Portraying Mental Illness in Video Games: Exploratory Case Studies for Improving Interactive Depictions

Video games possess a unique capacity to simulate psychological states through interactive mechanics, control schemes, and procedural design. By examining titles such as What Remains of Edith Finch, Hellblade: Senua's Sacrifice, and Doki Doki Literature Club, it becomes clear that the medium is currently at a crossroads between perpetuating reductive, harmful tropes and pioneering empathetic, nuanced representations of mental health. While some interactive experiences frame psychological struggles primarily as sources of horror or manifestations of lost agency, others successfully leverage professional consultation and lived-experience insights to humanize these conditions, illustrating both the challenges and the inherent strengths of the individuals involved.

The integration of specialized design choices—such as auditory hallucinations represented through spatial audio or control systems that mirror cognitive fragmentation—allows players to engage with mental illness in ways that traditional media cannot replicate. Hellblade: Senua's Sacrifice serves as a primary example of how collaborative development can transform a game into a tool for understanding, effectively moving beyond the common industry tendency to equate mental health issues with violence or inevitable tragedy. These design strategies demonstrate that interactive media can function as a form of peer support, fostering empathy rather than merely exploiting psychological distress for narrative tension.

Future progress in this field requires a shift toward standardized best practices that prioritize accuracy and ethical representation. By moving beyond isolated case studies toward large-scale content analysis, the industry can refine its approach to depicting mental health. Ultimately, video games hold significant potential as non-pharmacological interventions capable of improving public perception and individual well-being. Establishing a framework for responsible design is essential to ensuring that the medium contributes positively to the broader discourse on mental health, moving away from stigmatizing tropes toward a more holistic and supportive portrayal of the human experience.