Q&A -avoiding mental health stereotypes

This week’s question looks at how we avoid negative mental health stereotypes in genres which traditionally feature “madness” and “insanity”. It references the Mental Health Accessibility Guide for organisers.

Period horror is one of my favourite genres. You recommend avoiding using “madness” as a driver for “evil” NPCs… how do you think insanity caused by exposure to the Mythos (which is frequently a central plot point in Lovecraftian stories and games) might be best dealt with and addressed sensitively?

I think, for me, it would be important to focus on what drove them “mad” – an obsession and control over certain aspects of the mythos usually. The key would be making it clear that this is a derangement caused by a very specific thing, and that specific thing is evil, as opposed to just a general mental health issue that has caused them to be dangerous/evil/villainous. It is the thing that is evil, not the “madness”, and not the person experiencing the “madness”.

I think with period settings you have to take extra care with language and perhaps talk to players before hand. An open a discussion about what period appropriate language is acceptable and what people would be uncomfortable with can be very helpful for everybody, but be prepared to moderate the discussion and to stop any personal attacks. It helps to reassure players that certain language is only being used because it is in keeping with the setting, and also makes clear that you don’t think it’s acceptable OC. Exactly how a word is used can matter too, generally the difference between using a word as an adjective and as a noun. So people might be ok with “He’s gone mad!” but not “He is a madman” or  “He’s insane!”.

Talk to any players who have indicated mental health concerns on their booking form and ask if there is any language or specific illness they would prefer to be avoided. Several mental health conditions are still heavily stigmatised due old fashioned depictions and descriptions, and avoiding them altogether can stop inadvertently spreading dangerous misinformation. This is particularly true for things like schizophrenic disorders/psychotic disorders, dissociative personality disorder/multiple-personality disorder, and other personality disorders.

It can be important to make a distinction between IC period terminology which is often incorrect and outdated, and modern language and usage. This can be done OC prior to the game or you could include it IC  for example by having an NPC doctor or psychiatrist who is seen as progressive for the period and who explains proper diagnosis or shows compassion.

If you are including any sort of specific mental illness issues or depictions in your game, make sure to do your research well on both modern and period understanding and treatment of the condition. This can help you write it with respect and accuracy and avoid possibly damaging stereotypes and misinformation.

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