Ken Kensey was inspired to write One Flew Over the Cuckoo's Nest after engaging in medical experiments as a patient and working in a veterans' hospital. What he witnessed left him concerned for the lives of those in mental institutions and the ways their freedoms were upended.

The intended audience is all of society. Kensey seeks to demask a system of cruelty and ambivalence in the mental health industry. The audience is encouraged to consider the lives of these patients as more than irredeemable.

Chief Bromden (a schizophrenic Native American) evolves as his friendship with McMurphy develops. Chief pretends he is deaf and dumb to avoid unwanted attention from others. However, by the end of the novel, he is emotionally strong enough to escape the hell that is the asylum as well as to give his friend a final gift, peaceful death in place of living out his life as a vegetable under the thumb of Nurse Ratched. This growth demonstrates Chief's potential for redemption and free life to the reader.

We also see themes of totalitarianism which serve as a warning to the audience. Society should concern itself with the slippery slope of fascism and dictatorships. Nurse Ratched represents a horrendous dictatorship that uses brainwashing and gaslighting to keep the asylum patients in their place. The asylum is a microcosm of the world in general. Kensey is alerting anyone who strives to live free of the potentially catastrophic ways we can be manipulated into being anything but free.