I'm not going to explain the story, that has been done in other reviews. What I do want to say is this
The end of this movie brought tears to my eyes, and literally almost broke me, because I have experienced something similar. No, I didn't live in a mental institution all my life, but the pain and heartache is the same, it's excruciating, at the loss of a lover, a family member (including pets), and especially the loss of your child. At the same time the movie brought pain, it also brought healing.
Many movies can be confusing at first, and some stay that way until the very end. This was not confusing at all, you just needed to follow along, and know that eventually that everything will be clear and fit into place.
An awesome movie, exceptional acting, and the music is beautiful, especially the end title "The Cry Inside," written by Brian Byrne and performed by Kelly Clarkson. It was absolutely gorgeous, a masterpiece. Listening to it, and paying attention to the lyrics, is what finally broke me...I sobbed
"The Cry Inside" never goes away. Rose Kennedy explained it as follows ~
"It has been said, 'time heals all wounds,' I do not agree. The wounds remain. In time, the mind, protecting its sanity, covers them with scar tissue and the pain lessens. But it is never gone."