Kosovo Albanian director Isa Qosya, who has not made a film in 17 years, said Kukumi was his way of showing how years of ethnic conflict had dehumanised people in the region.
The film, shot entirely in Kosovo, received its world premiere late on Wednesday at the Sarajevo Film Festival.
"I felt uneasy during the first years of this whirlwind and felt a certain dehumanisation of people who did not understand and help each other," Qosya said on Thursday.
"The whole movie is a metaphor. Freedom is when you help someone and when you understand the other person too," he added.
The three main characters are two men and a woman - Kukumi, Hasan and Mara.
Despite coming from a mental institution, they often appear to cope better than others with life in postwar Kosovo, with its ethnic tensions, UN bureaucrats and the foreign troops who occupied the province.
But a misunderstanding with Nato forces raises the question of whether the characters were better off inside the asylum.
"The whole movie is a metaphor. Freedom is when you help someone and when you understand the other person too"
"The role of Nato troops in Kosovo has had positive but also some negative consequences," Qosya said. "I can't understand their role now; it has become totally undefined."
Qosya said the province's problems stemmed partly from uncertainty over the future.
Kosovo is still legally part of Serbia. The Serbian government and Kosovo's now-tiny Serbian minority hotly oppose the independence Kosovo Albanians want.
Talks over the final status of the province are expected to start this year or next, depending on progress on issues including human rights and democracy in one of Europe's poorest corners.
"Everything is undefined, and that is accompanied by a lack of character and principle among the people," Qosya said.
Kosovo is still legally part of
Through a simple plot and sparing dialogue, the director portrays the tensions between those people who left Kosovo during Serb rule and the war and those who stayed on throughout.
The main characters seem most at ease when left undisturbed in uninhabited settings, such as when they drive a railway car along deserted tracks, gaze at a lake in an abandoned quarry or convert a rundown stable into their home.
Qosya said he had difficulty raising funds for the film in a region struggling to provide the population with basic services like health care. But eventually Kosovo's authorities agreed to foot the $740,000 bill.
Croatia's Jadran Film provided the equipment, and the all-Albanian cast and Qosya worked without pay. Kukumi is in the competition programme for for the best regional film award at the Sarajevo festival.