In the novel, setting is important towards the interiors, as the vast majority of the novel is set within the closed, confined space, the interior, of the mental institution. The Institution is there for "fixing up mistakes made in the neighbourhoods." It is important as it is only in a confined space such as a mental institution, where Ken Kesey can achieve the dark, foggy atmosphere of conformity and oppression that the Big Nurse and the Combine exercises over all the patients of the Institution. The institution is a place under the strict control of Nurse Ratched, and it is only in the hospital where she can exercise her calculated control.
The interiors' act as a microcosm of American society, as Dr Spivey says, the hospital is a "made-to-scale prototype of the big world. Through the Chief's memories, we realise that the outside world is not much better, as we learn that Indian villages have been destroyed for dams, and the landscape overrun with houses for the white people. By showing us the similarities between the Inside and the Outside, Kesey is able to show how these processes not only make victims of the Chief, but also characters such as Cheswick, as he drowns himself in a river, the outside world.
The interiors are also significant as it is a representation of how' society applied their expectations of each other. Throughout the McCarthy period, there was the