Canadian director Ashley McKenzie’s two features pivot around people caught up in traps. She’s a regional filmmaker, making work based in the communities of Nova Scotia’s Cape Breton island, which is home to 132,000 people. Her 2016 debut, Werewolf, followed a couple of opioid addicts struggling to live on methadone maintenance. Her long-awaited follow-up Queens of the Qing Dynasty, opening this Friday at NYC’s Metrograph, begins with a suicide attempt by an 18-year-old girl, Star (Sarah Walker). Although she’s just begun life as an adult, she will likely require a lifetime of institutionalization, as the state has determined that it’s too dangerous for her to live on her own. She befriends hospital volunteer An (Ziyin Zheng), a genderqueer college student from Shanghai.

Most of Queens of the Qing Dynasty remains confined to the uninviting spaces of the hospital, but the final half-hour shows the possibilities of...