I was playing Mass Effect 2 the other day, when I realized how interesting the character Yeoman Kelly Chambers was. Not because you can seduce her to the point she comes up to your apartment and...

... feeds your fish, but because she has an unusually high interest in NPC mental health (for a game character). Each crewmember get's analyzed in front of the player by Ms Chambers, as a way of giving the player a deeper understanding and different perspective of the crew members - this is interesting, but I think games need to take this concept further and place it as integral to the gameplay of a game.

As games progress, so too has the graphics and to a lesser extent, the AI. Of course, AI fighting tactics are advanced, but games seem to be under using the advanced processing power of todays machines to add a little mental health into the mix.

There have been a few examples of pioneering in this arena and rightly so, these games have been praised.

The Mass Effect series, of course, shows an in depth understanding of characterization and motivation, highlighted as I said above, by Ms Chambers presence in ME2. The choices given to commander shepard directly effect how characters will react to you at specific points in the game, which is a fun narrative experience.

"The Thing" on PS2 addressed another aspect of mental stability, by putting the onus on the player to make hard decisions about followers by balancing the trust you have that they aren't infected sleeper zombies with the trust they have of your command. A very interesting and under rated mechanic for an exciting survival horror game.

Deus Ex also had a nice little social enhancement feature that categorized NPC's into psych profiles and made the player think about how to use dialogue options to stand down aggressive or secretive NPC's.

To a lesser extent, games like Skyrim and Fallout give players the option to peacefully resolve situations with words, using mind over matter, but compared to the aforementioned games, these RPG's do not exploit these game's unlimited "freedom" to design quests and narratives based around a character's mental health, trust, sanity and motive.

To The Point:

Of course, none of these games TRULY deal with serious mental health with the depth and respect the issue deserves. Most of the time, mental health issues are conveyed as rather comical or superficial and do not delve deep enough into characters enough to flesh them out.

This is why Jonathon Holmes needs to be a protagonist or companion in a game like Skyrim.

Gamers are interested in the tactics of battle why would they not be interested in the tactics of calming down an NPC who has been disadvantaged in some way by their mental health? A companion traumatized by obsessive doubt that needs to be saved by a dose of reason, sympathy while avoiding reassurance (which is apparently bad for people with OCD, I don't know ask Jonathon Holmes am I right?)

Imagine an NPC who has to deal with a schizophrenic parent, caused by a skooma addiction?

What about dealing with Farkas (?) arachnophobia by helping him confront his fear of spiders? Then he could come into Ysgrammors tomb with me!

Understandably, these gameplay elements on their own would probably become tiresome quickly, but as small elements in a larger RPG like Skyrim, they could present another level of richness to an already deep game.