Collaboration Award 2024

What is the research?

Professor Fletcher and his team have drawn together expertise in video game design and clinical neuroscience with lived experience of mental illness to co-produce two award-winning video games vividly conveying the nature of altered experience of reality in a character with psychosis.

Within the broadening conversation around mental health, psychosis is neglected and highly stigmatized. In creating a powerful character and telling her story through gameplay, their message has reached millions of people and provoked sensitive and thoughtful conversations about psychosis, and mental illness in general, as well as providing a valuable teaching aid. It has had a measurably positive impact on stigma.

Professor Fletcher’s research has explored psychosis in the context of how the brain normally comprehends reality. This research supports the idea that the brain is an organ of prediction, using prior knowledge and experience to make sense of ambiguous and uncertain sensory signals. We are not passive recipients of reality but are actively constructing it in accordance with our expectations.

Within this framework, psychosis can be viewed as arising from relatively minor disruptions in this process such that the inner construction of reality diverges from objective reality. Paul’s work has used clinical studies, psychopharmacological experiments and neuroimaging to understand the mechanisms by which these disruptions may occur and has yielded insights into the nature of psychotic illnesses as well as into how reality is generally constructed and experienced.

In linking with the video game design studio, Ninja Theory, he met a group of artists who are able to bring these ideas to life, linking them to the testimonies of lived experience within the design, narrative and gameplay of two major video games: “Hellblade: Senua’s Sacrifice” and “Senua’s Saga: Hellblade 2”.

This collaboration between Paul Fletcher and and the video game studio, Ninja Theory, began in 2014 in response to the studio’s plans, inspired by personal experience, to explore psychosis through the eyes of an 8th century Pictish warrior, Senua.

They wanted her representation and story to be sensitive as well as clinically and scientifically accurate and sought Paul’s help in this respect. The collaboration rapidly grew, involving formal scientific presentations and discussions as well as the early inclusion of a group of people with personal experience of psychosis based at the Recovery College (Cambridgeshire and Peterborough NHS Foundation Trust).

In 2017, “Hellblade: Senua’s Sacrifice” was released to widespread critical acclaim and to remarkable success (to date, over 6 million people have played the game). The game was accompanied by a video documentary describing the clinical neuroscientific foundation and how it was embedded in the game design. In addition to winning 5 BAFTAs, including a newly-established one for “Games Beyond Entertainment”, it received an award from the Royal College of Psychiatrists for its role in communication.