You don't normally think of mental illness as the stuff of games, but Alana Zablocki believes bringing the two together can be a powerful force for greater understanding.
The 28-year-old transgender woman, who has been in and out of psychiatric wards for the last three years, has created an online game to help the people close to her better comprehend her experiences inside.
Zablocki started writing Inpatient — A Psychiatric Story, a few months ago, just days after her last stay. She describes the game as a "choose-your-own-adventure" story but more intuitive and complex.
The player takes on the persona of a 32-year-old woman who has suicidal thoughts. You begin by checking yourself into a hospital. You then spend 72 hours navigating the mental health system by choosing between two or three pathways at the bottom of each page.
Depending on what you decide, you could get a nurse to give you the Ativan you need to sleep, or you could get "formed"— which is an application, or a Form 1, for psychiatric assessment that will allow the hospital to hold you involuntarily for 72 hours.
'This is your illness ... it's not reality'
Zablocki remembers trying to talk about her hospital stay with her friends.
"It's an uncomfortable situation for everyone. If you're dealing with passive aggression from one of your nurses, and you try to explain that, it could be viewed as 'this is your illness.' You're deciding that people are abusing you. It's not reality,'" Zablocki said in an interview with CBC Toronto.
So instead, she wrote this passage:
"You walk up to the nursing station. One of them is watching Netflix. You knock on the door. No one looks up. Sometimes pounding on the door helps, but it won't win you any favour with the nurses. You hope that at some point they will look up and notice you. Or stop pretending not to notice you."
Zablocki, who grew up in Port Elgin, Ont., has struggled with mental health issues since she was 15. Although her family has always been supportive, being transgender and queer in a small community was hard.
As a former computer programmer, Zablocki said creating a video game made sense as a way to express herself. She was also inspired by another online game called Depression Quest, which takes the player into the world of a person suffering from depression.
Working on the story was painful for Zablocki, who said she felt like "garbage" as she wrote it, repeatedly reliving her traumatic experiences.
"Over time it got easier, I was able to write longer sessions. But I think by the end my original purpose kind of turned to a macro scale— I wanted not just people in my life to see this, but I thought it would be helpful for the public in general to have this experience too," she said.
Providing an outlet
Lucy Costa, the deputy executive director of a patient advocacy group, the Empowerment Council, at the Centre for Addiction and Mental Health in Toronto, says the game shares a particular viewpoint that doctors can learn from.
She says it also allows users of the psychiatric system to see a similar story to their own unfold.
"People don't often get opportunities to speak about something as intense and complicated as suicide. I don't think people have enough places where they can see their realities reflected, so providing an outlet where somebody could engage with the game is a positive thing."
Costa is working with first-year psychiatry residents to help them better understand a patient's point of view. She said it is too late to add Zablocki's game to the curriculum, but would "absolutely have no qualms" about using it in the future.
'Us' versus 'Them'
Dr. Thomas Ungar, psychiatrist-in-chief at St. Michael's Hospital and associate professor of Psychiatry at the University of Toronto, has not played the game but says it could be a good way to get a better understanding of mental health issues.
Ungar said the psychiatric system can always be improved and that more funding is needed, but in spite of those problems, he said the quality of healthcare provided to people with mental health conditions is "remarkable."
"The health care providers have empathy for what's going on. I know that people receiving care sometimes don't think that it's understood, but the providers are struggling their best to provide quality care within the constraints of the resources they have," Ungar said.
According to the Canadian Mental Health Association, 20 per cent of all Canadians will experience a mental illness, which means most providers have intimate knowledge of the struggles patients go through, Ungar said.
"I've kind of moved beyond this 'us versus them' into a 'we're all in it together.' We have to fight for equality, understanding and enlightenment of mental health in society," said Ungar.
Both Zablocki and Costa said they feel that there is a big divide between the providers and the patients.
"A doctor has more privileges and can make decisions about your health care, and hopefully those are collaborative decisions, but not always," said Zablocki.
"It's the system that is responsible for creating 'us' and 'them.' It's the system that locks the doors, not the patients," said Costa.
The road ahead
Zablocki is currently working on a novel based on one of the characters in the game. The book will explore how poverty can affect a person with mental health issues, a story that she says is not often told.
"When you're worried about making rent you don't really care about therapy," said Zablocki.
Writing the game changed something in Zablocki, she said. She still sits in the restaurant for hours, now writing her novel, but says she has had relief from her mental health issues.
"I'm not thinking too far ahead. I want to try to enjoy life."