We have advanced. Gone are the games with totally perfect and seamless heroes, so brave, kind and strong that they seem cut with the same pattern. Now we seek to represent real characters, with their insecurities, fears and traumas, that make us see that we are people like them, that they feel real.

When creating them, there are many resources related to personality that can be taken into account, and one that is sometimes forgotten is mental health . Approximately 16% of the world population suffers from some type of disorder or mental disorder, most of them related to depression or anxiety. 1 of every 59 children is within the autistic spectrum. And yet, the representation of this mental diversity within video games still leaves much to be desired.

You have to be responsible and careful when raising and creating characters that live them. It is very important to be fair with their symptoms and daily life, because by misrepresenting them we are helping to establish stereotypes and stigmas that are deeply rooted in society and that make life difficult for people who suffer from it. Although it is a very enriching resource, it can be a very dangerous weapon if it is not used properly.


If there are two things that are usually deformed when creating horror games is the religion and mental state.

In 2016, two California amusement parks were forced to close two of their virtual reality experiences by being accused of being offensive to those with schizophrenia and psychosis. The complainants stated that the game stereotyped and stigmatized the disease.

The recourse of illness and "madness" is recurrent in horror games. Any type of ailment is intimately related to death, and the representation of people who have "lost their heads" are interpreted by the game and the players practically as zombies or monsters without conscience. In some cases, losing the judgment is considered directly as a game over, as is the case of Eternal Darkness, which inherits it directly from the vision H.P Lovecraft had.

Continue using illnesses such as psychosis or schizophrenia as a focus for horror stories is, simply, unfair to the people who suffer it every day

Outlast uses the asylum resource as a gloomy place, full of patients reduced to an empty shell or with a speech so distorted that they can not be taken seriously. Silent Hill 2 is built on the premise of guilt and mental deterioration of its protagonist and the other characters he knows throughout the game. Until Dawn introduces Josh, from whom it is discovered that he suffers from schizophrenia, psychosis and depression , of which he only becomes a doctor for the latter, so he presents himself as an erratic, dangerous and unstable character .

Manhunt 2, from Rockstar Games, constantly abused stigmatizing completely invented stereotypes, encouraged the player to have fun murdering the sick and demonized those who care for them, as well as graphically and meaninglessly depicting suicide images.

While it is true that fear of the unknown is inherent in the human being, in a time where we can choose between zombies, aliens, monsters and demonic possessions, continue using illnesses such as psychosis or schizophrenia as a focus for horror stories is, simply, unfair to the people who suffer it every day


To the Moon by Freebird Games hit the market in 2011, touching the hearth of thousands of players who lived it as a wonderful story of love and sacrifice. More or less in the middle of the game we are revealed that River, wife of the protagonist, is a woman within the autistic spectrum. However, what we live as players, is all the suffering that Johnny, the main character, spends sacrificing for the illness of his wife.

The autism of River causes difficulties when communicating and, however, instead of showing us the difficulties and frustrations of it could feel, it seems that the game wants us to feel Johhny as a martyr of the disease .

Ilargi Blasco, clinical psychologist and editor, reflected this in her article "The TEA (not) told through To the Moon" for TodasGamers:" When we finish To the Moon, we leave with tears in our eyes, with a bitter feeling, that we have fulfilled our work (... ) And we're also leaving, just like Johnny, without being able to give voice to a woman whose life we only know from outside , who is not represented and whom, consequently, we will not understand. "

To the Moon. Video game about mental health

In To the Moon we live the story through Johnny and not his wife with neurodivergence.

Good omens.

However, it's not all bad news. In recent years, mental health has become an issue on the table. The good representation has begun to be taken seriously by the developers, which has led to fantastic works that don't sacrifice the veracity in search of entertainment , but have realized that it does not have to be at odds.

One of the most recent examples is Hellblade: Senua's Sacrifice, which in recent years has championed the new wave of representation. Ninja Theory, developers of the game, had a team of psychologists, neurologists and people suffering from psychosis to perform a true simulation about the experience of suffering from the disease .

Hellblade not only represents the symptomatology, through the voices and attacks suffered by Senua, its protagonist, but also delves into the social rejection, the stigma that people with this type of ailment have to endure. During the trip of Senua, in addition, we are providing explanations about the needs and problems of these disorders.

Another good example would be Night in the Woods that, through Mae, shows us how depression is part of the lives of many people. In addition, the other characters in the story also have their own problems, like Gregg, who suffers from a bipolar disorder.

In an interview for Kotaku, the creators of the game said they had left the mental health of the characters in ambiguity, so the story would progress naturally. They knew that they wanted to talk about depression, since all the members of the team had lived it, but they were trying to talk about the people who experience it, not about the disease itself .

Night in to the woods. Video game about depression

The characters in Night in the Woods constantly reflect on life and its unknowns.

Mae, at the beginning of the game, leaves the university to devote some time to take care of her mental health. A 2012 study by the National Alliance for Mental Illness in the United States showed that 64% of university students suffering from mental illness end up leaving their studies. Night in the Woods highlights a big problem with university students who don't have access to the necessary services to treat themselves, which makes young people like Mae end up sunk.

Other games, like Sym, represent anxiety as a constant struggle between light and dark, fear and loneliness, in which you have to constantly try to return to the situation of calm and stability. Whether through narrative or mechanics, the ways of representing these feelings and symptoms are infinite.

Small games, great stories.

It would be unfair and totally counterproductive to leave aside all those little games created by the personal experiences of its developers. Many are those who have launched to take small experiences in the form of mini-games that help show and visualize their mental state.

Adriel Wallick represented his anxiety in 2015 through his minigame Press X to be Okay, in which the player had to strive to 'be well' pressing X repeatedly until he got tired of keep fighting and the game is over.

Zoe Quinn, through 'Depression Quest', presents us with a 'choose your own adventure' type game in which we put ourselves in the shoes of a person with depression. As the game progresses, choices such as staying with friends or going out at night become less and less accessible depending on the decisions selected, until in the end the most profitable option seems to stay at home lying down in the bed.

Brie Code launched last year Selfcare App, which sought to give players their own space in which to take care of their mental health by focusing on themselves.

And like them, a lot of people dare every day to upload their little games about their personal experiences to itch.io with examples of games that deal with psychosis, the autism, the bipolar disorder and among many more .

And this kind of games, along with a lot of serious games, brings with it a new opportunity to teach beyond books and classrooms, in a family space, so that new generations have a more open and empathetic mentality

If you have more interesting examples or want to tell us something, send it to us in our Twitter, Facebook or Instagram.



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Marta Gil

Marta Gil

PR, Product Manager & Social Media in Gametopia. FemDevs Regional coordinator.
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