Hellblade: Senua’s Sacrifice opens with a warning screen, which tells you all you need to know about Ninja Theory’s challenging new character action game. Developed in conjunction with physicians and mental health patients, the title tackles the taboo subject of psychosis – a disorder which causes hallucinations and delusions. As you may suspect, this makes for difficult viewing at times – but the Cambridge-based company must be praised for its dedication to depicting the disease in the right way.

Senua, the title’s dreadlocked protagonist, is a Celtic warrior from north of the English border. Upon witnessing the mutilation of her lover at the hands of the invading Vikings, she succumbs to insanity, and is cast away by her family in order to live out her illusions in a nearby forest. It’s here that she embarks upon a journey into the underworld – an alternate reality conjured by the demons which haunt her mind.

Much of the story is garbled – and intentionally so. You’ll need to be paying close to attention to piece together the thrust of the narrative, which can be difficult to parse given how “busy” it is. The game deliberately tries to overload you, be it through the number of voices speaking concurrently (more on that later) or the frequent use of visual effects, which fragment and distort the image on screen. This makes the title surprisingly stressful to play, but effectively helps convey Senua’s state of mind.

Ultimately, it’s a challenging game to play – and not necessarily in the way we’ve become accustomed to. The camera is pulled unnervingly close – uncharacteristically so for the genre – in order to create a sense of claustrophobia, which is leveraged particularly well during combat when adversaries will spawn behind you, making them difficult to keep track of. Bouts become all about positioning and enemy management, with no user interface or heads-up display to guide you.

The game instead utilises “the voices” that compose part of Senua’s illness to alert you to danger or provide hints, and it’s impressive how well this aspect has been married to the gameplay. You’ll constantly be hearing whispers throughout the six or so hour campaign, and while these do notify you to foes creeping up on you and important environmental details, they also deceive you, which creates some interesting scenarios where you won’t ever be quite sure who to believe.

This is where the sound design is so important. Ninja Theory’s used binaural microphones – similar to those you may have experienced in, say, ASMR videos on YouTube – to capture the positional data of every sound, and when paired with a decent pair of cans it can feel like there are other people in the room with you. All of this put together – the fragmented visuals, the goading voices, and the close camera – help to give a small idea of what suffering with mental disease may feel like.

In fact it’s only the final pillar of the psychosis depiction that falls short. Many with the disease say that they find meaning in everyday objects that others can’t see, and so a lot of Hellblade’s puzzles revolve around perspective similar to some of those found in The Witness. Unfortunately, the mechanic is overused, and scouring the environments for hidden runes soon becomes a pace-sapping hindrance that you’ll grow to loathe.

Thankfully, not all of the puzzles are poor: one section finds you virtually blinded and cleverly relying on sound to navigate a labyrinth and avoid enemy encounters; another introduces torches and light sources to help you combat an unseen antagonist who only appears in the dark. The game’s really good at keeping you on the edge of your seat, as evidenced by a mechanic that sees Senua gradually overcome by the darkness with each time you fail.

The threat is the most important part, as this isn’t a particularly difficult game in the traditional sense. The combat is satisfying, owing to a time-slowing mechanic and the fact that your adversaries cut and bleed the more you attack them. But you should see the campaign through without too much resistance, which may disappoint those looking for complex character action experience. Ultimately, though, that isn’t really the purpose of the game.

No, a vast chunk of your time will be spent simply wandering through stunning locales. Given the pseudo-indie budget attached to this project, it’s alarming that it rivals The Order: 1886 at times for sheer photo-realism. There are parts of the game that do seem purpose designed to show off Ninja Theory’s new facial capture technology, but given how convincing it is we can forgive the developer that. The studio’s penchant for iffy FMV does continue here, too, though we’re not convinced it fits.

Conclusion

Hellblade: Senua’s Sacrifice is not going to appeal to all tastes, and nor does it try to. As a character action game, it has decent if underdeveloped combat and a mixture of some excellent and some overplayed puzzles. But it’s the way that the title utilises the unique attributes of the medium to raise awareness of mental health that elevate this release beyond the sum of its parts.