I have to admit that my preference is for psychological horror where the imagination is left to roam. Thus I thought the lead-up to the unfortunate bloodbath was both interesting and different. Each of the asylum patients in the lead-up is given a chance to demonstrate his or her particular disorder— the compulsive soldier, the nympho hungering for love, the obsessive mother with her doll baby, the partially lobotomized black man, et al-- and except for the judge (Ross) none seems particularly homicidal. And, of course, there's the power-crazed "doctor" (Weenick). Then, into this loony bin arrives poor drop-in nurse Charlotte (Holotik) not realizing that a loony is in charge.
This sets up an interesting and fairly suspenseful storyline since we can't be sure where the plot is headed since the murder, mayhem and gore so far is at a minimum. Plus the acting is pretty darn good—Weenick & Holotik, especially. (And after 60-years of movies, I've never seen a cast with more un-Hollywoodized names!)
Now, in my view, had the creators exercised more imagination, they could have come up with a less hackneyed climax than the gore-fest we're subjected to. Of course, the blood-letting may satisfy many horror fans, but to me, it betrays the subtler possibilities posed in the lead-up. For example, why not have the real doctor murdered by one of the patients, and then try to figure out which of the patients is actually homicidal. A sort of loony-bin whodunit.
Anyway, the film is mostly well-crafted for a cheap-jack production. Still, I wish IMDb provided more background info, since what does appear looks like a wholly Texas production with a local cast. To me that would amount to quite an achievement, regardless of budget or fall off in imagination.