Warning: Minor SPOILERS for Unsane ahead

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The premise of Steven Soderbergh’s new thriller Unsane is so strange that it almost immediately invites the audience to doubt the protagonist’s sanity. Claire Foy plays a woman who visits a psychiatric hospital for an introductory counseling session, in order to deal with residual trauma from being stalked. She is asked to wait and fill out some forms, and once the paperwork is complete she is told to accompany a nurse to a room, where her bag is searched and she is then strip-searched. Confused, she asks if she can now leave the hospital, only to be told that she has been admitted and that the hospital can legally hold her for 24 hours… which then turns into 7 days.

It sounds like a nightmare, but horrifyingly Soderbergh seems to have been inspired by true events. Many details of Unsane bear a close resemblance to accounts in an investigation by Buzzfeed News in 2016, which found that psychiatric facilities appeared to be admitting patients unnecessarily and – in some cases – against their will, in order to collect their health insurance payouts.

The report leads with the account of a woman called Samantha Trimble, who joked about having suicidal thoughts during a counseling session, and was given a few papers to sign by her counselor – which she assumed were just standard paperwork. Then, things took a dark (and, if you’ve watched Unsane, familiar) turn:

A technician rifled through Trimble’s purse for sharp objects and then a nurse told her to strip down to her underwear. It was then, she said, that she realized the doors to the psychiatric ward had locked behind her.

Trimble, who has recently reached a settlement regarding her hospitalization, recalled shaking with fear and “deep, shameful humiliation” as the nurse examined her body, noting the location of any identifying marks. “All you can do,” Trimble said, “is stand there and let it happen.”

The nurse handed her a small cup of pills, and soon she was asleep.

When she woke up early the next morning, she recalled thinking, What the f— just happened?

Soderbergh has not said that he was specifically inspired by this article when making Unsane, but a lot of the details match up. Foy’s character, Sawyer, is kept waiting at the hospital for a long time – just like Trimble was – before being taken to the ward and ordered to strip by a nurse who says she needs to make note of identifying marks. She desperately tries to explain to her doctor that she’s not supposed to be there, but he dismisses her insistence that she’s fine, and tells her that she is a danger to herself and to others.

Later in the movie, Claire learns from a fellow patient, Nate (Jay Pharoah), that she is not the first person to be involuntarily committed. In fact, it’s part of a deliberate pattern of forcibly admitting people in order to make claims on their health insurance. Patients with insurance are admitted on the slimmest of pretenses (any mention of depression or suicidal thoughts in a counseling session will do), and are then tricked into signing the admission paperwork and held at the hospital until their insurance provider stops paying out. That, too, was one of the revelations in Buzzfeed‘s yearlong investigation into United Health Services, America’s largest chain of psychiatric hospitals. Unfortunately, Soderbergh’s grim tale of institutionalized gaslighting has its roots in reality:

Current and former employees from at least 10 UHS hospitals in nine states said they were under pressure to fill beds by almost any method — which sometimes meant exaggerating people’s symptoms or twisting their words to make them seem suicidal — and to hold them until their insurance payments ran out.

The full investigation is well worth a read, if you can stomach it, and features accounts from both patients and staff at psychiatric hospitals. A lot of the details mentioned in Unsane match up closely with details in the article – for example, one former clinician’s recollection that there was a clear demand to fill any empty beds in order to maximize profit (“Your job is to get patients… And you get them however you get them.”)

Unlike many horror movies, Unsane does not claim to be based on a true story – perhaps in order to avoid a lawsuit – but if you think that its premise is too crazy to be true… well, don’t be so sure.