In Ken Kesey's novel "One Flew Over the Cuckoo's Nest," the character's expression highlights the frustration faced by individuals oppressed by an authoritarian system. The quote underscores the struggle and backlash against the unfair treatment that many endure, especially in institutional settings. It reflects a sense of indignation toward those in power who fail to recognize the humanity of those they control.

The idea of voicing one's grievances becomes central to the narrative, illustrating the importance of speaking out against injustices. The character's assertion that they have been "screwed" conveys a deep sense of betrayal and the need for liberation, emphasizing the psychological and emotional damage inflicted by oppressive forces. This theme resonates throughout the book as it delves into the complexities of mental health, freedom, and individual rights.