Written by Sam Schorsch // Edited by D. Matthew Beyer // Media all sourced from Hellblade.com

Fairly recently, a game touted as the new answer to the Dark Souls series found its release on PS4 and PC from England’s Ninja Theory, Hellblade: Senua’s Sacrifice. Both hyped up by some and derided by others – most notably Total Biscuit in a since apparently deleted tweet- for its promised mechanic of deleting your entire save file and progress after a certain set number of deaths, the developers of the Devil May Cry remake have provided something that is, in my opinion, a massive and significant rarity in the video game medium; a well thought out, accurate, and deeply respectful portrayal of mental illness, specifically psychosis or psychotic mental illness (or some symptoms of it at least) in this case.

Discussing or using mental illness in games is nothing new. Horror games are rife with the allegedly or explicitly mentally ill from earlier PC games like American McGee’s Alice to modern indie games like Layers of Fear and Outlast, to triple A titles like The Evil Within. At their best, games like McGee and Layers offer an interesting outlook on severe, though very socially acceptable or socially acknowledged, mental illness via survivor’s guilt and alcoholism respectively. At their worst, the moderately to severely mentally ill are used as evil props or cheap and easy villains. As fantastic and raved about, deservingly, as Outlast is, it does still lean on the stereotype of the spooky asylum filled with horrific and monstrous people as opposed to the reality of asylums of that nature being by and large places where the inmates themselves were more likely to be victims of abuse and torment than they ever were to inflict it upon others. The Evil Within built upon this exact trope as well, though they did make their main insane patient a sympathetic, to a point, character. However, with the exception of Alice, all the madmen and women in these titles and in many others are explicitly bad, evil, or at least untrustworthy people. Hellblade, however, seems to be a different animal altogether.

In Hellblade you play as Senua, a Celtic woman who ventures into the Viking underworld of Helheim to seek out and save the soul of her former love who was murdered in a Viking raid while she was off on a vision quest of sorts in the forests. This vision quest is directly linked to her main character trait: Senua suffers from psychosis, complete with hallucinations both vocal and auditory, all of which are replicated and portrayed in staggeringly accurate and respectful detail. You hear voices the entire game, some narration some ambient, and there is always a sense of questioning of the reality of what you experience through her eyes, an aspect of which is used for a potentially very frustrating puzzle stage early on on the way to the boss Valravn (the Norse god of illusion). However, these things – Valravn’s explicit tricks and lies aside – are never shown as something evil or wrong, and neither is Senua. The voices and the world around you are simply what they are to her; ordinary, something she knows and is used to, a part of her as a person in totality instead of a horrific ailment and burden she should be feared and reviled for, though this did not stop her fellow villagers for blaming her for every single problem they ever had (something we see now with mental illness being the scapegoat for almost any kind of crime or violence you could think of to pin it on). Senua feels so flushed out and real, and her psychosis is never projected as something to gawk at or judge. In fact, most of the time in the game you won’t question the reality of what you’re seeing any more than she would, which makes the ending very interesting to think about and makes multiple playthroughs as interesting as well.

If there is any doubt into the sincerity of Ninja Theory’s portrayal, Hellblade’s website comes complete with a Help and Support link that lets you choose your country from a drop down menu and provides you with information on mental illness and support groups, crisis lines, and health screening links accordingly. In the game itself, the mental health consultant is one of the first two names you even see on screen in the opening credits (The other being the historical accuracy consultant) and during the most recent mental health awareness week, Ninja Theory even donated a large amount of their profit from the game to a mental health charity. Could it all be elaborate lip service, maybe, but I’m hopeful that it isn’t.

Mental Health Hellblade
The mental health homepage.

Going through the game, for me, was a process that took multiple playthroughs and a lot of personal thought. A lot of people may not feel that way, it could be another character action game with a gimmick and all that and it’ll be forgotten in a few more months, but even if it is, the fact that they have gone through so much effort that they have charity donations, a help page, and an entire documentary in the start menu about how exactly they went about sourcing information from people with symptoms of psychotic mental illness as well as professionals during the entire process is, in my opinion, groundbreaking in the game world. The amount of care, time, and sensitivity put into dealing with issues most companies would throw in for flavor text and spooky atmosphere exclusively is refreshing to say the least and, for me, tear inducing at the most. I went in expecting quality to be sure, but I did not expect to end the game sobbing with controller in hand after watching hours worth of something hit so close to home. In all my playthroughs after the first one, the result has been the same.

There are people who hate a few specific aspects of this game to be sure. The main complaint seems to be based in how heavily the game lies to you at times; lies about some mechanics, about some of the things you’re seeing, about some of the things Senua even thinks, but if you look at the game as a portrayal of a specific kind of mental illness or mental illness symptom there is no other way they could even try to showcase what it feels like without these systems of (honestly mild) lies. You’re irritated and confused, it seems to say, well you can turn the game off and not feel that anymore. Many games use misdirection and white lies for plot or suspense purposes, and it’s interesting that the complaints for Hellblade come with a game dealing with something so deeply uncomfortable and personal: your mind and how much you trust it and how much altering it can change how you feel and act. Players thought they were going to lose all progress if they died too much, that seemed to be not the case in the end, players got angry. Is that fair? Maybe so. Is it a fantastic way of forcing someone to experience even a fraction of the reality of another person with a different brain makeup? Yes, I really think it is. But there starts the argument of game vs art, and everyone’s mileage varies there.

In general, I hope Hellblade is not the last of its kind. I hope the PR, both negative and positive, help push other companies to look at mental illness in a way other than psycho killers in asylums and convenient plot devices with little to no backbone of actual research behind them. I hope Senua is not the only character shown with such attention and love, whose mental state is not shown as something wholly evil or flawed, but part of who they are for better or for worse. I really can’t get my hopes up too high, since The Evil Within 2 is out now and doing more of the same as all games even remotely dealing with the brain have before Hellblade, but at least there is one experience out there, and honestly regardless of quality I hope people will play it, play more than once, and maybe even learn something from it (which is more than I’ve ever hoped for from a game before).
Hellblade is available now on PS4 and Steam

(Editor’s note: After Sam wrote this piece, Hellblade won in three categories at the 2017 Game Awards. Melina Juergens received Best Performance for her portrayal of Senua, Ninja Theory took home Best Audio Design, and– most perhaps most relevant to this article– The Game Awards crowned Hellblade 2017’s “Game for Impact.”)


  1. Excellent, excellent review! Although I have read quite a few articles on Hellblade (I really want to play it but am forcing myself to wait for the end of year sales), none of them have mentioned how responsible the company has been in dealing responsibly with mental illness. The information page and donations to mental health charities are fantastic to hear about. Even if it is a PR stunt, my hat goes off to Ninja Theory!

    Liked by 2 people

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