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Hellblade’s portrayal of mental health is a watershed moment for video games

The British video game dominated the BAFTAs, standing out for bringing a sensitive approach to a maturing medium

There is a sect of video game fans for whom April 12 2018 will forever be remembered as a landmark day. This was the date of the British Academy Game Awards, the 14th since their creation in 2004, where the Cambridge-based studio Ninja Theory, makers of independent British video game Hellblade: Senua’s Sacrifice, took home five of the ceremony’s biggest prizes.

The awards were for Best British Game, Artistic Achievement, Audio Achievement, and, for Melina Juergens, the actress charged with depicting the titular Senua – a Pict warrior thrust into Viking ruled Orkney in the late eighth century – the Best Performer Award. But it was the studio taking home the inaugural Beyond Entertainment Award, that was most significant to the aforementioned sect.

Introduced just this year, the Academy describes the new award as one that “capitalises on the unique and maturing medium of games, to deliver a transformational experience beyond pure entertainment. Whether this is to raise awareness through empathy and emotional impact, to engage with real world problems, or to make the world a better place”.

For Hellblade, a game that fearlessly confronts the experience of psychosis – the developers riffing on the Celtic idea of ‘gelt’, a term used to describe a person who had been driven mad by grief or trauma, and who would thereby be cast out by their community into the woods in search of penance and purgatory – there was no game released within the last twelve months that fit the criteria quite so snug.

The game’s victory, as well as the creation of the award itself, felt like progress. For years, mental health has felt like it’s only depiction within gaming was as a fantasized, one note, even dangerous depiction of insanity. Many were set in juiced-up, video nasty takes on insane asylums (notable examples include the insensitive, but extremely scary Outlast, or the insensitive, not especially scary Dementium: The Ward on the Nintendo DS).

In fact, insanity is the go-to framework for a vast number of horror games to hang their narrative upon. Titles such as Eternal Darkness: Sanity’s Requiem or Alice: Madness Returns even feature devices like ‘sanity metres’ within them, a sliding scale of ‘madness’ that ultimately warps the players world.

In 2007, a group of US senators, including Hillary Clinton, called for the game Manhunt 2 to be recalled from sale or modified for its “irresponsible, stereotypical portrayal of mental illness”, going on to argue that they didn’t back censorship of entertainment, but expected a “higher standard” when it came to understanding mental health.

Not that this basic misunderstanding of mental health on behalf of video game studios is solely restricted to horror games. Grand Theft Auto V, the most financially successful entertainment product of all time, with over £4.3bn generated worldwide and 90 million copies shipped, featured a playable protagonist called Trevor. He’s a violent and unhinged man whose past struggles with mental health forms the basis of one long punchline throughout the game. Creator Rockstar’s cry of ‘it’s just entertainment!’ doesn’t cut it, when it also longs for its products to receive the credibility afforded to mediums like film, television and literature.


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As the excellent online games resource Polygon puts it, such depictions in games are dangerous, in that players “aren’t encouraged to understand and empathise with mental illness, but to fear it”. Similarly, there is an issue that poor writing, or just a linear gameplay device, means that in many games, a character’s mental health is their defining feature. A character isn’t a mother or a father, a brother or a daughter, as much as they are their illness.

There’s a great adventure game called Actual Sunlight that was released in 2015 about a severely depressed 30-something man called Evan Winter who lives in Toronto and hates everything. Depression is the filter through which he sees the world, but he isn’t depression. It’s only with writing as nuanced as Actual Sunlight that video games will receive the confidence that they’re equipped to deal with mature, multifaceted themes like those depicted in other mediums of entertainment.

Hellblade isn’t a game you have to look for. If you turn on your Xbox or your PS4, it’s, in the store, one click and you own it. There’s power in such visibility. With visibility comes change

Thankfully, it’s not just Hellblade that’s contributing to a turning of the tide. Created by husband and wife team Ryan and Amy Green and assisted by tiny studio Numinous Games, That Dragon, Cancer is an autobiographical game for iOS and PC, concerning the couple’s son Joel and his fight with cancer. Joel ultimately lost, and the game explores his parents’ battle with depression and anxiety during this wretched journey. There’s also Pry, again for iOS, which deals with PTSD among army veterans, an extremely innovative game that explores repressed memories and buried trauma, via a swarm of language and oblique images.

Within this independent realm of game creation, freed from the shackles of huge commercial expectation, there are numerous examples of titles filled with empathy, that take the medium forward. But one reason why Hellblade and Senua’s adventure, and its resulting acclaim felt so poignant, is that it isn’t a game you have to look for. If you turn on your Xbox or your PS4, it’s in the store; one click and you own it. There’s power in such visibility. With visibility comes change.

Hellblade Senua's Sacrifice
Hellblade: Senua's Sacrifice scooped five Bafta awards for its sensitive portrayal of mental illness

For the creation of Hellblade, developer Ninja Theory recruited a team of mental health professionals to assist throughout its development. One such person was Professor Paul Fletcher, a neuroscientist and psychosis expert at the University of Cambridge, and the first name the player will see in the credits. He’s excited by how destigmatising the game’s depiction of Senua’s mental health might prove to be. “It’s refreshing to see a representation of psychosis in which the person isn’t just a sort of passive receptacle for madness.” he says. “Senua is the hero of her own story, trying to make sense of her experiences and work her way through them.” In fact, the game’s director Tameen Antoniades is open about how the creation of the game challenged his own misunderstanding about such conditions, saying that upon learning that recovery isn’t always about “curing yourself” but “finding ways to live with it”, it was a teaching that he describes as a “revelation”.

It’s likely the game’s audience, swelled by its awards victory and its subsequent increased prominence, will come to the same conclusion.

Main image: Ninja Theory

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