Gallery: How 'Hellblade' explores real-life mental health issues Gallery Gallery: How 'Hellblade' explores real-life mental health issues + 4

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At a glance, the upcoming Hellblade has everything you'd expect from a new video game looking to make a mainstream splash -- lush visuals, a dollop of violence, and a trailer promising a grim and gritty story.


Look closer though, and you'll discover that the title, following Celtic warrior Senua in the wake of the Viking invasion circa 9th century CE, is attempting to do something deeper. It wants to use its hero's journey as a way to explore real life mental illness. The particular focus will be on psychosis, with Senua suffering hallucinations that splinter her perception of reality.

While several games have experimented with mental health themes, larger-budget titles have not always treated it with much nuance, preferring to depend on the catch-all term "insanity". In its efforts to create a game that could deliver on the action players crave -- and present these deeper themes in a non-exploitative manner -- developer Ninja Theory partnered with Paul Fletcher, psychiatrist and Professor of Health Neuroscience at the University of Cambridge, and the Wellcome Trust. "Wellcome have supported us with a development award [and] Paul has been working with the team very closely to help us in our goal of portraying the character's mental illness in an accurate and sensitive manner," Dom Matthews, product development manager at the Cambridge-based studio tells WIRED.co.uk. "Not only does Paul's involvement help us to understand mental health to greater depth, but it's also fair to say that his input has been felt in the creative process, where we can marry up elements of science with engaging gameplay and art."

Fletcher said he was "intrigued" by the idea of making a game that genuinely attempted to understand and represent his area of study. "I was contacted by Ninja Theory who told me that they were making a game in which the central character experienced hallucinations. They said that they were aware that this was sensitive subject and they wanted to make sure that they were faithful in representing such experiences," says Fletcher. "Since a lot of my research involves trying to discover the psychological mechanisms involved in hallucinations and other symptoms of mental illness, I was intrigued."

Fletcher and Matthews are also aiming for Hellblade to avoid the tropes of its genre forebears, and offer a more nuanced exploration of Senua's illness. "In movies and games, mental illness is often treated as a surprise reveal, reinforcing the idea that there is a clear line between reality and madness. In other cases, psychosis is confused with psychopathy and results in negative portrayals that aren't helpful," Matthews says. "[For Hellblade,] we have been researching the condition for over a year to understand how the mind perceives and makes sense of the world and how this manifests in cases of mental illness," he continues. "You are in the shoes of a character who is strong and aspirational and is [also] dealing with her own unique perspective of reality." "I have had a sense throughout that the team at Ninja Theory don't want to sensationalise or misrepresent this," adds Fletcher. "They want to make a highly-engaging game, of course, but not at the expense of being as accurate and sensitive as they can be." "Senua, who is deeply unsure about what is real, may offer new perspectives on what it might be like trying to make sense of conflict and ambiguity," he continues. "In this respect, I think that the fact that the player is actively participating in the process of learning and exploration offers some really interesting opportunities, rather than simply being a passive observer of someone else's difficulties."


However, given many of the models of mental health as we understand it only date back as far as the mid-20th century, and the game world is set in the Viking Age, how the team approached Senua's condition changed. "We have tried to shy away from applying diagnostic criteria to the main character -- after all, psychiatric diagnoses are pretty contentious even now, so applying them to past cultures is very risky," says Fletcher.

Instead, historically accurate reference material was close at hand. "I was fortunate to find someone in Cambridge who wrote her thesis on perspectives of "madness" in Celtic culture, and was able to discern a number of well-known features such as hearing voices and withdrawing from society to roam alone, perhaps going on a quest in search of redemption," Fletcher continues. "While many of these experiences were represented in religious terms, nonetheless, it's clear that the Celts had sophisticated frameworks for describing and understanding mental disorders." "I actually think games are a particularly powerful medium for understanding these complex experiences and engendering empathy," concludes Matthews. "It really does make the story and game a more compelling experience."

We'll be keen to see how well Hellblade delivers on its promises. As yet, the game has been announced for PS4 and PC but no hands on time has been made available. With the launch of the accompanying E3 trailer, above, hopefully we'll see more next week. If Ninja Theory can deliver on its lofty goals with an action game that doesn't reduce Senua's plight to that of a mad woman in the woods, it could be one of the most progressive games made.