the viewer into the experiences of the sufferers as well as the moment-to-moment resilience of dauntless medical professionals, tasked with making short-term decisions for people who require long-term attention.
The central trio of patients are Johanna, a vibrant woman in her 20s; Todd, who's nearing 50 and caught in a desperate years-long wait for public housing; and Monte, a gentle giant whose devoted sister Patrisse Cullors speaks about shame and silence over mental illness in the black community and the "cross-section between mental health and incarceration." During the making of the documentary, she would become a founder of Black Lives Matter.
The fourth key character is the filmmaker's deceased older sister, Merle, whose psychotic break at age 20 is the reason he pursued a career in psychiatry. He too confronts a legacy of shame and silence, and his direct but subdued grappling with his anguish over her fate is as moving as anything in the film.
Though the days of insulin coma therapy and the frontal lobotomy (a Nobel Prize-winning "breakthrough") are well behind us, experts note that, with the government leaving product development to Big Pharma, there's been little innovation in treatments, just new drugs with complicated side effects. (During one intake session, Rosenberg captures an ER doctor quoting the spiel of drug-company reps.)
When the three largest jails in the United States are also its three largest psychiatric treatment facilities, and 350,000 mentally ill people sleep on U.S. streets on any given night, Bedlam's call for reform is one that couldn't be more urgent. Only days before the largely L.A.-set film's Sundance premiere, the Los Angeles County Board of Supervisors voted unanimously to expand the availability of in-patient mental health care, citing a decades-long shortage that has only worsened over the years. And one of the concerned politicians interviewed in the film and seen visiting L.A.'s Twin Towers jail, Gavin Newsom, is now California's governor. So reform might be closer than it's been in a long time. But a deeper, more widespread awareness and understanding of the crisis has a way to go, and with its unblinking look at the lives of people with severe mental illness, this is a necessary and important film.
Venue: Sundance Film Festival (U.S. Documentary Competition)
Production company: Upper East Films
Director: Kenneth Paul Rosenberg
Writer-producers: Kenneth Paul Rosenberg, Peter Miller
Executive producers: Sally Jo Fifer, Lois Vossen
Director of photography: Joan Churchill
Additional cinematography: Bob Richman, Buddy Squires
Editor: Jim Cricchi
Music: Danny Bensi, Saunder Juriaans