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Can Horror Games Tackle Mental Illness Without Reverting to Stereotype?

Incoming indie game 'The Shattering' could change the landscape of virtual horror.

Above: 'The Shattering' screenshot courtesy of Super Sexy Software/Deck13 Interactive

"The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown," so reads the opening line of HP Lovecraft's perennial 1927 essay "Supernatural Horror in Literature". A central tenet of human nature, the idea of terror deriving from unfamiliar circumstance long predates the American horror fiction author's disposition—and is equally ubiquitous in our modern understanding of fear today. Somewhere along this timeline, perhaps rooted in the archaic institutions and so-called medical procedures of centuries past, popular culture has unashamedly tied mental illness to the concept.

This unhelpful correlation perpetuates mental illness as The Unknown, and as such something to be feared—which appears to be the rhetoric, or perhaps even the rationale, for pedaling enduring misconstrued stereotypes. To this end, countless horror books, movies, and of course video games are set within dehumanizing and/or outmoded representations of psychiatric hospitals. Recent years have seen a number of articles and initiatives within the video game sphere challenge these misconceptions in a bid to balance the scales. This is, for the most part, a good thing. Let me explain.

In 2013, Ian Maher wrote a fantastic article for Kotaku, entitled "Nobody Wins When Horror Games Stigmatize Mental Illness". Within, Maher challenges video games' interpretation of mental illness and suggests that as popular media drives popular beliefs, "which lead to reinforcement, adaptation or abandonment of stigmatic views", games have an onus to be more responsible in their depictions of mental illness.

Off the back of this piece and others, ex-games writer-turned-game dev Lucy Morris launched Asylum Jam that same year. Asylum is a 48-hour game jam with just one rule: "You should not use asylums, psychiatric institutes, medical professionals or violent/antipathic/'insane' patients as settings or triggers" in crafting games. It ran its fourth consecutive event in November 2016 and gets bigger year-upon-year.

'Outlast' screenshot courtesy of Red Barrels

I've long held the view that, as a persuasive and interactive medium, video games are unique and therefore owe even more to the conversation against other media. It's only as a result of my own experiences with mental illness in recent years that my outlook has shifted slightly. Examples such as the above are undoubtedly invaluable to the discussion. However, I feel a separate line of thought is being neglected in the process, and that these thoughts should co-exist alongside the idea that, yes, mental illness is scary.

No matter to what degree, experiencing mental illness for the first time is scary. No matter the wealth of research that exists today, from an idiosyncratic perspective it is in many respects the elusive Unknown, and that as a result it's inevitable that it will be feared, at least to an extent. Having spent the last few years coming to terms with my own emotional ups and downs, I think it's how this fear is portrayed which is missing from contemporary discourse. In short: I no longer think there is no place for mental illness in the horror genre, so long as it's portrayed in the right ways: thematically, conceptually and rhetorically.

Games like Depression Quest, Actual Sunlight and Ether One weave an abject sense of horror into their narratives that is driven by realism. Games like 2013's psychiatric hospital-set Outlast, on the other hand, err on the opposite end of the spectrum when portraying mental illness, wholeheartedly adopting tropes involving the criminally insane and abandoned, decrepit mental health institutions.

"There's an unfortunately illustrious portfolio of asylum-set horror games."

The latter game's developer, Red Barrels, declined to contribute to this article, but I did find this archived BeefJack article, by Jamie Donnelly (no relation) also from 2013, interesting. When quizzed about its decision to stage its then upcoming game in its Mount Massive Asylum setting, the developer appears to send mixed signals. Donnelly questions the distinction between the well-documented horror of archaic practices—Outlast, for one, is inspired by the MKUltra project—and the residents themselves, to which Red Barrels suggests: "We fear what we don't understand and asylums are full of people with disturbing behaviors."

The developer then adds: "By saying our asylum is for the criminally insane, I think players will understand they'll be dealing first and foremost with criminals who have psychiatric disorders. It's because they're criminals they should be feared. And by making a connection between our story and the MKUltra project, we hope to make more people aware of the terrible things some patients had to endure."

As Donnelly rightly points out, these statements are at odds with one another and in my view epitomize the confused message the horror genre too often sends. Having played Outlast since, the setting coupled with its volatile patients does nothing to alleviate the false stereotype that mental illness is something to be feared. Of course Outlast isn't alone: there's an unfortunately illustrious portfolio of asylum-set horror games, and even the ones which elicit deeper meaning, like Silent Hill 2, are centered around violence.

'Layers of Fear' screenshot courtesy of Bloober Team

Bloober Team's Layers of Fear is one of the most wholesome interpretations of the distinctive terror leveraged by mental illness that I've played in recent years. Assuming the role of an unnamed painter, the game tracks the protagonist's secluded journey as his turns into himself, battling his inner-demons, isolation and self-reflection in turn. The idea that this could happen to any one of us, anyone you know, or have known, is relatable here and thus accentuates what makes the game scary.

One of the most refreshing examples of this portrayal I've ever seen is upcoming horror game The Shattering from Polish developer Super Sexy Software (SSS). It's currently in its pre-alpha stage, but tells the story of John, an everyman who suffers from depression, bipolar disorder and psychosis as a result of traumatic events experienced in his past. The idea driving John's character is that his story is relatable, that everyone will be able to find something in common with him and his thought process. To ensure this was handled in a sensitive and constructive manner, SSS consulted with a professional psychiatrist who drew up a character profile for the protagonist.

"We started with project with the idea of consulting with a mental health professional," the studio's Marta Szymańska tells me. "Firstly, like most projects, we did a lot of reading, getting into it, understanding the subject, and we figured that there are some issues that we weren't sure if we could handle correctly. This game is scientifically based but is nevertheless going to be a game; but we visited the doctor who helped us create John as if he was real. We were also encouraged to focus on how people act, how people talk, how you should talk to them, how to interact with them, how to suggest things, how to suggest direction—and that all helped us to build the game."

'The Shattering' screenshot courtesy of Super Sexy Software/Deck13 Interactive

"The Shattering looks at the shattering mind, what the protagonist doesn't want to remember," Szymańska continues. "And why doesn't he want to remember? Because he's been through traumatic events. So, what happened in his life? We put everything together and focused on mental illness because everyone today could have it, and I think that's the horror aspect of this game: if you have depression, if you feel sad, you know emotions yourself. If you can see it through and understand John, in such a way, I think that'll push players towards eventually acknowledging those emotions. Mental Illness fits here naturally, somehow."

Having played a small demo segment of The Shattering, its intentions are already clear: this is horror against the grain. Set within the protagonist's mind, it takes place in an all-white world, and uses John's decision and, crucially, indecision in recalling his seemingly forgotten memories as its operative for horror.

"Horror video games can exist without reverting to lazy stereotypes; but likewise, the horror genre can still acknowledge mental illness without falling for careless tropes."

"It's easy to make games about happy people, or people who've failed for some reason but now return to greatness, you know?" says Deck13's Michael Hoss—said German company is currently working on The Surge, and are the publishers for The Shattering. "Doing something that requires they think outside of the box - doing something new is quite tricky. Why not talk about taboos? Because that's what they are, in the end, even in society nowadays."

The idea of breaking taboos is vital when steering clear of well-worn tropes—the latter exists, after all, as a result of habit. Without going into detail, the demo segment I played concludes with a compromising bathroom scene, with themes that most games would be afraid to tackle. With such a long lineage of "mental illness equals horror" to contend with, though, I ask how difficult designing a horror game really is without reverting to stereotypes.

'The Shattering' screenshot courtesy of Super Sexy Software/Deck13 Interactive

"It's hard, but it's doable," admits Hoss. "In the classic horror game you can shock people with a jump scare, but what Marta and her team is trying to achieve with The Shattering is actually projecting fears or shocking moments into the player's mind with… not with shock moments, but with situations where people are like, 'Oh my god, is this really happening?' or, 'Oh my god, this is so sad.'

"Imagine the scene where John is in the bathroom and climbs into the bathtub—it's usually a taboo, but the way The Shattering handles it, you still feel the horror without jump scares. These situations can be created, but it's hard to find them and design them where they not only make sense but also generate feelings inside the player's head."

From my own experience, societal stigma is a large part of what makes talking about mental illness difficult. Horror video games can and should exist without reverting to lazy stereotypes; but likewise, the horror genre can still acknowledge mental illness without falling for careless tropes. The Shattering's approach applies something so simple—consultation with mental health professionals—yet is already well on its way in tackling new ground. It's a ways from release yet, but I hope there are many games that follow its example down the line.

Read more articles from our Mental Health Bar column here. 

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