127 – Mental Health Systems in Roleplaying Games

The Mythcreant Podcast

Hitpoints and wound penalties cover a PC’s physical health, but what about their mental health? That’s what we’re talking about this week, to the cringe worthy “random insanity” of Call of Cthulhu, to the superb therapy rules of Eclipse Phase. We discuss the benefits that come with a mental health system, and the pitfalls that must be avoided. Plus, we find out that in at least one game, your character can go on such an intense bender that they’re unplayable for a session.

Download Episode 127 Subscription Feed

Have a question or comment for our hosts? Send it to [email protected]

Opening and closing theme: The Princess Who Saved Herself by Jonathan Coulton. Used with permission.

Show Notes:

Call of Cthulhu

Delta Green

Blades in the Dark

Eclipse Phase


Mouse Guard

Treat your friends to an evening of dark ritual murder. In a fictional game scenario, of course. Uncover your lost memories and save the day in our stand-alone game, The Voyage.

Read more about ,



  1. Adam Reynolds

    While I completely agree with the sentiment, I think that there is a fundamental problem with supernatural substitutions for mental illness or psychological trauma. When the effect is the same, it ends up effectively being about the issue one way or another.

    Jessica Jones is about mind control, but it is also about abusive relationships at the same time.

  2. Bellis

    I really like the idea of using something like stress and its effects (like anger, fear, etc, which can vary from character to character or situation to situation), especially since that also works for mentally ill players/characters.

    Instead of mechanics /giving/ your character a mental illness, the effects of stress can interact with one they already have (unless of course you want to have them develop PTSD or depression or something as a part of their character development, but that wouldn’t be dictated by the mechanics and be instead a flavour of the narration).

    So say I want to play a mentally ill character because I am mentally ill (I actually have dissociative identity disorder and y’all are right about it changing names lmao our country still calls it multiple personality disorder but that’s outdated), I can use the same mechanics and get stressed by difficult experiences. Then I can use my character’s mental illness to flavour how it gets narrated.
    Although mostly stress has the same effects, so I’d get scared or frustrated or angry like the next person, but I might also dissociate and just stare at nothing for ten minutes, or switch and now you have to deal with my protector system mate (“personality”). Could be interesting!

    Anyway, thanks for this episode, great stuff, very interesting!

    • Bellis

      Oh, totally forgot: this also works for recovering from stress! So the same mechanic can be used for neurotypical characters as for neurodivergent ones (for example someone with a mental illness).

      There are some specific things that tend to work for neurotypical people but not for someone who, say, dissociates and vice versa (putting an ice pack on your wrist can be effective to get out of a dissociative state, but probably doesn’t calm down most neurotypical people while meditation might worsen dissociation but helps a lot of non-dissociative people a whole bunch).

      I think the overlap is much bigger and more important though, basic things like having your physical needs met, being in a safe environment, humor, connecting to nature/plants/animals, talking to friends or other trusted people like therapists – this kind of stuff helps most people regardless of whether they have a diagnosable mental illness or are just stressed out.

      The idea of quirks or vices being used to de-stress is great too and can be used for characterisation and tone! Like your example of someone just dissapearing for a week until they show back up on the team

Leave a Comment

Please see our comments policy (updated 03/28/20) and our privacy policy for details on how we moderate comments and who receives your information.