With the scope of video game storytelling ever growing, one Game Rant writer takes a look at some of the most impressive discussions of mental health in gaming.

The portrayal of mental illness and disability has not always been one that popular culture has taken in its stride. Many forms of media, be they fiction, film, or video game, have struggled to portray these issues in an accurate and enlightening way. Be it the ‘mad’ serial killers of slasher movies, the clumsy portrayal of depression in paperbacks, or hordes of disposable enemies in survival horror games, an authentic representation of mental illness is a rare thing to find.

In spite of this apparent difficulty to accurately tell stories revolving around these concerns, most of the world’s population will have very close ties to mental health issues. Mental health charity MIND states that one in four people in the UK will experience a mental health problem each year. Among those affected in that statistic is the writer of the article you are reading right now.

During different periods of my life, I have suffered from severe depression. Thankfully, over recent years I have found myself able to control these bouts, and the suffocation that comes with it, but darker times are far from a forgotten memory. Because of my own personal history will mental illness, I have found it important to keep an eye on how these matters are represented in the media – particularly within video games, the form that I love above all others.

outlast doctor

It’s fair to say that a large number of games have fallen for some of the more obvious tropes regarding the representation of mental health in media. Mental illness has been used as a crutch for a variety of villains in gaming, with one notable example being the inmates of Mount Massive Asylum in phenomenal survival horror title Outlast, albeit with leanings of the MK Ultra scheme perhaps complicating matters. Meanwhile, Manhunt 2 takes a much more traditional approach to a psychiatric asylum, complete with the decade-old cliches surrounding that setting in a horror atmosphere.

However, other developers have instead used video games as a way explore these issues directly, rather than using them as a contextual element of a more traditional story. In fact, some studios and creators have found that games are the perfect way to talk about mental health. After all, video games, through the sheer direct action required of the player, forces at least some kind of involvement in proceedings other than that of a passive reader or viewer.

actual sunlight

In particular, depression has been a regular focus of developers trying to explain how this pervasive affliction affects everyday life. Although interactive narrative Depression Quest is one of the more well-known examples, this is far from the only game that focuses on depression, with many others giving players a more active role in the proceedings. Actual Sunlight allows players a stark look at the life of someone with depression, with powerful and emotional consequences.

Another example is that of Elude, a free-to-play platformer from a team at the Massachusetts Institute of Technology. The game attempts to capture how it feels to go through different emotional states, contrasting the feeling of depression against ‘normal’ and happy moods. The player character traverses different aspects of life, using ‘passion’ points to overcome obstacles, climbing towards the happy stages of the game. Intended for use in a clinical context, Elude was designed as a means for friends and relatives to gain an understanding of what people suffering from depression are going through.

Elude is far from the only game to act in this manner, or use escape or climbing as a metaphor for mental wellbeing. Take, for instance, Sym, a PC and Mac platformer from developer Atrax Games. Revolving around the theme of social anxiety disorder, the game focuses on a player character’s attempts to escape from the fears that plague their day-to-day life. Swapping between alter egos Caleb and Ammiel, the player must try to overcome a maze between the two worlds, using both Caleb and Ammiel to solve puzzles.

sym gameplay

Moving away from depression and social anxiety, games have even been used as a means to portray neurodevelopmental disorders. One notable example is Auti-Sim, a first-person exploration of auditory hypersensitivity, a symptom that some of those with autism spectrum disorders suffer from. Created as part of the Hacking Health Vancouver 2013 hackathon, players will find themselves subject to visual noise and blur, as well as audio distortion, as a means to try and explore the idea of sensory overload.

Although it is often independent developers and studios that try to discuss these issues in gaming, there are several more well-known titles that have explored mental health. 2012’s Spec Ops: The Line has become renowned for the way it challenges the player’s preconceptions of gaming, including some of the most shocking meta moments in gaming history. Although this metafictional role is perhaps the game’s priority, the title also touches on aspects of post-traumatic stress – although potentially in a heavy-handed way at times.

Spec Ops: The Line is not alone, however, and a wonderful example of how high-profile games can portray mental illness was shown just last year in the Square Enix-published Life Is Strange. Although the title, which was developed by Dontnod Entertainment, framed its story around Max Caulfield’s sudden supernatural abilities and attempts to mend the wrongs of Arcadia Bay, the discussions of mental health – specifically depression – were handled with care. Two major characters, Chloe and Kate, show symptoms of depression, and Life Is Strange manages to make the player think long and hard about their actions regarding the pair, resulting in one of the standout games of 2015.

life is strange photo wall

Aside from simply trying to make users see how it feels to suffer from these issues, some games have even been used to combat mental health issues. Take, for instance, SPARX. This project from New Zealand was designed specifically to assist children and teenagers combating anxiety and depression. Framed as an online fantasy game, scientific studies actually showed that it reduced the symptoms of both depression and anxiety, and was even more effective than traditional therapy in some cases.

It’s not only games specifically designed to combat mental illness that can have a positive effect on those afflicted. Indeed, there have been many studies that look into how gaming can help suffers of depression, with theories around the therapeutic nature of task completion in games, and even a level of escapism alleviating pressure. From personal experience, local co-op gaming also helped during dark moments, providing a pressure-free environment for socializing, when the risk of becoming more and more isolated was more than apparent.

Even though games have some way to go in their general representation of mental health issues, there are clear signs that the medium could be perfect for exploring these themes going forward. Indeed, the sheer notion of gaming points towards helping users to understand different thoughts and emotions.

elude gameplay

Video games have a clear advantage over the likes of books and movies in this regard, simply down to the requirement for active participation to work a game. This method of triggering different emotional reactions in players is a tremendous way to build empathy and awareness, while the medium also grants players the freedom to experience things differently. This, too, could certainly help with depictions of mental illness in gaming – after all, there is no cookie cutter approach or reaction to mental health issues, and as such each person suffering from mental illness has a very different tale to tell.

In short, these developers and projects have proven that video games can pose some interesting questions with regards to mental health. Gaming is but a fledgling in the grand scheme of things, but there are certainly signs that the medium can truly show players some vivid, immersive experiences to discover more about mental health. With some games even having a positive impact on mental wellbeing, there’s every chance that video games could continue to forge their own path with these themes.