Arkham Asylum and Mental Health: A Review of the Scientific Literature

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If there’s one thing video games get a lot of rap for, it’s about the alleged promotion of violence and its influences on young people. Have you ever wondered how people come up with such ideas? Connections such as these are made every day by countless people for an infinite amount of reasons. But just because people make these conclusions does not necessarily make them true. The real question then is: are assumptions such as these just baseless conjecture? How come the media is often heard portraying and perpetuating these ideas? This is because, contrary to what somebody may think, there are actually scientific methods by which such assumptions can be tested and become either verified or discredited. This is exactly the kind of work that social scientists conduct on a daily basis.

Most of the attention on media’s influences have focused on such mediums as film, television, and books. I’m not sure if this is an idea  as accepted as reality reflects, but video games have a significant effect on people and society at large. Today, I decided to take a look at an article titled, “Wham, sock, kapow! Can Batman defeat his biggest foe yet and combat mental health discrimination? An exploration of the video games industry and its potential for health promotion.” Yes. I’m dead serious. That is the amazing title of this scientific article. I’m not even being sarcastic.

Undoubtedly, people’s ideas and understandings of things are shaped by media influences. Mental health perceptions are no exception. After all, we are constantly hearing about rapes and murders committed by people suffering from some sort of mental illness. Given individuals’ propensities to adhere to availability biases (“shortcuts” in judgment that people tend to make based upon how easy it is for them to think of examples), many people have dangerous misconceptions about the mentally ill. After all, most people have little contact with the mentally ill. So for many, their knowledge of the mentally ill is limited to the ones who are frequently referred to in the media as committing atrocious crimes or being unable to contain their lewd and inappropriate behavior.

As you may gather from the below news report on some recent gun control debates, you can see the sweeping generalizations that all mentally ill people are dangerous. Here, there is little distinction among types of mental illness, just that mentally ill people ought to be treated similarly in light of the gun question.

[youtube]http://www.youtube.com/watch?v=JshqhARcDck[/youtube]

But on to the games, eh? According to the authors’ studies, excessive play time or exposure has evidenced a causal link between violent video games and subsequent violent behavior. In addition, it has been suggested that video games have addictive potential.  The evidence on this question, however, is unclear–the only indication of this addictive potential has been the increase in recent years in addiction clinics for online games. Evidence also suggests that increased time playing games may have such negative consequences as social isolation, decreased school performance, sleeping problems, depression, suicidal ideation, anxiety, obsessions, and substance abuse.

The authors, in keeping with their article’s title, focus heavily (though not exclusively) on a game known and loved by many in the gaming community: Batman: Arkham Asylum. They argue that this game reinforces stereotypical and stigmatizing views on mental illness and perpetuate the link between violence and mental illness.

For those unfamiliar with the game and the Batman mythos, Arkham Asylum is a mental institution for the treatment of the criminally insane (here, they seem to apply the more literal definition of “insane” as opposed to the legal definition).  As Batman, your purpose is to fight your way through the asylum as you track down Joker, a particularly “crazy” Batman villain. From the outset, the asylum is presented as dark, oppressive, dangerous, and decrepit. Essentially, the asylum is presented as a Gothic structure: one with a personality and life of its own. The dark themes presented alongside the asylum undoubtedly perpetuate the negative associations between them and the mentally ill individuals that the asylum contains. The authors further that many of the patients you do find are presented as feral and animalistic. Many of them walk on all fours, attack on sight, and make primitive, guttural noises as opposed to using learned speech.

Morris and Forrest make a particular example out of the Joker, focusing on his presentation in the game as striking. The game explicitly references him as a “violent schizophrenic.” In one of the first times players encounter Joker, he is shown to be heavily restrained, monitored and surrounded by armed guards. Each additional layer of protection and surveillance adds to the perception of danger that the Joker presents. And, in particular, this suggests that the mentally ill are both violent and unpredictable. They note that this presentation is particularly reminiscent of Hannibal Lecter in The Silence of the Lambs. I’ve never seen the movie myself, but I’ve been on the internet long enough to know that this is a pretty scary likeliness.

The feelings of threat and danger that this sort of chilling atmosphere presents are heightened by the addition of eerie and disturbing music. The music is meant to augment such feelings. The pitch and tempo of music changes when enemies are approaching, increasing suspense, tension, and fear, highlighting the oncoming approach of danger. Dialogue and narrative discourse, too, add to the stereotypical presentations. All throughout the game, players can overhear guards talking about the inmates using such language as “psycho”, “freaks”, “animals”, and “insane”, adding to the already-warped view of the mentally ill as primal, barbaric, dangerous, and incomprehensible. While individuals’ understandings of the game’s message may vary according to numerous different influences, the authors state that the game clearly sends the message that the mentally ill are hopelessly violent and unstable.

Here’s a video from early on in the game that hits on a lot of the points made, including the asylum’s look, Joker’s handling, and the general atmosphere that surrounds the portrayal of the mentally ill:

[youtube]http://www.youtube.com/watch?v=Ei2aYcsF7rA[/youtube]

But why do all these things matter in the context of video games? After all, movies and shows do very similar things. Morris and Forrest stress that what separates video games from these other mediums is their levels of interactivity with characters and environments.  In games, all the features of film and internet (written and spoken narrative, images, music and sound) are all presented, but games build upon these by offering the ability to be interactive. This sort of feature makes games particularly effective at communicating ideas, if at least implicitly. In Arkham Asylum, they note that the player is left with little option in dealing with the inmates other than by fighting them; the game leaves no room for such situational remedies as talking or negotiation: violence is the only way to deal with these types of people. This may suggest that the sort of conduct presented in the game is reflective of how all mentally ill people behave.

However, the effects of video games are certainly not all bad, and the authors stress that it is a very rich, interactive medium that has amazing potential for teaching. Because many games have the player assume the role of an individual, they are often brought to empathize with that character. The authors note that games are so immersive that players can even show feelings of anger when they sense a character’s distress or sadness. As such, if games were to allow players to assume the role of someone who was mentally ill, he or she would be more able to internalize and contextualize the issues of the mentally ill, providing for a valuable educational tool in sympathy and understanding.

Morris and Forrest cite many studies showing the therapeutic potential of gaming. They evidence that games can help build engagements and relationships, elevate mood, battle depression, and help people cope with stress. They cite one study in particular where older adults’ well-beings, senses of loneliness and isolation, and moods were all improved by playing the Wii. And if video games could be tailored to allow people to relive or simulate positive life experiences, many psychological benefits could be reaped. These effects may include positive reminiscences that could be used in dementia care or other issues of memory.

Here’s an adorable video on some elderly people getting the most heart-warming use of the Wii I’ve ever seen:

[youtube]http://www.youtube.com/watch?v=B6B7WDM02Fs[/youtube]

In realizing the enormous potential for therapy and cognitive development by playing video games, and recognizing the shortcomings they have in furthering negative views, the authors make a few recommendations. Foremost, they argue that there ought to be collaboration between game producers, developers, and mental health professionals in order to ensure that accurate and informative representations are being showcased. And as such, they also argue for some sort of regulation against inappropriate examples of mental illness so as to combat discrimination and discriminatory content. Additionally, they suggest that individual games should be reviewed for their therapeutic potentials and should be capitalized upon when their benefits are significant. Otherwise, games specifically designed for therapy and psychological benefit should be developed.

What do you all think? The science is definitely there and has been subjected to peer review. While this does not mean that it is without flaws, it definitely holds that the methodologies, and thus the results produced, are reliable enough. I for one appreciate that games are receiving such attention. Despite the arguably true statements regarding negative consequences, I’m very glad that they are being recognized in the scientific community for their positive potential. Gotta start somewhere, right?

If you’re interested in looking up the article, here’s the citation:

Morris, G. & Forrest, R. (2013). “Wham, sock, kapow! Can Batman defeat his biggest foe yet and combat mental health discrimination? An exploration of the video games industry and its potential for health promotion.” Journal of psychiatric and mental health nursing, 20(8), 752-760. DOI: 10.1111/jpm.12055

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About Author

(Editor in Chief)

Alex is the name. I'm a 20-something year old student of law at the University of Florida. Some of my favorite games are Pokemon, Mass Effect, Persona, Titanfall, and Final Fantasy. Outside of games, I lose my cool for such things as the Chicago Bears, Florida Gators, Doctor Who, Game of Thrones, and Power Rangers. Always happy to have a conversation about literally everything besides Seinfeld. Send me stupidities on Twitter @thecastroregime!

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