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For excessive blood, guts and severed limbs, flesh-eating, inhuman monsters and authority figures abusing their power, Insanitarium is the perfect fit.  Its special effects and makeup teams leave nothing to the imagination.  But there’s not much method to its madness. 

After their terminally ill mother passed away Jack, (Jesse Metcalfe) made a promise to his critically depressed sister Lily (Kiele Sanchez) that he would always take care of her.  But after he successfully stops her from killing herself, she is involuntarily committed to psychiatric institution and his only way to get to her is to commit himself to the same fate. 

Surrounded by paranoid schizophrenics, manic depressives and those with any number of psychological issues, Jack soon realizes that the twisted genius in charge of the facility, Dr. Paul Giannetti (Peter Stormare) and his admiring resident Vera (Carla Gallo) are injecting the patients with an experimental drug called Orpheum in an attempt to cure what ails them.  The only problem is, the drug turns them into inhuman cannibals. 

Jack attempts to save Lily and expose Dr. Giannetti, but Nurse Henderson (Molly Bryant), who herself gets infected through a patient’s bite and the sinister orderly Charles (Evan Parke) stand in his way.  With the help of Dave (Kevin Sussman) a gentle paranoid patient and Nancy (Olivia Munn) an understanding nurse, Jack manages to get to Lily before she is injected with the drug, but chaos and carnage ensue as a power outage locks the four into the maze of a building filled to the brim with stark-raving lunatics hungry for blood. 

Insanitarium has some terrific, complex relationships between characters.  Jack’s futile attempts to save Lily from herself.  Dr. Giannetti, who has clearly gone made from his desire to be the only person who can help his patients, exerts his dominance professionally and sexually over Vera.  Nurse Henderson, who clearly wants to see her patients succeed is being led blindly by Dr. Gianetti, much to the distress of the young idealistic nurse Nancy. 

But Jesse Metcalfe is not at all convincing as a person who has just made a grave mistake by involuntarily checking himself into a mental institution. His character plays the same notes through the entire film.  Jack’s clearly cavalier attitude toward his own safety is never challenged at all; in fact, the more outlandish and violent the patients become, the more calm and sure Jack seems to be.  Physically, Metcalfe seems uneasy in a role that requires so much action—hand to hand combat and impaling of cannibals bent on having him for lunch is a far cry from his most notable role as a jailbait heartthrob on Wisteria Lane and it shows.

Despite the flatness of the protagonist, Insanitarium certainly has one thing going for it: the special effects.  Relying mostly on realistic makeup techniques and not on computer-generated imaging, the rampant destruction of the patients is clearly evident and masterfully done with countless gallons of red dye and corn syrup.  The DVD extras include featurettes that document the making of the film including some great looks into the character makeup and some of the more gooey special effects. 

Though the blood and guts of the film are certainly very well done, the director could have ratcheted up the tension in many of the scenes by leaving more to the viewer’s imagination.  Buhler did create a few select patients to become bigger threats than the rest.  Heather, whose symptoms are clearly the aftermath of a brutal rape, has the hots for Jack and one of the patients from the maximum security ward takes down his competition before setting a trap for Jack and the others.  By creating more patients like these and not as mindless drones that somehow manage to pop up around every corner, but stalking their victims with more tact and cunning Insanitarium would become a more effective thriller by making the audience a more engaged partner in the escape of Jack and the others.

Those most likely to enjoy Insanitarium this are moviegoers who get amped by blood and guts and can make a leap of faith with the rest. 

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