Dominic Matthews is the Commercial Director at games developer Ninja Theory, developer of many fantastic games, especially, in this case, the PC and PS4 game Hellblade: Senua’s Sacrifice.

Hellblade has won an enormous amount of end-of-year “Game of the Year” style awards, not just because of the game itself, but, in its considered and deliberate depiction of psychosis. A difficult subject in itself, but even more complex when you try and incorporate it into a video game. Here, Lee talks to Dominic about how it came about and what steps they took to ensure it was treated with the respect the condition deserves and to balance that with making an enjoyable game.

PLEASE NOTE: The Amazon affiliate links within the interview will provide Men Tell Health with a small percentage of the sale to help support the work we do should you decide to purchase the item. Just click the link and complete your purchase as normal.

For those unfamiliar with it, could you please briefly summarise what type of game experience Hellblade: Senua’s Sacrifice is?

Senua herself.

Senua herself.

Hellblade is the story of Senua, a Celtic warrior on a vision quest into Viking heartlands to find the soul of her lover.
It’s a fantasy game, and we’ve always made fantasy games, but in the case of Hellblade we wanted that fantasy to be a creation of the character’s mind. Senua is a person who experiences psychosis.
Throughout her journey she experiences psychosis which manifests as seeing visions and having unique beliefs about the world around her, and hearing voices as well.
It’s a story-led action game. It’s not a game about rising awareness or being educational, but what we have done is taken care to portray the character’s journey and experiences in a way that is accurate to the type of things that people experience.

Hellblade does away with traditional 'video-gamey' conventions, like button prompts, Head-Up Displays (HUD), tutorials, etc. Why is that?

There are a couple of reasons. Firstly, we wanted to keep the game as cinematic as possible, to keep it uncluttered visually. We also wanted players to go into that world and not hold their hand, to give players an experience as close Senua’s as possible: you’re in this new world, you don’t know what the rules are.

What was the team’s motivation for making this type of game, with these specific themes?

As a studio, we worked ourselves into a position where we could create a game independently, and independence gave us the opportunity to tell whatever story we wanted. This was a story and an area we wanted to take on.
We thought that the subject matter was something that could be explored in an interactive medium. I think we always had the vague hope that if we did it well then it might open some people’s eyes to these types of themes.

Did you work with mental health professionals and people who experience mental health difficulties throughout the process of development?

We did and it was such a fantastic collaboration between a number of parties. We came up with the idea of the game and we knew we had to do our thorough research on this subject to do a good job on it. To not do that would be wrong.

No matter what our best intentions were, games have typically treated subjects like this quite badly. We met with an organisation called Wellcome, which is a huge charitable foundation, and they have a team called the Engaging Science team which helps fund projects that have the potential to engage people in scientific themes. Through them, we worked with two key groups of people, one on the science and academia side, and one on the lived experience side, so that we could have a good balance of understanding. This process continued right through until the end where we got all the people we worked with in the studio to sit through the entire game and play through the whole thing to show them what we’d done and to make sure there was nothing in there that felt like it was misrepresented – that was our biggest fear that we would do them a disservice.

This is taken from the Hellblade Development Diary 12 and in particular further enhances the ways Dominic and the team went into to explore the mind of Senua.

Do you feel that Hellblade might have deepened the discussion around mental health representation?

When you look around and see where Hellblade has reached, it’s quite phenomenal really. Something that we didn’t expect it to do and which people have told us it has done, is give people a platform to talk about their own difficulties. It’s part of a wave at the moment, not just in games but in society in general, in the UK at least, of people wanting to talk about these things, and understand it, and it becoming something that people actively want to understand. 

When you’re feeling low (for any reason), what do you always turn to make you feel better and (and why)…?

Blackadder or Alan Partridge. It’s something I like to do if I go on a business trip on my own, leaving family at home, I always like to take Blackadder Goes Forth with me on my laptop or iPad. When I’m in the US I can go back to my hotel room and watch a bit of Blackadder and it makes me feel homely. There’s nostalgia in there and nothing too taxing.

What’s the thing you’re most proud of, looking back over the whole development, promotional campaign and release of the game?

I’m incredibly proud of what the team achieved against the odds. I’m proud of the people that we worked with, with lived experience, who gave their time and opened up to us and spoke to press because I know that’s not easy. On October 10th 2017 World Mental Health Day, all of the proceeds we received for Hellblade were donated to Rethink Mental Illness so our sales spiked massively on that day, and we were able to give them just over £60,000. Hearing how that money would change lives was a proud moment. It’s very rare we get the opportunity to do something that goes beyond our everyday work.

Why do you feel it is important to talk about our mental health?

Mental health difficulties is something that affects almost everyone in one way or another and I think it has been stigmatised for far too long, and treated as a weakness. I think understanding of mental heath difficulties will help reduce the fear around it. I think a lot of the stigma is rooted in fear, because I think people like to think that something like psychosis - which is what the character in Hellblade experiences - people like to think is a very binary thing. You have the “sane” person and “insane” person, and it’s very comforting to keep them distant and that’s really not the case.
I think it’s important for people to understand, that it’s very comforting for people to know they’re not going to be judged. By having that confidence about not being judged, more people will talk about their experience, and the more people talk about their experience, the more confidence it will give other people to talk about theirs.

A huge thank you to Dominic for being so open about what is all too often a difficult subject. Credit must go to all the team behind Hellblade for their consideration and tact in ensuring the virtual Senua was treated with the real respect the condition deserves. Also, many thanks to Lee Skittrell for carrying out the interview on our behalf. 

You can follow Dominic and Ninja Theory on Twitter, where they're @domvsalex and @NinjaTheory respectively. You can also find out more about Hellblade: Senua's Sacrifice on their website over at

If you want to buy it, it's only available as a digital download, but you can get it on the PlayStation Store (Europe) or (US), for PC on Steam or via

(Hellblade: Senua's Sacrifice is on sale for the PS4 until 7th February 2018)

If you want to play with the team from Men Tell Health on PS4 (not this particular game, but still), you can send us a friend request, just search for 'Men Tell Health'. Be gentle with us.