A mindset to match The Evil Within

I think a lot about mental health. Partly because I co-founded a charity dedicated to increasing empathy and education about mental health issues, but mostly because I love horror games like The Evil Within. Zombies and ghosts and demons are fun, of course, but what I really like is a good old-fashioned psycho killer. See? "Psycho," as in "crazy," as in "mentally ill." Part of The Evil Within, like so many other horror games, takes place in an abandoned mental asylum (they're always abandoned and left to decay, never bulldozed and turned into condos). There is a stigma about mental health that prevents people from seeking care, and even though I believe the way mental health is portrayed in entertainment is a big factor in maintaining that stigma, I still love me some crazy bad guys. So, I think a lot about mental health.

I'm going to use some terms in this article that get thrown around a lot when discussing the mentally ill, like "crazy," "psycho," "nutcase," and so forth. These are commonly-used, accepted shorthand, but they're not appropriate when encountering real-life situations of mental illness. Just don't. At the very least, it displays a lack of awareness of the scope of mental conditions, and at the worst, it's pejorative and rude. Mental health issues are a touchy enough subject without making those who have them feel even more self-conscious about it. Do I think the same sensitivity needs to be shown to fictional characters? No, I don't, but that's where we start to run into the problem with depicting mental illness in games and other media.

Let's start with some basics: Despite what you've seen in movies, comic books, TV shows and games, mental health issues are, for the most part, mundane. Like physical health issues, they cover a broad spectrum of conditions, from minor stuff that's the mental equivalent of hay fever to something more serious like leukemia. One in four working adults currently has some kind of mental health issue, so odds are pretty good that you or someone you know has something going on in the ol' brain box. Most of it is treatable and utterly ordinary.

Of course, someone controlling their panic disorder through a combination of diet and exercise doesn't make for very exciting drama, so naturally that's not what we tend to see in our entertainment. We rarely get genuinely accurate portrayals of anything in media (unless the apartments in New York are way larger than I've been led to believe), so that in and of itself isn't such a problem, but much of the audience lacks the valuable context to know what parts are being exaggerated and which aren't. You know that Vaas from Far Cry 3 is loony tunes, but if he's your only reference point for mental illness, small wonder if you get a little uneasy when your pal tells you that he's started to see a therapist. We know what an ordinary person can do physically, so we know that when Nathan Drake takes four bullets to the chest and keeps running, that's fantasy. Not all of us know what an ordinary person with mental health issues goes through, so we can't draw as clear a line when we see a cultist in Silent Hill.

Hyper-crazy antagonists have value in our entertainment, however; because they're known to be unhinged, they have license to do all manner of excessive, outrageous, shocking things. Batman wouldn't be nearly as entertaining if he didn't have various Arkham Asylum alumni to battle, after all. (Not that Batman is exactly the poster child for excellent mental health, himself.) Sending our antagonists around the bend makes them easier to understand and enjoy, because it makes them feel less real; no sane person would do such horrible things, after all, and obviously anyone who's truly crazy is very easy to spot. And therein lies one of mental health's biggest misconceptions – the notion that "crazy" is binary. That you either are or you aren't, and if you are, you're putting on costumes and hearing voices, and if you're not, you're a perfectly rational, level-headed person. There's a whole lot of gray area when it comes to gray matter, I assure you, and while it's certainly true that some conditions can make a person violent or dangerous, they are the minority. I think most people understand that on an intellectual level, but because people are reluctant to talk about mental health issues in general, many of us haven't yet grown to understand that on an emotional level.

It's easy to understand the appeal of hospital imagery in horror games, particularly, because sickness is the ultimate betrayal – your own body fighting against you. Even though it's scary, physical illness is something we can wrap our heads around; You fall down a well, you break your leg, or maybe you smoke too much and develop lung cancer. Mental illness, however, is this vague, nebulous sort of thing that happens out of sight. Did you catch it? Were you born with it? Was it lurking somewhere in a dark corner of your brain, just waiting for the right moment to leap out and say, "Boo!"? A skilled writer or artist can make just about any location scary, but a lot of the legwork's already been done if you set your scary story in a mental hospital. Simply put, crazy creeps us out.

I'm an advocate for greater empathy and awareness when it comes to mental health issues, because I want people to feel comfortable getting help for them. I want someone to feel as normal admitting that they have anxiety as they do admitting they have a cold, because it makes it far more likely that they'll get appropriate treatment and lead happier lives. I'm okay with media representing an exaggerated view of mental issues, because I have appropriate context for them. I also recognize the shivery fun to be had by shambling through the blood-stained hallways of an abandoned mental hospital, or listening to an audio diary about Patient 32's emergent psychoses, and I don't want to deny that to anyone - I just hope people make an effort to understand the reality while appreciating the fantasy.