You Were Never Really Here sees Lynne Ramsay not missing a beat after a long break, with an intense and visceral dive into mental health issues wrapped up in a gritty crime mystery.

Joaquin Phoenix stars as a Joe, a contract fixer, who seems to be mostly trading his services for work that helps young females who have been kidnapped or are lost to sex trafficking world. He does this around taking care of his elderly mother, who doesn’t seem to haven’t all together, but still has moments of joy and clarity with her son. As the film unfolds in the early going, we are given flashes of Joe’s past, at home and in his work (as a soldier and FBI agent), which has made him depressed, suicidal and frequently becoming debilitated with PTSD flashes. Joe is often barely holding it together and only has so much to live for, so when he falls into a large conspiracy that leaves bodies everywhere, you wonder how he is going to get through all of this.

The mystery that begins to unfold about halfway through the film is engaging, keeps you on the edge of your seat, but is ultimately not what pulls you into this film. Phoenix’s performance as Joe is a thing of beauty, as he reminds us, once again, that he might be our greatest living actor. The complexity and humanity he brings to Joe and his struggle, all while making us believe he is very capable and skilled at his job of choice, is an incredible feat of acting that I don’t think anyone else could pull off so convincingly. He’s powerful, yet vulnerable; he’s warm and loving one moment, then terrifyingly brutal the next; he gets lost in his addled mind and then brings it all into focus on the moment; and Phoenix handles all of this with such grace and nuance, it’s truly some incredible work. The film feels so much for Joe, and people like him, with an ending that calls out all of us for ignoring and letting people with illness like Joe completely being swept under the rug by society as we go about our lives; Ramsay’s finger is pointed and rightfully so.

Ramsay’s filmmaking is also excellent, taking us into the brain of Joe and successfully disorienting the viewer when he is and finding laser focus when he feels the same. She bypasses showing much of the violence in this film, which there is plenty of, but I think that is the clue to the viewer about what we should really be focusing on. The most violent imagery of the film comes at a very specific moment, making visually explicit the agony individuals with suicidal depression and PTSD feel every day, and sends us out of the theater wondering how anyone can carry on with a sickness like this coursing through them. Ramsay’s soundscape, with a score by Jonny Greenwood!) is just as expertly crafted, disorienting and focusing the viewer along with Joe, with a soundtrack that keeps you uneasy as the mayhem begins to unfold. But, I think it is her insertion of Joe’s background and flashes of trauma that made him who he is, at precise moments across the film, that help to further inform and flesh out the battle of mental instability and the toll it takes on one’s mind. These flashes are often some of the most affecting moments of the film.

Ekaterina Samsonov stars as Nina, a girl at the middle of all of the film’s trouble, and she does a fine job of handling the trauma that comes at her. Stoic, but with that thousand yard stare, Samsonov can be unnerving, and rightfully so. Judith Roberts is also great as Joe’s mom, and it was a real joy to see her and Phoenix interact in the early part of the film. The two have wonderful chemistry, and Roberts does a great job of showing us everything going on with her character without ever committing to melodrama or hysterics.

You Were Never Really Here is another fantastic piece of filmmaking in 2018, and one that will be in the conversation for me at the end of the year. Ramsay executes an often harrowing dive into mental illness, delivered with care and subtlety by Joaquin Phoenix. This is a visceral experience, full of compassion in its portrait of an under seen community of our society, and is one of the best films of the year.