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What is the Reality of Mental Health Stigmas in Video Games?

Updated: Mar 20

Written by: Lainey Huffman

Edited by: Huimin Zhuo

It is not a secret that many individuals play video games in order to escape. With such vast, expansive worlds and stories right at one’s fingertips, it seems like a viable coping method to drown out worldly troubles. Gaming is an easy and fun way to forget about troubles such as stress, anxiety, depression, and other daily difficulties. Knowing how often gamers rely on this form of escapism to aid their mental battles, it is also important to dive into what mental health in video games really looks like, as well as what effects it may have on game developers and gamers alike. Whether the spotlight is on developers, game content and character portrayals, or simply on gamers themselves, there is much to be said about the ups and downs of mental health in the gaming industry as a whole.

When video games contain aspects of mental health, regardless of how clearly or subtly they are presented, it is necessary to understand how these portrayals might affect players. There is a very fine line when games utilize mental health/illnesses as influential aspects to their storyline.


On one hand, video games can (and definitely do) provide an amazing outlet for individuals looking to forget about their troubles for the time being (that is, when mental health is handled correctly). There lies a simple beauty in the ability to find joy and control in immersive, fictional worlds, especially for those who lack these experiences in their own realities.


Alternatively, there are deeply rooted issues of stigmatization present in countless games. Before we get into the nitty gritty of it all, it is important to properly define stigma as it relates to mental health in video games. According to researcher Elizabeth Dickens in her work on mental health stigma in horror video games, “stigma is described on its most surface level, in terms of mental health, as qualities associated with mental conditions that are directed towards those deemed lesser in the social sphere,” (109). In other words, this stigma portrays individuals with mental illnesses negatively - often as broken, damaged, or even unpredictable and scary. An additional study done by Manuela Ferrari et al. finds that 97% of Steam video games from their research in the years 2016-2017 were found to portray mental illness in stigmatized ways. These stigmatizations not only display a destructive image of and for people suffering from mental illness, but can trigger players who experience symptoms themselves. The American Psychiatric Association tells us that because of the effects of stigma, people often avoid seeking help or treatment for their mental illnesses, and social isolation is common. It is a proven fact that about half of those who experience mental illness do not seek out treatment. Playing video games with harmful portrayals of mental health can aid this statistic as they can lower a gamer’s self-confidence and willingness to communicate their emotions.


Let’s break down some general statistics to gain perspective. According to the National Alliance on Mental Illness, 1 in 6 youth and 1 in 5 adults in the U.S. experience mental illness each year, and 50% of all lifetime mental illnesses are developed by age fourteen. To take these numbers into consideration for the gaming community, about 65% of the entire U.S. population are gamers, and this percentage is only rising each year. With such daunting overall mental health statistics in our country, what can that mean for the exposure to stigmatization that our fellow gamers are enduring?


Particularly, games categorized under the horror genre have countlessly used mental illness as means for a cheap thrill, oftentimes depicting asylums and their patients as dangerous and uncontrollable. For example, the game Outlast (2013), developed by Red Barrels, is about an investigative journalist who explores an abandoned asylum. The patients in the asylum are disfigured, rabid, and downright terrifying; not to mention that the player often has to kill them throughout the game. From the surface, it seems to be an enjoyable game for thrill-seekers and overall horror nuts looking to get their fill of being scared. However, these problematic stigmatizations are present throughout the entirety of the plot, which provides a harmful image for individuals who suffer from mental illness. In reality, most people who play games like Outlast probably do not notice such stigmas so explicitly. Despite this, the simple presence of them can influence a person’s thought processes, even if unconsciously.


While Outlast was ultimately filled with harmful tropes for mental illness in its storyline, games like Dontnod Entertainment’s Life is Strange (2015) and Ninja Theory’s Hellblade: Senua’s Sacrifice (2017) do a much better job at depicting mental illness in a constructive and realistic way. In Life is Strange, main characters Max and Chloe both experience symptoms of depression and anxiety. The characters are well-rounded and relatable. Mental health resources are listed in the game when it deals with heavier topics such as self-harm and suicide. In Hellblade’s case, the main character Senua has psychosis, a mental illness that causes “strange or bizarre thinking, perceptions (sight, sound), behaviors, and emotions,” (Cheang, Mental Health America). Individuals who have psychosis often struggle with depressive moods, difficulty concentrating, social withdrawal, and hallucinations. Although Senua’s mental illness is explicitly portrayed in Hellblade, the storyline does not try to “fix” her illness or invalidate her experiences. Games like these two accurately approach and handle mental illness in a way that is not harmful or stigmatized and other games need to follow suit.


Rather than encouraging society’s already-negative views on individuals who struggle with mental health, games should focus on portraying mental health in a more realistic and positive manner. Thus, the effects on players might not be as detrimental. Overall, it is important for gamers to know their limits. There are plenty of games, as well as gaming communities, that will nurture and guide individuals rather than stigmatize them. Gaming organizations such as TakeThis, CheckPoint, Safe in our World, and Rise Above the Disorder (RAD) work tirelessly to promote positive influences on mental health in the gaming industry. Each of them provide resources to the gamer in need as well as other helpful information and guides.


It is vital to promote and increase awareness about the harsh realities of mental health in video games, as the previously mentioned organizations do. We can end stigmatization and nurture safe, secure environments for ourselves and our fellow gamers this way. Game developers should tread carefully with mental health content, ensuring that experiences of individuals are not devalued or handled insensitively. It is up to all gamers alike to help educate and implement strategies for bettering mental health in our communities.

*If you or someone you know is struggling with mental illness, please check out these resources below.

Professional, psychological help resources and helplines:


National Alliance on Mental Illness National Helpline

Substance Abuse and Mental Health Administration’s National Helpline

Mental Health.Gov’s Crisis Resources

Call 1-800-273-TALK (8255) for the national suicide prevention lifeline, call 911, or text MHA to 741-741 to reach a trained crisis counselor.


Gaming organizations that support mental health for gamers:


TakeThis

CheckPoint

Safe in our World

Rise Above the Disorder

References


Borenstein, J. (2020, August). “Stigma, Prejudice and Discrimination Against People with Mental Illness.” American Psychiatric Association. https://www.psychiatry.org/patients-families/stigma-and-discrimination


Cheang, J. (2017, August). “How a Video Game Could Change the Way We Think About Mental Health.” Mental Health America. https://www.mhanational.org/blog/how-video-game-could-change-way-we-think-about-mental-health.


Dickens, E . (2017). “An Evaluation of Mental Health Stigma Perpetuated by Horror Video Gaming.” The Young Researcher, vol. 1(1). http://www.theyoungresearcher.com/papers/dickens.pdf.


“Exploring the Psychological Benefits of Video Games: Research.” (2019, June 05). CheckPoint. https://checkpointorg.com/games-research/.


Ferrari, M., Mcllwaine, S. V., Jordan, G., Shah, J.L., Lai, S., Lyer, S.N. (2019). “Gaming With

Stigma: Analysis of Messages About Mental Illnesses in Video Games.” JMIR Publications. https://mental.jmir.org/2019/5/e12418/.

Judge, A. (2018, July 14). “Video games and mental health: ‘Nobody's properly talking.’” BBC News. https://www.bbc.com/news/newsbeat-44662669.


Kaushik, A., Kostaki, E., & Kyriakopoulos, M. (2016). “The stigma of mental illness in children and adolescents: A systematic review.” Psychiatry Research, 243, 469-494. https://doi.org/10.1016/j.psychres.2016.04.042.


“Mental Health By the Numbers.” (2020, December). National Alliance on Mental Illness. https://nami.org/mhstats.


Wakefield, J. (2018, January 02). “Gaming addiction classified as a disorder by WHO.” BBC News. https://www.bbc.com/news/technology-42541404.



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