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“You Wake Up in An Asylum…” Panelists Focus On Why Mental Health Horror Tropes Are Harmful!

Many horror games and movies don’t do justice toward living with mental health issues! Five people took part in the PAX Online East 2021 panel discussion “You Wake Up in An Asylum…” and endeavored to bring mental health into a different light; taking stigma out and replacing it with facts.

Raffael Boccamazzo [PsyD], also known as “Doctor B”, moderated the discussion. His organization “Take This” — for which he is Clinical Director — is, in his words, “the very first mental health non-profit to serve the game community exclusively.”

“Lectures like this, panels, studio workshops, all sorts of great stuff to educate people on mental health matters!” said Doctor B regarding the work of his organization.

The panelists for “You Wake Up in An Asylum…” gather to discuss mental health tropes in the horror genre! Picture credit to

There are so many — as Dr. B put it — fantastic horror tropes which exist for the “regular people” to use and survive; he asked the panelists to share what they could list among them. Answers included:

Mental illness means you’re going to be a violent psychopath. Coming from anything other than a nuclear family with 2.3 children and a mother and a father and a white picket fence means that you are dangerously predatory and violent. If you explore your gender whatsoever you are very clearly going to be a mass murderer. Mental health professionals are probably mass murderers or aspiring or something even worse. If you’re non-verbal for any reason you are clearly hiding something. Those with developmental disabilities have a special connection into the “otherworldly” and are usually some sort of psychic plot device or have dual personalities with one being the killer.

Dr. B questioned the problem with such horror tropes. Jay Justice [Editor, Cosplayer, and Freelance Consultant] started with her answer that “when you consistently, repeatedly ‘other’ marginalized people in a way that encourages the audience — which is everyone watching the movie — to be afraid of them, to see them as a threat, you are re-enforcing these negative stereotypes that cause abuse to people who are extremely vulnerable in real life.”

Film psychopath Hannibal Lecter is a famous horror icon; but are we tired of seeing psychopathy lead to being a killer? Picture credit to

Something which Kelli Dunlap [PsyD, MA and Adjunct Professor for American University] said about stereotypes in horror tropes made sense to me; they’re boring! It’s old-hat and boring that the threat in some form is simply crazy or had a bad trauma.

“In general, you can’t make fun of or exploit a thing a person can’t control.” said B. Dave Walters [Streaming Personality and Freelance Writer]. “And so when that is your plot device, it is the same as saying everyone that fits this profile is the same as that; be it a developmentally neuro-divergent human, or ‘everyone from this place is bad’, ‘everyone that is from this religion is bad’, any time you’re, like, ‘everyone that is X is Y is bad’!”

“House on Haunted Hill” serves to push the trope of the malevolent mental health facility and/or caregivers in the field. Picture credit to

There basically aren’t many good or non-harmful stigma-based and stigma-setting examples of mental health depicted in horror games, movies, etc. I’ve noticed this trend too; it goes way back decades in the movies with psychopathic killers like Jason Voorhees, Michael Myers, or other slashers; or even the depiction of mental health facilities like in House on Haunted Hill (1999)!

“This is the very definition of ‘othering’.” said Dr. B. “This is using somebody else’s pain, this is using a one-dimensional portrayal of experience with no more depth than that, to move somebody else’s plot forward.”

Dr. B then raised the question what could be done to make better stories without these mental health horror tropes. I feel Jay’s statement following the question sums it up pretty well:

“The unknown does not have to be based on a known trope to be successful.” said Jay. “All you have to do is look outside your own prejudice and stop thinking that the shortcut to the unknown is a crazy person.”

The panelists laugh at the concept of the creepy child in horror! Picture credit to

The discussion varied in what horror tropes get carried out and how to do better; it all seemed to basically lead to the point that what is unknown to people who fit the “regular” type need not be feared or misused as a means to push the main character’s story. Creativity comes from differences and the differences need to be better researched and better told; perhaps talking about “the deep-down fears people actually have”, as recommended by Cassandra Walker [PsyD and Owner/Psychotherapist at “Intersections Center for Complex Healing“].

I highly recommend watching “You Wake Up in An Asylum…”; you can see this plus other panels on the official PAX Online East 2021 Twitch channel videos list! Check out the Geek News Now article “Stack Up Interview: How Gaming Helps Military Veterans” which tackles mental health and gaming. Any other tropes you’d like to see handled differently in horror? Comment below!

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