can video games (finally) talk to us about mental health?

For a long time, mental illnesses were simply absent from the video game industry, except as an element to explain the aggressiveness of an antagonist. We fought against the “mad scientist” Wily in the series Mega Man and against bloodthirsty psychopaths in Final Fightor even escaped from internees inspired by horror cinema in games Outlast. But in recent years, the situation has changed. And despite some blunders, independent productions and big studios alike seem to be tackling the subject head on, often with the help of people involved and specialists.

Awareness in the 2010s

Researchers and people directly affected by mental health issues know this well: until the 2010s, many games failed to address the issue satisfactorily. To the point of establishing lists of recurring clichés, ranging from the atrocious description of the places to the symptoms of the characters which would be their only personality trait. A study from the journal Front Psychiatry shows that up to 75% of video game representations of mental disorders are negative.

With the explosion of independent games and the proliferation of ambitious narrative experiences over the past fifteen years, the situation seems set to change. First of all because the fact that the characters sometimes suffer from mental disorders is more directly integrated into the scenario. According to Joël Pannelay, co-host of the podcast The Best Electronic Game Ever : “Games like Celestial, Disco Elysium And What Remains of Edith Finch have obviously addressed this type of question in depth and with great accuracy in recent years. »

A reflection shared by Adèle, a player passionate about narrative adventures: “In a game like Mind Scanners, for example, there is a very in-depth reflection on neuroatypicality, which is not a disease, but it explains what it means to live in a world that wants to eradicate us when we are concerned. I found the representation very positive and very skillful. » She adds that more and more games include characters with mental syndromes, without making it their only character trait: “ This is particularly the case for the works of the studio Die Gute Fabrik (Mutazione, Saltsea Chronicle…), where all the protagonists are very well written from this point of view. »

Titles that innovate in the representation of monitoring and care

Some titles even go much further than a simple positive representation, avoiding clichés and stigmas towards sick people, and even discussing the correct way to speak and interact with them. Celestial, a platform game released in 2018 by Extremely Ok Games, has particularly attracted attention. Its creator, Maddy Thorson, tried to talk about depression in a fair and innovative way throughout the journey of the heroine, who climbs a mountain while fighting this illness.

Valentin, city doctor and creator of the show Tomberry Musicalexplains how the game aptly talks about the heroine’s panic attacks: ” In Celestial, you are sometimes made to press in rhythm according to a precise sequence, which will calm the character, Madeline. These sequences are modeled on a cardiac coherence method known to relieve panic attacks. In addition, the title features very accurate dialogues confronting someone suffering from depression and an outside person, who does not understand what it is. It’s very fun and very educational! »

This way of mixing illness and gameplay with pedagogy has become more and more common in recent years. We have seen similar approaches in role-playing Omoridepicting in a very frontal manner the extreme social phobia of Sunny, its main character, or even in Chicorya very popular exploration and adventure game in 2021.

In the latter, we play a young painter suffering from imposter syndrome seeking to follow in the footsteps of a great artist, herself battling depression. Throughout the adventure, a play on shadow, light and colors wonderfully illustrates the state of mind and the inner struggle of the characters.

Big-budget games follow indie’s lead

Little by little, the major studios followed in the footsteps of the independents and also began to address the issue with greater precision and accuracy. Since 2014, timid attempts have been made, for example at Ubisoft in its role-playing game Child of Lightwhich speaks in a fairly cutting-edge way about serious mental health issues.

A mediator for young people in difficulty, Carole sometimes uses this opus to illustrate workshops and discussion groups: “It’s a title that allows us to talk to children about depression without shocking them, but by making them think. It is suitable for all ages, it does not stigmatize the sick and it helps to make people understand that sometimes, a psychological or psychiatric disability can be completely invisible. »

Closer to us, Hellblade: Senua’s Sacrifice, a very ambitious game from Ninja Theory, was noted for its depiction of the violent psychoses suffered by its heroine, a Pictish warrior from the 8th century. The narrative treatment of his illness was done in conjunction with health professionals and specialized organizations. In addition, a documentary accompanied the release of the game, to explain the process in depth. Always careful treatment should be observed in Hellblade IIwhich comes out May 21, with an expanded team and more time and resources to explore these delicate questions in more depth.

Ninja Theory is not the only studio to have taken great care to best deal with issues of mental health. During the development of Psychonauts 2a mostly comedic platformer set inside the chaotic minds of several characters, studio Double Fine worked to improve on this treatment.

Aurélien, fan of the license Psychonauts and author of articles on video games, explains it to us: “The first installment in the series came out in 2005, and while it was a good game, it made a lot of mistakes in the way mental disorders were portrayed. For the second, Double Fine put together a team of consultants, specialists and people concerned to manage to maintain the humorous tone of the saga, but while being much fairer in the subject. » Here again, a very long documentary explains the intricacies of the game’s development.

Still some progress to make

However, everything is not perfect yet. It happens that games dealing with psychological or psychiatric disorders miss their target or their message. Arnaud and Théo, two players aware of these issues, give us some examples: ” Series Watchdogs Ubisoft completely misses its representation of individuals suffering from psychiatric disorders. Almost all the criminals we encounter are described as “mentally ill”, and the game constantly associates illness and crime, which gives a very poor representation of the reality of the lives of people with these disorders. »

Another example: the card game Neurodeck, from Goblinz Studio, in which you must build a deck to overcome your fears and mental disorders. Theo adds: “This game aligns the worst clichés about mental illness, without any documentation. The initiative is interesting, but the treatment is disastrous, bordering on offensive for the people concerned. »

As for the most classic representations that we cited at the start of the article, they continue to thrive in certain horror games, like the much-maligned The Suicide of Rachel Foster which completely misses its approach to the suicidal behavior of a teenager… And comes to indirectly justify abusive behavior of control and domination of an adult over a young girl.

Without going to such extremes, it simply happens that titles address these issues imperfectly, despite good intentions. Carole, our mediator, takes the example of Darkest Dungeon II and the role-playing game series Persona. “In the first, mental illness is omnipresent, it is even an essential gameplay mechanic. We must ensure that our characters have as little stress as possible, treat them with medicines and objects, etc. But, in practice, it doesn’t work like that. The care of these diseases cannot be just a variable with gauges! Concerning the second license, I love it, but there is a treatment [des troubles mentaux] disastrous, and even sometimes homophobic until the fourth episode ! In the fifth [paru en 2016, ndlr]it was much better, but still a little confusing, clunky, and too focused on type answers. “Get out of your house, it will be better!” This is the worst thing to say to a young person suffering from depression. I hope that the sixth opus will be good, from this point of view! »

In any case, the observation of all our interviewees is the same: the situation is improving, whether on the side of independent games or large productions. An opinion widely shared by the specialized press as well as by the world of research, which, if they underline the room for progress still possible in this area, almost unanimously point out the long road already traveled by the industry video game.