Playing video games can be many things: entertaining, collaborative, emotional, or even a learning experience. Using video games for education is nothing new, but in recent years developers have seen how interactive media can help create an understanding of those around us. According to Professor Paul Fletcher at the University of Cambridge, “Video games can be powerful tools because they are absorbing and immersive. They require active participation, and they allow players to explore new and uncertain worlds.” The topic of mental illness is one such area that feels uncertain to many. So, when Ninja Theory created a game to break the stigmas about mental illness and supply an immersive experience in the form of Hellblade: Senua’s Sacrifice, many saw it as an amazing use of the media and technology as a tool to educate.
I am sure when I say “mental illness” in the context of video games, you might think of the multiple negative tropes that have been used over the years. The horror video game genre is filled with patients in asylums as a tool to produce fear in players or games where you have a sanity meter which you keep in check with items in the game. These depictions are problematic as they make mental illness something to be feared or oversimplify mental illness as if it is something that can be easily turned on and off. Thankfully now we are getting games like Hellblade which work to push these types of problematic tropes away and build an educational foundation instead. To give a quick summary of Hellblade, you play as Senua, a Pict warrior who is travelling to Hel to save her partner’s soul after he died. A narrative that draws upon Nordic myths is not too different from others we see in games such as God of War (2018), but the difference with Hellblade is: Senua has psychosis. As the player, you are put into her mind, experiencing the story along with her as she both struggles with and comes to terms with her mental illness.
According to the National Alliance on Mental Illness (NAMI), “Psychosis is characterized as disruptions to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t. These disruptions are often experienced as seeing, hearing and believing things that aren’t real or having strange, persistent thoughts, behaviors and emotions. While everyone’s experience is different, most people say psychosis is frightening and confusing.” To make sure psychosis was shown accurately and respectfully, the developers at Ninja Theory brought individuals who live with psychosis and mental health practitioners to the table to provide insight and feedback. This collaborative research allowed for the voices of those being represented to have a say in how the game presented what they experience. Game Informer magazine described how through these interactions developers began to see Hellblade within the video game format as an opportunity for players to see the world through the eyes of someone with psychosis and to better understand them.
The effects of psychosis on a person were then interpreted into the narrative, graphics, and binaural audio, or 3-D audio. The audio, to me, was the most eye-opening feature of Hellblade as you play through each stage of the game. The sensation of disembodied voices whispering in your ear, moving around you—some coaxing you on, others filling you with doubt about your choices, some threatening you, others meek and worried about you—at times is overwhelming, but then when the voices go silent you begin to worry where they have disappeared to! What makes this portrayal of psychosis respectful, though, is despite her mental illness, is Senua still a strong, brave, and independent warrior. She can talk back to the voices and push them aside sometimes, but other moments they overwhelm her, and there is nothing the player can do to prevent these moments. While this may be a minor spoiler, I feel it is also important to note how Hellblade ends the game with the voices still present in Senua’s head. The game was never about curing Senua’s psychosis, as there is no cure for mental illnesses, instead there is treatment, therapy, strategies, and resources available to help.
The immersive experience of Hellblade represented psychosis to players so effectively that the developers at Ninja Theory won the Psychiatric Communicator of the Year Award from the Royal College of Psychiatrists in 2018 for providing a “candid and honest portrayal of mental illness, presenting psychosis in a first-person experience”. Good communicators for mental health and examples in the media we consume are important, as in the United States one in five adults experience mental illness each year according to NAMI’s February 2021 factsheet. As Hellblade shows, you never know the struggle someone may be having with their own mind. Even if Senua’s experience is only one person, her story has allowed many players to understand psychosis better without negative tropes causing more harm than good for those who deal with mental illness daily. In 2018 Ninja Theory posted on their YouTube channel an accolade video that showed just how much Hellblade: Senua’s Sacrifice meant to fans. One quote I think sums up the amazing impact of this video game: “With this game, I’ve found the language I need to talk about my childhood illness. A way to teach compassion for people that suffer from psychosis. No other game, book, movie or artform has done it so amazingly well.”
For more information on mental health, tools, and resources for treatment, I encourage you to look at the NAMI website.