You wake up in a tiny, dirty room. Like in many other videogames you've played before, you've been involved in a car accident, and now you don't remember who you are. Unlike any other videogames you've played before, you open the door and find yourself in mental facility located in a a gothic tower, and one of the patients is smashing his bloody head against a wall. An alarm rings intermittently in the distance, and the patients are all out of their cells. The staircase has broken down, and one of the patients is standing at the edge with his pants down. You go talk to him, and he falls down. It's a long fall. There's a huge statue in the middle of the tower, and suddenly it lights up and starts talking to you. Now you're in a small town full of giant plants. There are no adults to be found, and all the kids are mutants. You play Tic Tac Toe with one of the mutant kids. This goes on for the duration of the game.
Sanitarium is, mechanically speaking, a fairly by-the-books adventure game with a minimalist UI and control scheme. You play only with your mouse, left clicking to observe and manipulate objects, and holding the right mouse button to move around. Clicking on your character will show the items you're carrying, which are never more than four, and clicking again will let you use them on the environment. The UI consists of the inventory and a simple conversation system. That's it.
You walk around, look around, talk to people, find objects and use those objects on other objects. Sometimes they are a bit hard to figure out because of the sheer amount of cool details that are on the levels, other times the top down perspective will trick you and an obvious solution will seem impossible, but those moments are few and far between. The puzzles are mostly relatively straightforward, and compliment the story nicely. There are also one or two action sequences which can prove to be frustrating since the game's controls are clearly not designed with that in mind. Every now and then though, the camera will change to a fixed first person perspective, and you'll have to solve a "proper" puzzle. Breaking down the pace of the story to turn switches and pull levers for ten minutes can be irritating. These feel out of place, since this game's strength is in it's atmosphere and story.
After a cutscene showing the accident, you're thrown into a spooky, twisted world. It quickly becomes apparent that this is all a product of your imagination, and yet, there seems to be meaning in it. You find yourself in a series of locations, all exceptionally different and familiar at the same time. Nothing is the way it should be, it all feels wrong. There's a certain uneasiness that permeates the whole experience. I wouldn't describe Sanitarium as a horror game, but it is, however, continually unsettling.
Proudly taking inspiration in Alice in Wonderland, Sanitarium is a game full of apparently random fantasy elements, that anyone who doesn't give it his full attention will find merely amusing. That's why the adventure game format fits it so well. As you're constantly looking for clues to solve your mostly trivial puzzles, you focus on the details of these dream-like worlds, and you start drawing lines between them to solve the real puzzle: "Who are you? And why are you here, doing these things?". The answer isn't in ringing the bells of the church so the kid with the deformed face fishing in the beach will leave his fishing rod up for grabs, but in the details that shape this place, a place formed in the mind of the protagonist, but also in the mind of the player.
I guess what I'm trying to say is that the story is multilayered. On one hand you have a very concrete situation in every dream/world you come across, and problems will come up in that story in the form of puzzles, but on the other hand, all these say something about the broader story, which is the real life of the protagonist. Weirdly enough, my first cblog was about a game idea with a very similar concept. My thought when writing that and when playing this game were very similar; games are a great way of creating metaphors, and it's a shame not many games have exploited that potential.
Sanitarium is wonderfully creepy, it tries some new things, and does some old ones well enough. For some it might be too weird, but for any fan of adventure games, this one's a gem.
P.D: More unsettling screenshots in the image gallery, with a look at the inventory system and the annoying puzzles. Also it's dirt cheap on GOG for the next few hours.