13 min read
We can learn about our cultural values by looking at the media we consume. In other words, how various groups of people are portrayed in the media communicates a feeling of cultural value, which we then absorb and incorporate into our general thoughts, values, and beliefs. This can have a good effect as in for instance, when people watch inspirational entertainment, their worldview may change to one of a "benevolent world", however briefly, and embrace more optimistic ideas about people. The flip side of this notion, however, is that stereotypes can be created and reinforced by media messaging, which can have a more damaging effect.
Stereotypes are widely held cultural presumptions about a particular group of people’s relationship to a particular trait. It is the creation of bias in how information about any given group is processed that makes a stereotype more than just a social classification. That is, even when confronted with knowledge that defies a person’s preconceived bias, they may still hold onto that stereotype. While stereotypes by themselves may not be harmful, the labelling and categorization that goes along with them frequently supports discrimination—the unfair treatment of various categories of people—and marginalization—a division between us and them—both of which have serious, adverse effects in the real world.
Getty Images/IStockphoto
To elaborate, according to research, media messages about a range of topics, such as body image, race and ethnicity, gender roles and identity, and more specifically, mental illness, help to create and maintain stereotypes. Particularly, labelling and stereotyping—which frequently derive from media messages — film, television, video games—are significantly responsible for creating and shaping the stigma that surrounds mental illness. According to Wahl (2003) quoting the US Department of Health and Human Services (1999, p.viii), “Stigma tragically deprives people of their dignity and interferes with their full participation in society”.
It might surprise you, Rockstar, but the mass media has been found to be the most common source of information for the general public about mental illness and the tendency is towards representing mental illness as an object of ridicule, “...characters with mental illness are often portrayed as being fundamentally different than other characters at best and deviants at worst”. Earlier studies show, exposure to negative media portrayals of mental illness is associated with not only stereotyped views of those who are mentally ill but also show a decrease in the behaviour to seek out treatment for those who are mentally ill. This is why accurate representation of mental illness is crucial in our mass mediated cultures, of which video games play a large role in.
So, what does all this have to do with you, Rockstar Games?
Well, several video game studies found that portrayals of mental illness often tend to be negative, exaggerated, and inaccurate, with people with mental illness frequently portrayed as violent, criminal, dangerous, and psychopathic. The six common mental health tropes identified in video games include; the homicidal maniac, the rebellious free spirit, the enlightened member of society, the female patient seductress, the narcissistic parasite, and the zoo specimen.
As I examined these studies that inform the public with dangerous messaging about mental illnesses, I came across many familiar titles that you might recognize. For example, this study, which examined the top 30 best-selling video games for each year from 2002 to 2019, and the top 20 titles from each year from 2020 to 2021, I discovered 6 video game titles developed and created by Rockstar Games. They include: Red Dead Redemption II, Max Payne, Max Payne 3, Grand Theft Auto: San Andreas, Grand Theft Auto: Vice City and Grand Theft Auto:V. Of the six titles mentioned, five had characters deemed to have “negative” mental illness representations in that the illnesses presented, were stereotypical in how the media often portrays these illnesses, for example, a homicidal schizophrenic, or a psychotic madmen suffering from hallucinations.
The following diagram charts out the distribution of mental illness representations in popular games from the researcher’s analysis. It appears that schizophrenia-like depictions were the most common, the majority of which were found to be negative portrayals. For a more comprehensive look, please see the actual study linked above.
Of Rockstar’s titles mentioned in the study, only GTA: San Andreas had a “neutral” representation of depression and suicidal tendencies, of which the game player was able to assist in getting the character help through game mechanics. I suppose all is not lost considering GTA: San Andreas entered the market in 2021 when conversations surrounding mental health stigmas (and how we talk about mental illness) in the last 5 to 10 years has somewhat improved. But couldn’t we possibly do better than one game in a bevy of best-selling releases?
You might say that GTA is your most lucrative series to date, and it’s obvious (given record sales into the billions) that gamers want to see more of the same. However, a quick search on Reddit regarding the importance of accurate mental health depictions in video games is also quite telling. Gamers actively seek out positive or at the very least, accurate mental health depictions as this poster from r/GirlGamers asks:
From user, u/Psyduck_used....” I'm in an incredibly tough place mentally right now and feel that playing something that reflects certain issues might be helpful. Specifically, something that deals with depression, trauma, and social anxiety or social isolation.”
Or this post from u/Free-Progammer9518 on r/gamingsuggestions:
Or from u/SaneSchizophrenic who posted on r/gamedev, and who subsequently suffers from schizophrenia. I’ve highlighted in blue the portion to take note of.
As you can see, Rockstar Games, there is no shortage of gamers seeking gameplay that accurately reflects mental health concerns. I've only provided you a snippet of what's available on these Reddits.
This leads me to the next point that can not be left out of this dialogue. The issue of empathy. Or, perhaps more importantly, the need that mental illness be portrayed in video games in a way that encourages empathy for those who are affected by it as opposed to the present narratives, which often emphasize the need to fear or disparage them. When the general public has erroneous and unfavourable attitudes towards people who have mental illness, such as the belief that they are violent, unpredictable, unworthy, and unlikely to ever be effective members of their communities, it perpetuates the negative stigmas and discourages empathy. These depictions reinforce the idea of "hostile environments" for those who suffer mental illnesses and may undermine treatment seeking.
Interestingly enough, there is mounting evidence that suggests that most people who suffer from mental illness do not engage in violent behaviours. Many of your video games that misrepresent those with mental illness as psychotic, homicidal, etc., perpetuate the stereotyping of the violent mentally ill person for gameplay or exposition purposes. I’m here to tell you that it CAN BE DONE DIFFERENTLY both for commercial success and entertainment value as well as impacting those who suffer from mental illness, positively.
There is a wide selection of video games available now that present a constructive image of mental illness. In spite of the fact that these games are typically of a more modest scope and are developed by Indy studios, Hellblade: Senua's Sacrifice stands out as an especially lucrative example of the genre.
Image Courtesy XBox Wire
Hellblade: Senua's Sacrifice is an action-adventure game developed and published by Ninja Theory. The story follows the protagonist, Senua, a young Pict warrior who suffers from severe psychotic mental illness. She embarks on a journey to rescue the soul of her lover, Dillion, from the Norse underworld of Helheim. Senua's mental illness causes her to experience hallucinations and delusions indicative of psychosis, which the American Psychological Association defines as a “gross impairment in reality testing”.
In order to accurately depict Senua's psychosis, Ninja Theory consulted with world-leading neuroscientists as well as organisations such as the Welcome Trust during the development of the game. This allowed them to properly portray Senua's psychosis in a way that was both realistic and non-reliant on typical tropes used to portray mental illness in other forms of media and video games. They also met with real people who had psychosis and performed interviews with them, after which they incorporated the patients' experiences and feedback into the game itself.
Hellblade’s successful depiction of mental illness has garnered them multiple awards including the BAFTA awards for Best British Game and Games Beyond Entertainment, along with the Games for Impact award at The Game Award. To date, Hellblade has taken home 12 awards but despite its accolades and perhaps more importantly, the game changed a lot of lives. Players with mental illness who played the game or players who knew people with mental illness contacted the company in the hundreds to express what it meant to experience such a realistic and thoughtful portrayal of the illness in the game. In spite of its lucrative profits from sales, Hellblade is the measuring stick for a truly successful game as it demonstrates the impact the game had on individuals who played it.
Perusing the r/Hellblade reddit site you will find scores of stories on the positive impact this game had on its players. One such post gave me pause for its raw emotion and eloquent expression. Imperium8 writes:
Hellblade’s accurate portrayal of psychosis through the embodiment of the main protagonist who struggled with it had a two-fold effect on players. First, it allowed for a tremendous amount of empathy and compassion towards those experiencing psychosis, which is crucial if we are to understand their struggles accurately and not stigmatize or fear them. And second, it gave those suffering from mental illness a sense of accurate identification with the character. As in how Imperium8 (above) no longer felt alone in his struggles because the game helped him see that others could understand what he continues to go through. Thus, you can see the crucial importance of accurate mental health depictions in video games.
Rockstar Games needs to create characters and games that build empathy and understanding of sufferers with mental illness. Like Hellblade, this can be done in a multitude of ways. In Hellblade, mental illness is portrayed via the lens of four distinct themes: as a gift, as the product of competence, as a hell or curse, and as a process of conquering obstacles. The procedurality and the rules of the game, as well as the game's audiovisual aesthetic, all serve to illustrate these ideas.
It is possible to depict mental illness not as a narrative justification for horror, but rather as something that occurs naturally in everyday life. The character's mental health could be portrayed as a difficulty that needs to be overcome, addressed, and possibly even improved upon, rather than as a stereotype that is used to explain the villain. In order to avoid inaccurate or even totally uninformed depictions of what it is like to experience the symptoms of mental illness, game designers can take a page from Hellblade's playbook and incorporate mental health professionals and people with mental illnesses into the process of creating media in order to gain insight into how those depictions are portrayed. By the use of control techniques similar to those seen in Hellblade, video games have the potential to incite a physical and interactive empathy in persons who suffer from mental illness. These portrayals are important to consider. They contribute to the formation of public opinion, which in turn contributes to cultural practises that have the potential to cause significant harm to individuals who suffer from mental illness.
As leaders in the gaming industry, YOU, have the ability to take the initiative in this critically vital area and truly live up to your potential as the ROCKSTARS you were always meant to be.
Cheers, and welcome to The Advocate's Corner. I'm Viki Posidis, known as a writer/director and all round creative person. You'll find I often root for the underdog, the marginalized, the oppressed, the disenfranchised, the victims of social institutions/injustices, etc. If reading this kind of stuff is up your alley, then consider dropping your email in the subscription and you'll get my musings in your inbox each month. Thanks for stopping by!
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