Warning: Major SPOILERS for Unsane ahead

-

Steven Soderbergh's tense new thriller Unsane stars Claire Foy as Sawyer, a woman who is starting a new life in a new city after escaping her creepy stalker, David (Joshua Leonard), only to find that new life disrupted when she is involuntarily committed to a psychiatric hospital after a simple counseling session. As she begins to question her own sanity, she is pushed even further when she discovers that David has seemingly gotten a job as an orderly at the hospital,which gives him all the control over her that he could ever want.

For much of the movie, the audience is invited to question Sawyer's reality right along with her. Is she really mentally ill, and simply in a place where everyone is trying to help her? Is David really there, or is she projecting the face of her stalker onto an innocent orderly? Is her friendly fellow patient Nate (Jay Pharoah) telling the truth about the hospital keeping patients unnecessarily and against their will in order to make claims on their insurance, or is he paranoid and delusional?

Related: The Horrifying True Story Behind Unsane

Things gradually become clearer as the movie progresses: Claire is not seeing things, nor is she stuck in a delusion, though it might be better if she were. The hospital really is keeping her locked up in order to milk her insurance, and David is gradually closing the net around her in an effort to win her love (or, you know, keep her prisoner in his creepy cabin in the woods). By the end of the movie, the whole horrible truth has come out.

This Page: David's Plan (and Murders)

David's Plan (and Murders)

David and Sawyer first met when she was volunteering at a hospice, and would read to his terminally ill father while David stood silently staring at the back of her head. As she explains to Nate, David began stalking her after the funeral, claiming that his father would have wanted them to be together. She blocked his number after he sent incessant texts declaring his love, but he then escalated things by breaking into her home while she was showering and laying out a blue dress on her bed. She filed a restraining order against him, and some time after that she moved far away, but David followed her and got a job as an orderly at the local hospital, using the alias George Shaw.

The real George Shaw, it turns out, has actually been murdered and had his identity stolen by David. David also murders Nate, for getting too close to Sawyer, and murders Sawyer's mother (Amy Irving) when she makes efforts to get Sawyer released from the hospital. Finally, David murders Sawyer's fellow patient Violet (Juno Temple), after Sawyer tricks him into bringing Violet down to her solitary confinement cell, in order to get her hands on a blade that Violet threatened her with earlier. Sawyer stabs David in the neck with the blade and manages to escape, but as she flees she sees David breaking Violet's neck, killing her instantly.

Sawyer manages to escape the building, but David sneaks up on her from behind and knocks her out with a hammer. She wakes up in the trunk of his car, next to the decomposing body of her mother, and in her desperation manages to open the trunk and break free. She runs through the woods, but falls and twists her ankle - and David finishes the job by smashing her ankle with a hammer. He then drags her, seemingly unconscious, to a quiet place amid the trees, and tells her about how he wants them to start a family together. However, Sawyer is actually still awake and still has Violet's blade, so when David lies down next to her she stabs him in the eye and then slits his throat. She's finally free... or is she?

The Insurance Scam

The whole reason that Sawyer ends up committed to the psych ward against her will is that she has health insurance, and the hospital has a system of committing people on the slightest of pretenses and "treating" them for as long as their insurance companies are willing to pay out. Nate, we eventually learn, isn't actually a recovering drug addict, but is in fact an investigative reporter who has allowed himself to be admitted in order to uncover the shady practices at the hospital. Claire soon realizes that Nate has a cell phone, which he uses to call in regular reports about his findings. After David drags him down to the basement and murders him with an overdose of fentanyl, his notebook is discovered and promptly hidden away by the hospital's administrator, Ashley Brighterhouse (Aimee Mullins).

However, after Nate's body is discovered (and while Sawyer is being held prisoner in solitary confinement by David), his editor publishes his story and the press hounds the hospital for answers. At around the same time, the real George Shaw's body is discovered and the police show up with a warrant to search the hospital - which leads them to discover Violet's body in the basement, and Nate's notebook in Brighterhouse's office. The horrible truth about the hospital forcibly admitting patients in order to milk their insurance (which is based on a real investigation into a chain of U.S. psychiatric facilities) is exposed, and Brighterhouse is arrested.

Related: Unsane Trailer: Steven Soderbergh Shot This Thriller On An iPhone

The Final Scene

Of course, it wouldn't be a horror movie without a stinger scene where the seemingly-dead monster comes back from the grave. The final scene of Unsane cuts to six months later, when the now-freed Sawyer is having a chilly lunch with her co-worker, Jill (Sarah Stiles). Sawyer has since received a big promotion, and uses her newfound power to fire Jill over their salads. Her composure is disrupted, however, when she sees a man across the restaurant who looks like David, and fancies that she can hear him talking about a girl he's in love with, who volunteers at a hospice and works at a bank.

In a trance, Sawyer picks up a knife and walks slowly across the restaurant, until she's standing right behind the man who looks like David. When he turns around, however, it's revealed that he's just a random stranger. Sawyer breaks out of her trance, drops the knife, and flees the restaurant.

The credits roll over a freeze-frame of Sawyer's frightened face looking back over her shoulder, indicating that even though she has killed her stalker, she will never truly be free of him.

More: Unsane Review