Set in an Oregon psychiatric hospital, the narrative serves as a study of institutional processes and the human mind, including a critique of psychiatry[3] and a tribute to individualistic principles.

Bromden's tale focuses mainly on the antics of the rebellious Randle Patrick McMurphy, who faked insanity to serve his sentence for battery and gambling in the hospital rather than at a prison work farm.

Billy has an emotional breakdown, regressing immediately back to a boyish state, and, upon being left alone in the doctor's office, takes his life by cutting his throat.

Kesey started writing One Flew Over the Cuckoo's Nest in 1959, and it was published in 1962 in the midst of the Civil Rights Movement[6] and deep changes to the way psychology and psychiatry were being approached in America.

The novel is a direct product of Kesey's time working the graveyard shift as an orderly at a mental health facility in Menlo Park, California.

[9] Not only did he speak to the patients and witness the workings of the institution, he also voluntarily took psychoactive drugs, including mescaline and LSD, as part of Project MKUltra.

The novel's critique of the mental ward as an instrument of oppression comparable to the prison mirrored many of the claims that French intellectual Michel Foucault was making at the same time.

Similarly, Foucault argued that invisible forms of discipline oppressed individuals on a broad societal scale, encouraging them to censor aspects of themselves and their actions.

The novel also criticizes the emasculation of men in society, particularly in the character of Billy Bibbit, the stuttering Acute patient who is dominated by both Nurse Ratched and his mother.

With few exceptions, they are there voluntarily, a fact that angers McMurphy when he first learns of it, then later causes him to feel further pity for the patients, thus further inspiring him to prove to them they can still be strong despite their seeming willingness to be weak.

The novel was adapted into a 1963 play, starring Kirk Douglas (who purchased the rights to produce it for the stage and motion pictures) as McMurphy and Gene Wilder as Billy Bibbit.