Mental illness is a tense subject; there are a lot of strong feelings on it. Almost everyone finds mental illness disturbing at the very least. It is however a part of life, and this means that it occasionally comes up in roleplaying games. As in literature, TV and movies, mental illness can make for an interesting plot or character aspect. It’s a frightening subject, which often makes people want to explore it, oddly enough. A number of GMs have concerns or questions, however.
Offending Others and Player Comfort
Some GMs worry that approaching the subject of mental illness in their game will offend someone. Well, on the one hand, if you worry about offending the mentally ill in your own living room, then you should probably worry about offending the religious, the sick, and everyone else too. That would make for very few subjects that you can actually explore in a roleplaying game.
On the other hand, if your players are zealously religious you probably know it. If they’re sick, you can probably tell. But you might well not know it if they’re mentally ill. About 1 in 10 people is estimated to have a mood disorder, and mood disorders are only one category of mental illness. With those odds it’s reasonable to assume that someone in your group might be mentally ill, might develop a mental illness someday, or might have gone through a relative or close friend’s mental illness. If they’re medicated or the mental illness is mild, you might never notice it. And people often go to great lengths to disguise and hide mental illness.
I’ve seen people who worried that if they approached the subject of mental illness with seriousness in an RPG, they’d offend people — sort of an “I’m using your illness for my entertainment” worry. Others worried that if they approached it anything less than seriously (which they felt would take too much research), they’d offend people by taking mental illness too lightly.
First of all, it can take surprisingly little research to find out about mental illness to a reasonable approximation. Do a web search. Buy a copy of the “Diagnostic and Statistical Manual.” Ultimately, use this metric: do your players laugh when you roleplay mental illness? If not, then you’re probably doing something right. You don’t have to get every detail correct.
Second, most of the mentally ill people I know (myself included — I have bipolar disorder, also known as manic depression, as well as attention deficit disorder and post-traumatic stress disorder) are only offended when people perpetuate harmful stereotypes about the mentally ill. A reasonably sensitive or serious portrayal of mental illness wouldn’t upset any of the mentally ill people I know (obviously I can’t speak for everyone else)
Don’t worry about getting every detail right; just don’t make it silly or otherwise grotesquely exaggerated. There are a couple of reasons for this. Many people make some pretty nasty assumptions about what it means to be mentally ill. We get put down, treated badly, and even fired from jobs with little provocation. Most of us are capable of living full and productive lives, and can do most of what a “normal” person can do. In addition, the more of a negative or humiliating stigma that mental illness carries, the more unwilling the mentally ill are to admit that they have a problem and seek help for it. This means that they don’t get medicated or therapized. As a general rule, mental illness doesn’t get better without treatment. So this causes a real problem.
Mental illness can show up in roleplaying games simply as a side effect; it makes for an interesting character detail or plot. However, RPGs can also serve as a wonderful forum for exploring mental illness, for those who are interested in approaching the topic. It’s a place where players and game master can broach subjects and feel them out in the safety of their living room.
It’s Your Game
It’s your game. Really. You don’t have to worry about offending me or anyone else who isn’t there. It isn’t like a movie, where you have a few thousand or million people tuning in to watch and then send complaint letters to your boss.
What you should consider, however, is your players. If you know your players well enough or feel close enough to them, ask them individually whether they’re okay with you dealing with the subject of mental illness, and then whether they’d be offended or bothered by whichever direction you want to play with it in. If you don’t know them well enough or don’t feel comfortable asking them, then just try it out — but go slowly. Build with small details and watch carefully for whether anyone is bothered by the plot advancements. If they seem bothered, or if they say anything, then ease off. Try something different or ditch the direction entirely.
Ultimately it’s up to you to do what you want. I can only gently suggest that you consider handling the subject with a little seriousness and sensitivity unless you’re running a humorous game. If you contribute to the idea that the mentally ill are ridiculous, silly, pathetic creatures, it may come back to haunt your players later, when they find themselves ashamed enough of their illnesses that they won’t consider treatment.