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Deb Hade, playing Nurse Ratched, confronts McMurphy, played by Chris Williams, in a scene in Carousel's production of "One Flew Over the Cuckoo's Nest."

Things have changed since the 1960s.

Treatment for mental illness has changed. Native Americans are portrayed differently today than they were then. Transgendered and other members of the LGBTQ community are more accepted than they were at the time.

Some things have not changed, said Joel Hade of Indianola’s Carousel Theatre.

There still is a stigma attached to many of those communities, he said. And “One Flew Over the Cuckoo’s Nest” still tackles them.

“It’s a timeless subject about the stigmatization of people who are marginalized and are not mainstream,” said Hade. “These are people that society has always had a hard time dealing with.”

Indianola’s Carousel Theatre is presenting “One Flew Over the Cuckoo’s Nest” Thursday, March 14, through Sunday, March 17, with evening performances Thursday, Friday and Saturday at 7 p.m., and a matinee Sunday at 2 p.m. All performances will be at the Better Home and Gardens Real Estate Innovations office at 117 E. Salem Ave., in Indianola.

The play tells the story of Randle McMurphy, a happy go-lucky repeat criminal who fakes insanity in order to serve his sentence for battery and gambling in a psychiatric hospital rather than a prison work farm.

There he encounters the residents of the ward with all of their neuroses and insecurities, and the steely head nurse, Nurse Ratched, played by Deb Hade, who rules the ward and its residents with an iron fist.

McMurphy disrupts Ratched’s control, inciting the other patients into rebellion until the head nurse re-exerts her control with permanent and tragic consequences.

It can be a dark play, with characters who hallucinate, stutter or struggle with their sexuality, said director Mickie Larche. Ratched takes advantage of all of those vulnerabilities to manipulate the patients and their behavior. Despite the darkness, though, Larche said she sees light.

“It’s really a celebration of humanity,” said Larche. “As dark as it is, you’re watching the people and how they affect each other for the positive.”

Chris Williams of Des Moines, who plays McMurphy, said his view of his own character has evolved throughout rehearsals.

“I always took (McMurphy) as a huge con man,” said Williams. “But he legitimately cares about these guys, how they view themselves, carry themselves.”

In the first act, Williams explained, McMurphy “has no idea what he’s waltzed himself into. He’s kind of running amuck and challenging authority. He didn’t pay any mind to the consequences involved.”

That changes in act 2, Williams added. “Everything starts to collapse in on him.”

The cast of 16 includes only three women. Many of the characters were stereotypes in the original play and film, released in 1972. The Carousel version has tried to avoid the many potholes the show provides.

For instance, Mark Cory of Indianola plays Chief Bromden, a half-Native American who is presumed to be deaf and mute.

“We were sensitive to that and tried to make sure we didn’t create a caricature of a Native American,” said Hade, who both acts in the show and is assistant director. “We just let Mark, who is a good-sized guy, bring the audience with him.”

The one character the audience probably won’t follow is Nurse Ratched, said Deb Hade.

“She’s pretty evil,” said Deb Hade. “She plays at being sympathetic, but that’s all part of her manipulation. To me, she’s the sickest one of the bunch.”

Deb Hade said she hopes the play will remind the audience of the ongoing challenges of treating mental health. While the treatments outlined in the play have largely vanished, the challenges they tried to address have not.

“I was a social worker in the 1970s, and we did some of this crap,” she said. “We thought we were doing some good stuff.”

The play, she said, should cause people to question how mental health is treated today.

“How have we changed, have we changed for the better?” she asked. “Are we meeting the needs of people struggling with mental health issues?

“I hope when the play is done, they really hate me, and they really think about mental health.”

The show is being performed in the back room of the Better Homes and Garden building on the east side of the Square. It’s a set up that puts the audience literally in the lap of the action.

“It creates a very small, intimate and wonderful theatre,” said Joel Hade. “In a show like this, the audience will be a heavy part of it.

“It’s not going to be for the faint of heart,” he added. “You have to come knowing there’s going to be some adult language and content.”

The cast is sensitive to that as well. Ordinarily, he said, the performers stay on stage after the final curtain to visit with the audience.

On this show, he said, things will be different.

“This time, we’re going to go back stage and let people breath,” he said.

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