By Reason of Insanity


Due to the recent issues at the BBC with the Jeremy Clarkson ‘fracas’, Louis Theroux fans will have been pleased to see that his latest documentary, By Reason of Insanity, was moved forward a few weeks in the schedule and broadcast in March.

The two part documentary follows Louis as he spends a month with people who have committed crimes, but have been found not guilty by reasons of insanity, and sent to a psychiatric hospital for treatment. This presents a dilemma; how do we care for vulnerable but potentially dangerous people in society?

Although there are patients that have not committed crimes and are in the hospital because they have lost touch with reality due to their illness, it is those that have committed crimes under the banner of mental illness that Louis is focused on meeting. Louis delves into the day to day lives of the patients, which mostly consists of therapy, classes and medication.

As Louis travels around the wards of a hospital in Ohio, we see him talk to the patients, their families and the staff. Anyone who has seen any Louis Theroux documentaries before will recognise the gentle approach he has, in his questioning and tone. One of the reasons he is successful at getting responses from people is his non-judgmental style, and his ability to speak to everyone at the same level. He doesn’t push for an answer, but he will ask and move onto a different topic if he senses any hesitation.

From the outset, it is very noticeable that the majority of patients in the hospital are male, and also the range of differences each patient has with their illness. We see some believing the staff are trying to help them, whilst others, including the one female patient Louis talks to, thinking the staff are only out to help themselves. Additionally, some are also aware of how unwell they are, whilst others believe they are not mentally ill at all.

We also hear why certain patients have been admitted, for crimes including sexual assault and murder. We hear how one patient believed that his attacking a police officer on Martin Luther King Jr. Day led to Barack Obama being elected President. There is also a lack of guilt amongst certain patients, who realise they were not in the right state of mind when they committed their crimes. Others are fearful that they were, as they try to face up to what they have done.

In treatment, the patients are trying to come to terms with the crimes they have committed, whilst aiming to eventually return to society and lead a normal life. The main focus during treatment is assessing whether the patient will try to hurt themselves or others. Will this change as they spend time in the hospital? Will this happen when they leave? This poses the staff with a difficult question; when is someone ready to be released? We follow one patient, William, as he prepares to leave, and his clear anxiety at the new life that awaits him. The staff also face the realisation that anyone who is released could commit another crime, and potentially hurt or kill someone.

Life in the psychiatric hospital shows the great relationships between the patients and the staff, which appears very warm and friendly, showing the human reality of mental illness. They are rooting for the patients to get well and eventually leave. Indeed, it seems that the presence of Louis has also helped some of the patients, as he is told by one that he asked questions that he hadn’t been asked before and which he hadn’t thought about.

Without documentaries such as this, how would we see the treatment that mental health patients are receiving? This allows us a rare glimpse into the world of mental illness, from a non-biased point of view, with Louis asking the questions on behalf of the viewers. Fans of Louis Theroux will not be disappointed, and neither will those who wouldn’t immediately be drawn to this type of show; it captures your attention as the patients are presented and portrayed in their own words.