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Gus's undercover identity as an orderly in the mental hospital is Suggs. Suggs is the stage name of Graham McPherson, the lead singer of English 80's ska band Madness.
Brad Dourif plays Bernie Bethel, recently committed as criminally insane. Dourif also played mental patient Billy Bibbit; a Golden Globe winning and Oscar nominated role; in "One Flew Over the Cuckoo's Nest". The 1975 film and Dourif's role are payed homage to in this episode.
The house used for the facility Bethel and Shawn are in is the same place used for the set of the reality show Shawn goes on in Shawn and the Real Girl.
In keeping with Psych's love of everything 80s - especially John Hughes - Molly Ringwald guest stars in this episode.
Spot the Pineapple: Shawn orders three pineapple razzmatazz's and there are pineapples in the fruit basket.
Julianna Guill, who plays Vivian, will also play another character in Psych: the Movie