The portrayal of mental illness in Heavy Rain

UPDATE (08/05/2020): This was originally posted in 2016, and I have to admit my understanding and experience of mental illness was a lot narrower then than it is now. The content of this article does not reflect my opinions as they are today, and I apologise if anything stated below is unfactual or offensive.

This blog post includes spoilers for the 2009 video game, Heavy Rain. It also deals with mental health topics that may be of a sensitive nature.

It’s Mental Health Awareness Week. I’ve been reading a lot compassionate and helpful posts for those that suffer from these kinds of health problems. I find that it’s very important to keep a healthy mind just as you would with your body, so it’s heart-warming to see so much support coming through from across the internet. This blog post probably isn’t the place for that. I’ve opted to write something that I’ve been analysing ever since my last playthrough of Quantic Dream’s Heavy Rain.

Heavy Rain is a psychological crime thriller that forms part of David Cage’s Sadness Trilogy. It features the stories of four different characters as they intertwine trying to stop the “Origami Killer”, a serial killer that drowns young boys, from taking the life of his latest victim. I’m going to get straight to the point: it’s a very bad crime story. It suffers from pacing issues and cringeworthy acting. It’s biggest felony is probably the amount of plot holes the story has managed to fit in to the point where it makes no logical sense. I won’t waste my time describing these plot holes, but this lengthy article here details the majority of them.



Before I analyse the game, I’m going to give a brief overview of how mental illness has been portrayed in video games in the last few years. In 2013, an open letter was emailed to the developers of Outlast, a horror game set in an asylum that features violent patients as enemies. The writer of the letter explains how some of the language used in marketing was pushing harmful stigmas about mental illnesses, essentially treating them as dangerous, unstable antagonists that should be avoided. I doubt the developer intended for that to happen; we all make mistakes. Unfortunately, this is nothing new for video games. The Silent Hill series uses monsters to represent the fears and insecurities of the character. It antagonises them to the point where we feel frightened and provoked by them. It’s inappropriate. An outside-looking-in approach. The common link between Outlast and Silent Hill is that they’re both part of the survival horror genre. The intention is to scare the player. 

Fortunately, this is avoided in Heavy Rain. One of the game’s strengths is the emotional honesty. It has character. Ethan is depressed. Madison is an insomniac. Norman, an addict. Scott, a psychopath. These are people we spend roughly 10-12 hours with. We hear the thoughts in their head, and we make rational (or irrational) decisions with them. They are normal every-people, and we can empathise. There’s no stigma attached to them.


Let’s begin with Norman: he’s an FBI profiler who struggles with addiction to a drug called Triptocaine, which allows him to stay physically and psychologically focused.  It’s never clear why he is addicted to Tripto (this was supposed to be explained in the now-cancelled prequel DLC), but one thing the player has control over is Norman’s use of the drug. During critical moments of the game, we given the option to take the drug or refuse it. If the player does decide to take it, then Norman manages to finish his task without any major problems. Despite being warned against it, I found myself choosing to take the drug so I could progress through the game. This is parallel to how real-life addictions work. They are compulsive, often with the belief that it will lead to a desirable reward. I felt guilty for it, but the progress felt satisfying.


In her opening scene, Madison is awoken in her apartment only to be attacked by masked burglars. After a lengthy struggle with the assailants, her throat is cut and she bleeds to death. She awakens again, the attack revealed to be a nightmare. Madison suffers from insomnia, and finds it hard to sleep in her apartment. Unfortunately, this is not touched upon as much later in the game. I used to think it was weird why Cage chose to do this, but it recently hit me; Madison’s insomnia is not a big deal because she knows how to handle it. She tells Ethan that she’s had this disorder since childhood, and that sleeping in motel rooms helps her. Her insomnia doesn’t need to be brought up again. She’s a character that has managed to live with their mental illness without letting it overpower her. I have to admire Cage for this. The other three characters seem to struggle with their mental health, but Madison can maintain hers to a healthy standard.


Now, onto Scott. He’s a hardboiled PI hired by the families of the victims of the Origami Killer to investigate the murders. During the first 75% of the game, he’s shown to be very stable. When we hear his thoughts, we know he is determined to solve the case. But then it’s revealed that he was the killer all along and was really just eliminating evidence and trying to frame someone else. It was very bullshit, I will admit. By having him as a playable character, the game cheats the player into eliminating him as a potential suspect. I’m not here to agree or disagree with that, instead I just want to look at Scott as a character. The reveal changes how we see his actions throughout the game. We see that he is cunning, proficient, a compulsive liar, but also charming, charismatic and careful. This fits with the profile of a psychopath. Do I think Cage managed to pull it off? Well, apart from the dodgy writing, I think the presentation of Scott’s actions is… decent. There is a clear motive for his crimes. His childhood trauma would have triggered the antisocial behaviour he exhibits. Psychopathy isn’t always immediately obvious; in fact, a lot of cases go unnoticed for years. This is what the twist symbolises; Scott lies to the player, and his true nature remains a mystery until the final few chapters.


Arguably the main character, the first thing to note about Ethan’s story is the shift in tone between the prologue and the rest of the game. When we first meet him, he is a successful architect, happily married father of two. His life is pretty great. We get to connect with him during this scene where he prepares for his son’s birthday party. Not long after, that son dies in what I would say to be a very traumatic way. Ethan goes into a six-month coma, and the tone suddenly shifts. The colour scheme goes from lots of greens, blues and reds, to brown and grey.  Our connection to Ethan suddenly increases tenfold when we understand everything he has lost. He loses his wife and his house. His surviving son resents him, and his work suffers. 

We quickly work out that Ethan suffers from a variety of mental health issues, including anxiety, schizophrenia and depression. The conversation with his therapist reveals he is suicidal, no longer having the will to live. The realisation hits the player very suddenly, much like how depression works in real life. It can come seemingly without warning. It’s dangerous, and can even happen to those who seem to have their shit together. He is an example of how cruel life can be to ordinary people. When his son is chosen as the Origami Killer’s next victim, Ethan finds something to fight for. We are increasingly subjected to his devotion to pass the killer’s trials. If the player makes all the right choices, the player gets a good ending where he saves Shaun. The epilogue, which takes place months later, reverts the colour scheme back to what it was in the prologue, indicating that he’s doing much better these days. Ethan’s story is about fighting depression, and finding support in the right people (Madison). He’s a very rounded character; a reminder of how important it is to keep your loved ones together and support them. He’s the most human character in the whole game.

Heavy Rain doesn’t push any prejudice, and unfavourable agendas aren’t being exploited here. Instead, we witness very human characters struggling with their mental health. In an age where such illnesses are antagonised in the horror and action genres, it was nice to see Heavy Rain take these afflictions and turn them into something beautiful. It’s a bad crime game, but I think it’s an excellent drama about mental health.


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