If you’ve followed this blog for a little while, you’ll know I have a love affair with Call of Cthulhu. To add to this, I’ve been reading a bit of Zweihander recently. I’ll also say that Darkest Dungeon is one of my favorite videogames. If you’re wondering what all of this has in common, I’ll refer you to the title of this post. Each of these has a mechanic to model stress and general mental well-being of characters. So let’s talk about that.
First and foremost, let’s talk mental health. Not the fictional kind. I have a degree in Psychology, and I’ve taken a significant amount of coursework towards understanding mental health issues. I’ve also engaged with people who live a variety of neurodiverse experiences, and I’ve got my own experiences of a similar kind. All this to say, we can’t talk about a game’s modeling of this stuff in a vacuum. We’re portraying real-life issues when we bring this into a game. And even though these are generally acknowledged to be an abstraction rather than a faithful representation, and even though these depictions are usually in good faith, it’s still worth considering carefully how we portray these things so that we do so in a manner that is sensitive to the lived realities of those who deal with this.
Now that said, let’s address why you might want to bring this into a game. Again, as someone who has an educational background, interpersonal, and personal experiences with it, I can safely say that mental health issues can impair your daily functioning. it can make you less motivated and less effective. So it does make sense to include this on some level as a way of representing that your character isn’t at their best. Motivation and morale are important to optimal functioning. Thus, the more stress you have to endure, the less likely you are to perform well. This is why I like mechanics that model this. The aforementioned Darkest Dungeon models this well, such that stress accrues and must be managed with self-care activities or else it may manifest as maladaptive behaviors. Another game that I think addresses this simply and well is Ironsworn, with the Spirit score. This is your character’s motivation and will to go on. It will suffer when things go poorly for you, and must be managed through rest, or can be regained if things start to go well for you again.
That in mind, when gamifying specific mental health issues, you should be a bit more careful. For example, if your character has a social or developmental disorder, and the game attaches a stat decrease to that, your game is implicitly saying that people with that disorder are less capable of such things (which is almost always *not* the case if they are accommodated properly or in an environment that allows them to function optimally with respect to their differences.) You’re in essence portraying them as less desirable or slapping a negative label on them, which is really not something you should do. Instead, leave this out of mechanics. Allow this to be roleplayed appropriately (and respectfully,) but don’t attach a value judgement to it. Also, try to refrain from being prescriptive. Some games have a tendency to emphasize random determination of mental health issues manifesting (usually through dice rolls.) This also gameifys things to an extent. I’m not saying you can’t have a table for this. Such things can often serve as prompts and suggestions for handling such things. But don’t be beholden to them. Always allow for GM and player discretion in these matters. Forcing somebody to roleplay distressing experiences and symptoms they actually struggle with in their characters can be uncomfortable, as you’re asking them to put themselves on display in a negative and performative way. Conversely, asking somebody to roleplay something that they have no knowledge of can lead to stereotyped behaviors that are insensitive or inaccurate in a way that benefits nobody and can be actively harmful. So don’t force these elements into your game, and if you do use them, treat them as prompting rather than scripting. Don’t feel beholden to them, and do take steps to ensure things are done in a healthy and respectful way. Safety tools are strongly recommended.
Carrying that thread forward, I think games should allow you to opt out of it entirely, even if they do give you the option to model it. I’m not saying that the game should build these things as optional rules to bolt on. Such a design decision would likely be inelegant and would defeat the purpose of including it in the first place. Instead, if it is part of the game, there should be means to play the game without utilizing it, even if it is commonly utilized. For example, you rather than being afflicted with some form of “madness,” allow players the ability to opt out and face some other consequence instead, such as facing physical harm or being stunned, or some other more conventional core consequence. Doing this allows players to avoid engaging with messy mental health portrayals if they choose to.
Ultimately, take steps to ensure that everyone at your table is comfortable and that you aren’t pathologizing mental health differences. It’s okay to have some mechanical attachment to it if done in a way that doesn’t directly uphold stigma about mental health issues, and it’s okay use it descriptively, but not prescriptively. At least as I see it. Because while yes, i have some personal experience with it and academic understanding, I can’t speak for everyone. While I personally am okay with including it in my games, others may not be, so make allowances for that and respect the needs of others.
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