"One in four of us will experience some kind of mental health problem at some time in our life," reads the Getting Help section of the UK Mental Health Foundation website. And yet talking about issues of mental health is something we inherently struggle with as a society. Worse still, statistics echo just how devastating the result of this incessant and systemic failure to share how we feel really is.
For example, did you know that depression affects 20 to 25 percent of Americans aged 18 and over in a given year? Or that the latest NHS figures show the number of deaths annually among mental health patients in England has risen by over a fifth in the last three years?
Did you know that the same set of figures shows the number of people killing themselves, or attempting to do so, in England has increased by 26 percent year-on-year? That in 2012-2013 that figure was 595; but in 2014-2015 it'd jumped to 751? Did you know that there were 41,149 suicides in 2013 in America—which is a rate of 12.6 per 100,000 people?
That's the equivalent of 113 suicides per day. Or one every 13 minutes.
Did you know this? If you did, great. If you didn't: now you do. Either way, it took me less than five minutes to find this information. You see, many people fear the unknown. One in ten people suffer from anxiety in Britain, which is a condition characterized by many medical professionals as an irrational fear of events that have uncertain outcomes. The spectrum of mental health—like any other illness or condition, as outlined by the statistics above—is not the unknown. So why do we fear it?
"Mental illness is an intensely personal thing that is often vilified by society and the tropes that exist in our media perpetuate misinformation," says Lucy Morris. "Video games aren't innocent of that at all—games have the same accountability as film and books and music to stop spreading misinformation and stigma about mental illness."
A native New Zealander, Morris is an independent game developer and lecturer in creative technologies at the prestigious Media Design School in Auckland. In 2014, she co-founded the Women in Games NZ initiative, and was named in both MCV Pacific's Top 75 Most Influential Women in Games in 2015 and Develop's 30 Under 30 in 2016. In her precious spare time she organizes game jams, one of which she runs by herself that's now in its fourth year of existence: Asylum Jam.
Inspired by Ian Mahar's Kotaku article Nobody Wins When Horror Games Stigmatize Mental Illness, that challenged the themes and sentiment of horror game Outlast, Morris quickly set about planning a game jam that'd take Mahar's ideas one step further. In late October 2013, in time for Halloween, Asylum Jam was born.
Here, the rules for developers were simple: design a horror game without inaccurate stereotypes. That meant no "asylums, psychiatric institutes, medical professionals, or violent/antipathic/'insane' patients as settings or triggers", as it aimed to show that video games can be scary without relying on the misinformed trope that issues of mental health are something to be feared.
"The first one was actually back when game jams weren't super common, and they weren't on platforms like GameJolt and itch.io," explains Morris. "It was still very much the case that you needed a niche platform to do it. I wasn't really sure how it'd be received but I was pretty blown away by the reception of the first year. The second year was a bit quieter but in the third year it picked up quite a lot again, so I'm constantly astounded each time by how many people take part.
"The amount of people that took part in the third year has ratified the point that obviously even if people aren't as passionate about the cause as I am, they're still willing to make a game that fills the criteria and have a fun weekend."
While directed at Red Barrels' asylum-set Outlast, Mahar's 2013 editorial could have been aimed at any one of the multitude of video games that take place in psychiatric institutions, that set the player against deranged or psychotic or catatonic patients—many of whom are perceived as unwanted or unloved individuals, who've either been left for dead or who've been subjected to crude experimentations at the hands of equally unstable doctors. All of which of course serves to cement the idea that, yeah, maybe mental illness is scary.
The knock-on effect this gross misconception has on wholesome discourse is disastrous. If games pedal such a warped sense of reality, what chance do we have of ever realizing discussions around issues of mental health free of stigma? Asylum Jam hopes to answer this question by showing the world how games can be scary minus stereotypes. That's not to say it's easily done, however, as the 140-plus people that signed up for last year's jam understood first hand.
"I think it is quite difficult to work away from the tropes," admits Morris. "We do get a lot of questions asking about the specifics. For example, we've had questions asking: if you have murder in your game does that immediately make it a mental health-related issue? Or, if we have a cult in the game, does that make it against the jam's rules? A lot of the games that we've had have been very creative and you can explore outside of it, it doesn't necessarily need to catalyzed by someone with psychopathic tendencies.
"This level of questioning was actually really good because it meant people were thinking really closely about the jam theme and what we were trying to achieve. We've had a lot of people raising those questions and we've even had people on Tumblr go through the past jam games and [when] they find a game they feel doesn't meet the criteria, they'll make a post about it, being like, 'Hey, this isn't appropriate content for Asylum Jam because of this, this, and this.'
"It's interesting that people actually go through playing the games, stop and think about it, and then try and alert other people to it. This means that they're really thinking about it. I haven't censored any games from the jam, apart from obvious troll games, because I don't believe in censoring any creativity."
Aside from my own belief that video games are the most capable form of artistic media in relaying information, seeing mental health discussed in such civil and sensible context means a lot to me personally. A close family member of mine took his own life a number of years ago in circumstances that perfectly illuminate how ridiculous the warped stiff-upper lip mentality our society insists on perpetuating really is. Morris too lost her stepsister to suicide just prior to the 2014 Asylum Jam, thus has more drive than ever to ensure it returns year after year.
With so many people affected by issues of mental health in varying degrees, then, it's worth asking the question: why is it stigmatized to the extent that is it? In this day and age, why are developers putting out video games that belittle such a relatable and common illness?
"I guess there's a number of reasons for it," suggests Morris. "A common reason is that people will say what happens in games doesn't affect reality and it doesn't matter what they put in it. Like, they'll use the excuse that, say, Postal is really violent but people who play Postal don't go out and, you know, murder people, right? Second, it is quite difficult to come up with engaging narrative not based on stereotypes and tropes and to come up with something very original is difficult.
"That said, there are games that can approach it in a less stereotypical way and still be enjoyable—I'm not saying that games should never do these things, it's that people should be aware of the design decisions they're making and have a good reason for it, rather than just putting it in the game for no reason at all.
"This is something I teach my students: if you make a decision about including violence, or including mental illness, or including objectification, there should be a really good reason behind it. I'm not suggesting censoring anything, but it's something that should be considered."
On Broadly: Living with My Mother's Mental Illness
Needless to say, this consideration applies to all forms of media but it's especially pertinent to video games. The medium's unique interactive and immersive potential has scope to sculpt opinion and outlook like no other—even more so as we stand on the cusp of virtual reality. The line between reality and virtual interpretations of the world in which we live will inevitably become less obvious in the advent of VR, thus the messages video games choose to send are more important than ever.
In 2015, Asylum Jam partnered with Games for Change Europe and Prescription Pixel, and was hosted by GameJolt. When the jam was live, Morris received between 30 and 40 emails each day and is now considering bringing in a second pair of hands to help organize 2016's event. Running it is tough, she says, but the fact that players and developers are engaging with the subject matter, that they're discussing these sensitive issues in such a constructive manner, makes it entirely worth it.
Asylum Jam 2016 is provisionally scheduled to run in its usual slot towards the end of October/the start of November. However, it's an event that should be celebrated all year round. Last week, BMX performer Dave Mirra—who headlined Crave Entertainment's Dave Mirra BMX Challenge and Acclaim's Freestyle BMX series of video games—died of a self-inflicted gunshot wound at just 41 years old. Each case of suicide is different from the last, but tragic events such as this serve to galvanize the need for more discussion around mental illness on a much bigger stage on a much wider scale.
In other words, we need more events like Asylum Jam.
More information on Asylum Jam can be found here, as can the games that entered last year's event.
If you or anyone you know has been affected by the issues discussed in this article, the following phone numbers might be handy. I'm also always free for a chat anytime on Twitter.
US National Suicide Prevention Line: 1-800-273-8255