Out of Mind,
Out of Sight

a film directed by John Kastner


+1 416 964 0596
357 Brunswick Ave.
Toronto ON
M5R 2Z1

Why does the general public know so little about what happens to people with mental disorders who commit serious acts of violence after they’ve been convicted and deemed “not criminally responsible”?

They are hidden away in forensic psychiatric hospitals. The public sees the horrific headlines and is convinced they are monsters. Once they are deemed NCR, they just disappear them from public view. The authorities have allowed only a few media people inside very briefly but nobody has managed to get cameras into a Canadian forensic mental hospital for a long-term look at how they treat what used to be called “the criminally insane” (a term no longer used in Canada)—not for around 30 years or more. Until now, that is. We filmed with 46 patients over an 18-month period in the Brockville Mental Health Centre. Audiences will be meeting patients, getting to know them as human beings for the first time through this film. People can judge for themselves if somebody who commits a monstrous act must inevitably be a monster. 

How did you manage to gain access to the Brockville Mental Health Centre? What was the process?

There are a lot of people who work in the forensic psychiatric field who pay lip service to the notion of de-stigmatizing patients with mental illness. But you cannot de-stigmatize people by hiding them from public view. In my personal opinion, this communications policy—or rather non-communications policy—has been largely a disaster. People see forensic psychiatric patients as monsters, just as they did 100 years ago. Obviously the intentions were good, to protect the patients. Ironically, it’s had the opposite effect; it has enabled the stigmatization, not helped to overcome it. A new approach is long overdue.

I presented my case to the Brockville staff that if they truly wanted to de-stigmatize patients they were going about it in the wrong way—and I had good ammunition to prove it: I have made several films de-stigmatizing criminals who have been demonized by other media, and have actually managed to change the perception of them by some of the media and the public.

The Brockville hospital took a bold step. They’re proud of what they do and it shows. 

Your previous film, NCR: Not Criminally Responsible, was shot in the same facility. What made you decide to go back and make another film there?

Actually it was the other way around. Out of Mind, Out of Sight was the film I originally intended to make; the story of a year in the life of a forensic psychiatric hospital. I didn’t intend to get into the story of the out-patients who’d been released into the community (which is what NCR: Not Criminally Responsible is about). Then I spent one day accompanying the forensic outreach nurse, Janet Cooper, on her rounds dealing with patients in the community, and I was hooked. I quickly saw the drama and importance of managing the risk to the public when patients who’ve committed violent acts hit the streets. So I found myself shooting two films simultaneously. The story of the out-patients was finished first.

What was most surprising to you about the patients in Brockville?

I had never done anything on mental health before and to be honest I came to the project with many of the same prejudices other people have about forensic mental patients. I’ll never forget my first visit to the Brockville institution, walking into the building past patients lounging on the lawn, just sitting there watching me. I’ll admit it: I was spooked. Despite decades of filming with killers and other violent prisoners in penitentiaries, I was spooked.

Eventually, I came to understand they’re mostly gentle, good people who are not evil, just ill.

What was the biggest challenge you faced making this film?

People have such ingrained prejudices against forensic mental patients! They run so deep, formed and hardened over literally centuries of misinformation. To overcome that—wow, that has been a challenge… By the same token some hospital staff—the kind of people who believe in hiding patients from the public—had ridiculous prejudices against the media. They opposed the filming, convinced that any media attention would be a disaster for the patients. Fortunately, most of the staff disagreed (we filmed around 75 staff members). And when the film was screened the audiences responded so positively to the patients in the film that it was extremely moving. Virtually no negative comments.

Was it difficult getting the patients to trust you? What was your relationship like with them?

I think every single party had damned good reasons not to co-operate with me! Seriously, it took some convincing, I can tell you. Many patients are ill, fearful and fragile. The first issue we had to deal with was: Were they mentally competent to make the decision to participate? Before allowing us to film, the hospital assessed each one to determine if they had what is called the “capacity” to agree to “file disclosure.” Sometimes outside doctors were called in to assess patients independently. Out of 59 patients at Brockville, we thought we’d be lucky to get half a dozen to agree. But 46 patients participated—amazing.

How did I get along with the patients? One Globe and Mail critic—speaking about me—said something like: “It appears Kastner can get anybody to talk about anything.” My iron rule is: approach them as a human being first, not like a professional seeking a story. In the case of people suffering from mental illness, the operative word here is “suffering.” Many are horrified by what they did while in a psychotic state and can hardly bear to think about it. You have to convince them that you’re not going to hurt them, that you’re going to protect them, and that you feel they are more important than the film.

When making the film, what was your biggest breakthrough in terms of the story?

Two things: first, it’s such a secret world, we didn’t know at first if we’d get anything worth a damn. So the moment when most patients and staff decided we were OK and began to trust us, put themselves in our hands, opened up, began sharing some of their darkest thoughts, letting us shoot nearly everything that was happening—wow. We had 46 patients and 75 staff on board, and with that scale of co-operation we began to get the kind of rare access every filmmaker dreams of.

Second breakthrough: getting Michael Stewart and his family to agree to be filmed. Mike is a lovely man, who is very ill. It breaks your heart.