Deinstitutionalization was a tough cookie to crack. Not many people knew about what was happening behind the scenes of mental asylums, because they were not committed. The mentally ill in the 1950's were treated as if they were not people but rather vegetables. This is clearly the same relationship that Kesey develops between Ratched and the black boys and the patients. Although the end of the novel does not illustrate what the true goal of deinstitutionalization was, it still pushes the messages that people do not belong in such dehumanizing institutions and that many of them desperately want out.

Chief obviously escaped before deinstitutionalization was in full swing- before he had any hope to get out other than his own actions. The truth is, deinstitutionalization was a very slow and lengthy process. Judge David L. Bazelon, from the Center for Mental Health Law, comments on the stages of development of deinstitutionalization:
In the initial stages, states funded small community pilot programs for the individuals who responded well to antipsychotic medications that were then becoming available. The national deinstitutionalization movement was launched in 1965 through the community mental health centers program. Our efforts with this movement were further fueled by concerns over civil rights and the conditions in institutions. That led to the courts limiting involuntary institutionalization and setting minimum standards for care in institutions. (Bazelon 7).

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