Yesterday was the first real test of my experimental course structure and it went as well as I could have hoped. For homework, students were required to read:
- Representation of Mental Illness in Video Games
- Framing Mental Health within Digital Games: An Exploratory Case Study of Hellblade
- Gaming with Stigma: Analysis of Messages About Mental Illness in Video Games
- Why Representation Matters in Video Games
Students were also required to either play or watch a walkthrough of The Elder Scrolls IV: Shivering Isles, a 2007 expansion to The Elder Scrolls IV: Oblivion. The premise of Shivering Isles is that Lord Sheogorath – Deadric Prince of Madness, The Mad God – is seeking a champion to defend his realm, the bifurcated land of Mania and Dementia. Not exactly subtle in terms of mental health references, but it’s week two and like any good game onboarding I wanted to make it pretty much make feeling successful and competent almost guaranteed.
Before class, students sent me a brief email with three observations from their play or walkthrough about what psychological or mental health portrayals they noticed. This assignment was one part easy points, one part familiarity check, and one part accountability check.
At the start of class, I spoke for about an hour about, high-level, mental health, mental illness, and why game devs should care about it.
I talked about research pertaining to stigma and stereotypes in media as well as specifically in games. The Ferrari et al article referenced above was one resource as was a 2016 study by Shapiro and Rotter that found, of the 90 or so AAA titles they studied, 25% portrayed a mentally ill character. In other words, devs need to care because mental illness is already pretty common in games and that these portrayals can have an impact. Specifically, perpetuating negative and harmful stereotypes about mental illness in media has been linked to decreases in willingness to seek treatment, and increases in self-stigma, discrimination, and marginalization.
Before I go any further, it’s important to emphasize that I do not believe people, when playing a game, take in and accept wholesale whatever they see. Playing games doesn’t make people violent (all the research), largely because we know 1) it’s not real and 2) we’re taught from infancy that violence is bad. We can enjoy these violent games precisely because we understand that it is pure fiction. It’s different with mental health, however. Unlike violence, most people do not receive any kind of education, either from loved ones or through the school system, about mental health. In fact, the #1 public resource of information about mental health is digital media – television, movies, the news, and games – and none of those mediums have a great track record with how they depict psychopathology.
For example, when mental illness is discussed in the news, over half the time it’s in relation to acts of violence; only 7% of news coverage of mental health mentions successful treatment or recovery. Because talking about mental health and sharing experiences related to mental illness continues to be significantly stigmatized (one of the top 3 reasons people don’t seek help, right after cost and geography), we don’t talk about how a person with a mental illness is 10x more likely to be the victim of a violent crime that someone without a mental illness or how persons with mental illness account for only 3% of all violent crime committed. What we’re left with is an enormous chunk of the population who have never been taught about mental health and whose main source of information is what is shown on a screen.
So, back to class! After lecture (and a break), it was game time. I’d spent almost the entire previous week replaying Shivering Isles and taking notes, so for class I brought in my Xbox One and had the perfect quest set up. Fittingly titled “Addiction”, the quest involves exploring Dunroot Burrow in to retrieve the Chalice of Reversal for Thadon, Duke of Mania.
The Chalice balances out withdrawal from Felldew, an addictive narcotic akin to cocaine or other uppers and a favorite pastime of Thadon’s. In order to enter the Burrow, the player must take some of the drug. The drug has an instant effect of buffing stats related to health and strength and the player gets a “Felldew Euphoria” notification. After a short while, however, the effect fades and the player begins to experience withdrawal; in this case, a decrease in attributes like strength, speed, and carrying capacity. Players need to continually take Felldew, which has limited availability throughout the burrow, to maintain their stats until they find the Chalice (and slay the “Felldew Addicts” that protect it).
During class, we’d discussed the portrayals students had noticed from their homework, mostly talking about character depictions, environmental design (e.g. naming the land Mania and Dementia), how “normal” NPCs treated those who had spent time in the Shivering Isles. But I saved the discussion on mechanical representation until after the play-through. I always find it hard to talk about how mental illness, or at least its symptoms, can be manifested in game mechanics and in what the player actually feels and does.
During the class play-through, I watched as students began to figure out what was going on, how the person playing began to look more stressed and at one point stated, “I need to find more cocaine!” (aka the Felldew). During play I actually asked the student who bravely volunteered to be the player how they felt, to which she said she felt more and more stressed as the burrow became more confusing and the Felldew harder to find.
At one point, the withdrawal took down the player’s carrying capacity which meant she had to sort through the inventory to find things to drop. Because this wasn’t her character and she hadn’t put time into building the inventory, it wasn’t a big deal. However, when I had my spouse play through this part (for science of course), he was quite precious about his inventory and, when forced to drop items, seemed distressed. He described it as, “I had to give up things that were important to me. I had to make hard choices.”
We talked about all of this until the end of class, how this particular mission was designed to provoke feelings similar to those an addict may experience. Feelings of stress, discomfort, confusion, disorientation, anxiety, giving up things, and making hard choices. Obviously this is not a one-to-one experience for what someone living with an addiction experiences, but it’s a flavor and generated interesting conversation around how we talk about drug addiction and the term “addict.”
Next week, we start a section that digs deeper into specific mental disorders and their in-game portrayals. Readings for next class are:
- Night in the Woods: A review
- I want more depressed video game characters: Here’s why
- Playing autobiographically with depression