Does gaming sweep mental health issues under the rug?

The games industry is locked in the throes of renaissance. It’s frequently challenging norms with a push for equal representation. It’s daring artists and players to dream bigger than the clichés which dominate worldwide charts. Despite intense resistance, it's a war being won inch by inch. However, the battle for diversity is blind in one key area; it flies over the misunderstood realm of mental illness without a backward glance. Bearing in mind how far we've come in the last decade, gaming's efforts at tackling this subject are depressingly awkward (if it isn't ignored entirely). At best we get predictable, wildly generalised tropes hurled into our laps. Grief. Anxious ticks. Madness. Few come close to portraying--or even understanding--the reality. 

That’s some distance from the rallying cry bellowed across the web when Ubisoft ‘justified’ not including playable female heroes in Assassin’s Creed Unity. Gender or sexuality remain attractive inequalities to get behind, thanks to their simplicity, but the subject of mental illness isn’t so easily understood. Consequently, we see much less ‘White Knight’ behaviour from gamers when it comes to this subject. Less outcry.

This isn’t helped by the fact that players’ perception of issues like OCD can be far removed from fact. Most trivialise the matter by suggesting its presence in our need to reload after shooting, or a drive to vacuum up every item we stumble across in Super Mario or Ratchet & Clank (regardless of whether we need them or not). The truth is infinitely more invasive.

The distressing condition is tied into a need to alleviate worries. This is achieved by repeating a compulsive behaviour, even if it only works in the short-term. After saving to buy a PS4 earlier this month, for example, I suddenly found myself putting off opening the packaging. The only explanation I can give is that I felt mentally ‘unworthy’ in some fashion, as if I wasn’t ready to appreciate the new generation of consoles. Over time, I began to recognise the signs of what has long-since become my shadow. When finally connecting the system, I was forced to keep checking that I hadn’t forced the power-cable in too hard. Then I had to ritualistically clean my glasses and go to the toilet numerous times before I was even close to ready. Worse, my concern over causing an electrical fire through ‘damp’ hands saw me repetitively drying them off on towels, regardless of the fact that they were already bone dry. It’s possible to fight this mounting sense of panic and win, but not before it’s sucked the fun from whatever its come into contact with.

If I was to personify OCD, it would be as a mewling creature pulling at your sleeve; one that operates on blind instinct. Having such a monster riding around on your shoulder every moment of every day is exhausting. As such, sufferers need a bright spot in amongst the misery of a life which crushes them. They need heroes they can relate to, characters who remind them that it’s possible to battle out to the other side. That it’s possible to win.


Sadly, those idols don’t really exist in games. There are a number of protagonists out there who grapple with anxiety, but their struggles are usually bland and ‘safe’ from a storytelling perspective. The murdered spouse we must avenge, the kidnapped family to save. The emotional weight of being a saviour. Even if I went on for a full page with numerous examples, it’d rarely touch upon the horror mental illness brings about in reality.

Perhaps the best example would be Heavy Rain’s Ethan Mars. A father who spirals into misery after losing his son, his is a clunky exploration of anxiety that’s mostly restricted to visual cues such as the re-watching of old videos, a scruffy beard, and tatty house. When it cuts deeper, exasperation follows. Blacking out for minutes at a time, Ethan finds himself in unfamiliar places with an origami figure nestled in his palm. Rather than fostering sympathy for a man who is clearly falling apart, I get the impression audiences are supposed to be uneasy about him in those moments. We are led to believe he is the Origami Killer, in large part because of his mental illness. That isn’t a healthy image.


It isn’t unusual, of course. As Ian Mahar pointed out in his thought-provoking Kotaku article, if mental illness does make an appearance it’s often something abhorrent. His observation that the role was primarily reserved for "the villain, and typically used to justify extreme violence or antipathy" is a bucket of cold water to the face.

This is a strange reality, because the number of those suffering from anxiety is astonishing. According to Anxiety UK, one in six Britons have suffered from depression in the last week. For context, 2013’s survey from the Office for National Statistics suggested that there are around 64.1 million people living on these islands. With that in mind, approximately 10.6 million of that number were struck by it in the past seven days alone.

The number of those lumbered with obsessive compulsive disorder isn’t a huge amount better. As noted by OCD UK, it "affects as many as 12 in every 1000 people". It can be so debilitating and disabling that the World Health Organisation (WHO) has actually ranked OCD in the top ten of the most disabling illnesses of any kind, in terms of "lost earnings and diminished quality of life". Given the similarity of our lifestyles, it's likely that the rest of Europe and the US have similarly disturbing statistics.


So why isn’t this handled better in video games: a medium that’s played by a phenomenally broad user-base? I can sympathise with those who raise the complaint that we should use games for fun rather than a social message. Nevertheless, if including a character with anxiety or OCD could give hope as well as understanding, that’s an opportunity the games industry should jump at. It’s cruel to go through each week living in constant fear. It’s a roulette of panic that doesn’t ever stop. Giving someone in that boat a figure to relate to--maybe admire--might show them they’re not alone. It would provide an example that this is an adversity that they can overcome, regardless of how hopeless it seems at the time.

I could have used that when I didn’t understand my own severe OCD. I doubt I’m alone. People in our shoes are left with the impression that they’re somehow coming unhinged, or are outright crazy. This only makes the situation worse, leading to a destructive self-loathing. Speaking personally, seeing a character going through the same trials (albeit emerging victorious) would have provided a light at the end of a very long tunnel. It would have reminded me that victory is possible if I fight hard enough, no matter how bleak my situation appeared.


Although this might sound rather cornball, think it over for a second. Have you ever had an character you admired? For some it was Han Solo, an outsider who learns the value of working for the greater good in spite of his arrogance. For others, Spider-Man’s journey from self-centred teen to a man who wouldn’t back down from everyday problems is a huge influence. Why can’t those with mental illness or anxiety get someone to look up to as well? Tens of thousands need it, along with those who haven’t realised they aren’t alone. Video games are a uniquely interactive medium, and they should be taking a little more responsibility.

Additionally, this wouldn't only benefit those in the grips of mental illness. It would also push those who don’t understand to see things in a different way. That in itself is crucial, no matter how mundane it appears to be. Even as these characters might give hope, so they could open eyes too.


  • chainchomp - August 9, 2014 7:48 a.m.

    Good article and very thought provoking. But I didn't see the word recovery.
  • mesa12358 - August 7, 2014 3:26 p.m.

    Thankyou; that's a really interesting point, and not something I'd thought of. There is some precedent for an accurate representation of mental health issues in games: I'm thinking of To the Moon, which is by far and away the best depiction of autism I've ever seen in any form of media, but then that's not so much a game as a story with interactive gameplay elements. That makes me cry every time. But I guess it shows that it is possible. I'm really struggling to think of ways to incorporate mental health issues into the main, playable character of a game. The problem I'm having is that mental health is, well, mental: the only bit you observe from the outside is its effect on the person's behaviours, and the player controls the character's actions. So that's way more tricky to do, But I imagine it would be relatively simple to work this into an important side-character's personality; and watching them go through trials, overcome them, struggle and succeed, could be really good for people to see. I guess instead of having someone to directly empathise with, you have a role model. Not quite as good, but still something.
  • darkmorgado - August 9, 2014 6:07 a.m.

    Dude, Autism isn't a mental illness and it's actually quite offensive to label it as such. It's a developmental disorder, a very separate category from mental illness or learning disabilities. Completely different thing.
  • Clovin64 - August 7, 2014 11:55 a.m.

    I'm understand you're points very well, as I do a lot of research and reading about mental illness and I suffer from a personality disorder myself. It would be great to see videogames present some role models who overcome their own mental illnesses, but I'd imagine it could be complicated to realistically integrate mental illnesses like OCD, Schizophrenia, Dissociative Indentity Disorder etc. into gameplay elements. At least, not in a way that would'nt be very risky commercially. Like some of the other commenters have mentioned here, Indie games would probably be the most likely to challenge such as risky concept in a realistic and enertaining way. I wouldn't, however, expect to see the next Assassins Creed/Call of Duty include a protagonist with OCD.
  • DarthPunk - August 7, 2014 9:24 a.m.

    I can't imagine that ME the game would be the most compelling thing though
  • pl4y4h - August 7, 2014 7:56 a.m.

    Going off of what Jack had previously mentioned, for the most part people use games to escape from things like that. And similar to the sex article from earlier, most developers probably wouldn't be able to tackle it with enough...."maturity?" I guess would be the closest word. It would have to be crafted into a great story and not shoe-horned in just to be "edgy" and "different" (I mean hell, you think people complain about repetition in games now? A poorly tackled protagonist with constant OCD or tourettes outbreaks randomly thrown in that impede on your progress and you better believe that won't get sold). That risk alone means AAAs probably won't touch it.
  • Cruddi - August 7, 2014 6:43 a.m.

    When I leave the house and lock the door I will sit in the car and I will be hit with the over whelming need to go back and check that I locked the front door, I know I did in my head but I still have to go back. I don't think this OCD but just concerned about losing everything I own to a local smack head, but at times I get angry with myself over it because I worry it is an OCD
  • bko - August 7, 2014 6:33 a.m.

    This is why I'm grateful the dam has broken and indie developers are running wild everywhere. They're the ones who will take this subject matter on without restraint. AAA developers are often too petrified to even broach such subjects, much less center a game around such experiences, and they're only playing it safer and games get more expensive to make. But some of the stuff I've seen coming out of indie outfits -- even hastily assembled at game jams -- has put the big-budget games to shame in terms of emotional maturity. And it really puts into light just how powerful games can be as a way to convey experiences that are hard to put into words. Thanks for sharing, Benjamin.
  • jack-hannaway - August 7, 2014 6:07 a.m.

    This is a really interesting point, OCD in some cases should be addressed! Although perhaps checking locked doors 10 - 15 times or that the gas is on over and over - may be something that could be shown through a cutscene - I would rather not play my life out virtually as well as it may futher exacerbate said OCD!!!
  • ethan-gibbs - August 9, 2014 9:11 p.m.

    i dont really see the reloading after each kill thing as OCD halo did that to me because it is just good strategy and i check to see if i cut the oven off sometimes even if im almost sure i did just making sure.

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