Mental health in video games is pretty black and white. Think about how many times you’ve seen someone babbling, a person in a straightjacket, or someone who decides to destroy the world because of the voices in their head? This is common among many mediums (books and movies aren’t fault free either), but there is at least some variation in the portrayal of mental illnesses in these other mediums. Perhaps it’s simply because they’ve been around longer, but the truth remains that there are more progressive portrayals of mental illness in other mediums, while video games trail behind.
It was while I was playing some Evil Within that I started really thinking about it. Evil Within has both types of insanity that are common to games. The mad antagonist who puts himself above all rules and sense while a clearly broken boy in a straightjacket mutters and repeats himself constantly. I was trying to think of a game where mental illness was handled differently. Where was the game with a character who has borderline personality disorder and suffered as quietly as they could so they didn’t bother other people? Where was the person with the crippling anxiety, or people who had trouble functioning normally due to the severity of that anxiety? Where were all the people with mental illnesses who were still high-functioning and able to mostly keep themselves on an even keel outwardly even as they suffered inwardly?
All I could think of in terms of video game representation was the idea of ‘insanity.’ Someone who is criminally insane and wants to destroy the world is easy to think of in video games. Also, playing as a main character who is slowly losing their sanity due to the events going on around them. Don’t get me wrong, people can be negatively affected by the environment and their mental health can suffer for it, but sanity is not something that would go down like a health bar. Furthermore, it leaves the eerie suggestion that people with mental health issues are only affected by traumatic events and that they are less complete than “normal” (that’s a loaded word, but I’m using it for simplicity’s sake).
If someone with low sanity is hallucinating, the suggestion is that your mind is at 50% the capacity of a mentally whole person. This stereotype effects the sanity meter, which is pushed onto the player, meaning that when people think about mental illnesses, they think about people screaming and holding their heads, hallucinating, and generally seeing the same type of mental breakdown portrayed over and over again.
Don’t get me wrong, I love the shit out of Eternal Darkness: Sanity’s Requiem and I generally enjoyed Amnesia when I played the demo. I do not want these games or any of the Silent Hill series to stop existing or not be available for players. It’s just that the pictures these repetitive tropes paint about mental illness make it look like people who are ‘insane’ all act similarly, and that they can be easily set apart from ‘normal’ people.
I think the most troubling idea to me when it comes to gamers’ thoughts about insanity is that they are not aware insanity as a mental health diagnosis does not exist. The Diagnostic and Statistical Manual of Mental Disorders (DSM) does not list insanity as a diagnosis. You can’t be deemed insane by a doctor and then treated for insanity. You can, however, be legally declared insane by a doctor since that’s what it is. Insanity is a legal term which basically states that it’s a “mental illness of such a severe nature that a person cannot distinguish fantasy from reality, cannot conduct her/his affairs due to psychosis, or is subject to uncontrollable impulsive behavior.”
Looking at it that way, insanity as a blanket term for mental health is insulting, and doesn’t consider the different nuances or degrees of disorders. Insanity is a metaphor to help the legal system make concise decisions without needing as deep an understanding as expert psychiatrists would have. If you’ve been paying attention, you’ll have realized that almost all video game characters who’ve been shown to have a mental illness could fit into that very broad definition of insanity.
People with mental health issues are more then crazed, murderous villains. They’re more than the person in the straightjacket who talks and giggles to no one in particular. For every game you can think of with a more nuanced portrayal of mental illness (Actual Sunlight), there are three games that you could think of more easily that have shallower, more negative portrayals (Portal, BioShock, Silent Hill 2).
As much as I love these games, I can also see a common trend within them. The tropes about mental illness that make people into murderers would also make it seem like it’s common for someone with a mental illness to kill people. It can stigmatize and leave people more wary of others who do not have what is perceived as “perfect mental health.” It strips people down to certain traits and leaves them stuck in two-dimensional representations of their characters. People are not their mental illnesses. While it can be a big part of people’s lives, it does not push out the other traits that they have. People can have mental illnesses and be calm, intelligent, kind, and supportive. They can have full, rewarding lives and function so well within society that there is no way for you to know that they have a mental illness without them telling you.
I have heard countless complains about video games stories and characterizations over the years. So let’s stop with the shallow, single-minded representations of the human mind, yeah? They’re boring.