[Quick editorial note: To fully discuss the game’s themes, there are some light spoilers about mid-game mechanics and a few people’s stories. No major plot stuff though. If you want to go in fresh, go pick it up and then let’s meet back here after. Enjoy!]
My favorite type of movie is pretty specific. I love original sci-fi, with a deep world that I only get to see a part of. Even better if it’s a one-and-done deal - I don’t want 7 movies that lay out all the mystery that intrigued me in the first place. It’s rare to find movies like this, but one that’s always held a special place in my heart (despite breaking the sequel rule) is Blade Runner. It’s a weird movie, with pacing that honestly leaves a lot to be desired, but every piece of lore you see just pulls you in further, needing to know more about the world and its characters.
In the movie, the main character is trying to determine if someone is a replicant (robot) or a human, using the Voight-Kampff test, a series of questions that describe situations where someone needs to make a moral choice. The tests are long, dialogue-heavy, and strangely unsettling, for what essentially amounts to two adults discussing how they would hypothetically treat a turtle. But really, the tests lay the groundwork for a much more fundamental question: what does it mean to be human? And while the movie shifts to action-packed sequences, I always wondered about the day jobs of the other blade runners - how they might feel about it, and the choices they made along the way. Enter: Mind Scanners.
In this game from developer The Outer Zone, you play as a newly hired mind scanner, tasked with finding and treating “anomaly” patients in the Structure - the retro-futuristic megacity you live in. This isn’t your dream job though. Your daughter has been taken into custody by the Structure, and the institute where she’s being held requires a level 3 clearance to enter - no visitors allowed. Since the Structure tightly controls everything, and disobedience means expulsion, you’ll need to work your way up the chain in order to find her.
Not everyone agrees with how the Structure operates though. Allegedly dangerous people are piling up outside the city gates, a covert organization wants you to oppose your orders, and some of what you’re being asked to do just doesn’t seem right. How you choose to treat your patients, who you decide to help, and what orders you follow are all up to you, and each decision will ultimately decide not only your fate, but those of the people around you.
The day-to-day job of a mind scanner involves visiting patients, diagnosing them as either sane or insane through a series of Rorshach-meets-Voight-Kampff tests, then “removing” their insanity. The diagnosis part has them describe what they see in an inkblot test, and how they feel about it. You’ll need to choose an interpretation of their thoughts (is this person afraid of Cacti, or does their desert vision represent a fear of abandonment?), and repeat this a few times until you have a clearer picture of their personality and state of mind.
After diagnosis, each patient will be assigned insanity types, represented by different symbols. Each of these types corresponds to a unique device used to extricate that issue from their psyche. Each removal device is also fairly disturbing. For example, you have a thought-reading machine, where you adjust levers until you can make out a word in their jumbled crossword of a brain, and choose whether to keep or erase that feeling. My personal favorite device is an absolutely disgusting throat… thing that you need to wind open carefully. How will you know if you’re being careful enough? Well, for starters the patient will make a HORRIBLE warbling sound if you go too quickly. If that wasn’t enough, their trembling lips give you a handy visual cue as well.
The insanity types have to be taken out in order but similar types can be bunched together for faster removal, like a macabre match-3 game. Removing these blocks isn’t the only thing you’ll need to keep in mind though. Each removal also takes a block off of a bar representing their personalities, and making a mistake raises their stress. If they get too stressed out, they’ll need to take the rest of the day off of treatment before you can continue. If you obliterate their personality though, it won’t come back - more on that in a minute.
There are only so many hours in a day, or in the case of the Structure, seconds. Each day you have a total of 200 seconds to complete your workday. Time doesn’t go down while you’re reading or deciding where to go next, but while you’re treating your patients it ticks down in real-time. Traveling to each patient and developing new tools to cure people takes time as well. While you might be thinking that there’s always tomorrow, you’re only half right. You don’t have a specified daily quota, but the Structure requires daily maintenance payments of 7 “Kapok”, and you only make 15 per patient cured - which can easily take multiple days of work. Failing to make your payments means expulsion, which guarantees a swift death (and game over screen). This precarious situation makes the ethical choices you face all the more difficult, as you may not always have the time or money to do what’s right.
Back when I played the demo, the three patients I encountered and treated all seemed to pretty fairly meet the criteria of someone who needed the intervention of a professional. In the full game, things are a lot less clear. Most patients weren’t doing great, but that doesn’t mean they were exactly the dangers to society that the Structure was describing. There was one woman who was incredibly depressed after losing her family in an accident, and a burned-out student who couldn’t cope with the pressures of constant achievement. These people needed my help, not the destruction of their personalities and minds. Which brings me back around to the game’s central theme: the essential component of empathy and care in mental health treatment.
To make the Structure happy, all you have to do is treat every patient as quickly as possible. There are no penalties or even concerns raised if you overdiagnose people, only fines for failing to diagnose people who needed it. In fact, the game’s mechanics strictly encourage you to irreversibly trample people’s personalities, as it’s faster and therefore safer for you to get through as many patients in as little time as possible. It’s so encouraged, in fact, that in my first playthrough I actually missed that you could construct devices to restore or protect people’s personalities - I felt completely helpless as I turned person after person into a sanitized husk, acceptable to the authoritarian regime but no longer wholly human.
Once I realized that I had the power to change what was happening, the game became an entirely new experience. While mindlessly following the Structure’s instructions and obliterating minds was pretty simple, taking care of people was harder. But for every day I sweat over making my maintenance payments, I was as often rewarded with dialogue from an overjoyed person who felt like themselves again. What they needed was someone who cared enough to listen, not a blanket diagnosis and a harsh treatment that conditioned them into bland, acceptable, obscurity.
This isn’t to say that every choice will be easy. That depressed women I mentioned earlier? She’s literally begging you to rip her memories out so she won’t have to feel anymore. Another time I was given specific orders from the regime, concerning someone who really had accidentally killed someone, which seemed impossible to ignore if I still wanted to see my daughter again. Honestly the freedom to approach treatment on what terms I felt were right was exactly what made the ethical decisions so hard. This isn’t the story of one person fighting against a dangerous government, it’s the story of how complex humans are, and the nuance of the “right” thing.
It also lends itself well to a critical eye on the current state of the mental health industry. There is no way to help someone without labeling them as “insane” - either they’re a complete danger or they receive no help at all, with no options in-between. This pretty clearly speaks to how in most cases, people can only receive help when mental health issues have progressed to a certain point, as preventative care or mental health checkups are unfortunately uncommon. Though a tricky subject for a smaller game, and I don’t love perpetuating the trope of mental heath care taking away personality or creativity, I still think it’s well-addressed and satirizes the authoritarian regime well enough to drive its point home.
In Mind Scanners, I had a variety of choices to make beyond who to diagnose and treat. I was offered intelligence-increasing drugs, mysterious gifts, and alliances with covert organizations - all in my fist week! Many of these seemingly innocent choices influenced how the story would eventually play out, but there was also a nice balance of smaller interactions that seemed to just be for me. The control offered through my actions, coupled with the story beats that reflected how I played, made the game feel like it was respecting my choices, while always offering other possibilities.
The game also has a handy rewind feature, which was helpful for both figuring out the treatment games and for when I was mauled to death by REDACTED. Rewinding will take you back to the start of any day, erasing all of your actions since then. This made checking out other storylines, possibilities, and consequences way faster - my first playthrough took around 2.5 hrs so there’s definitely a lot to see. Of course, it can be a little difficult remembering what happened on which day (unless you’re cool and take notes, like me) so you may end up just wanting to play fresh to see what the other paths would have looked like.
For subsequent playthroughs and maybe even your first one, I’d heavily recommend checking out the easy difficulty setting. It slightly lowers your maintenance payment and makes it much easier to see more of the game. You’ll still need to do about as many of the treatment games, but it negates a little of the pain of the high travel costs and smooths the 1 or 2 arcade games that feel a little more like luck than skill.
Overall, I had a great time helping* the citizens of the Structure, and finally got to live out my blade runner dreams. Once I had the mini-games sorted, their consistency let me focus on exploring the side stories and characters. While the games’ aesthetics and frantic arcade-style treatment devices were good, the true highlight was its exploration of theme through gameplay.
This game uses its mechanics to fully embody the difficulty of dedicating time to your patients, illustrating its larger point about the importance of care in treatment. You fully feel the weight of your decisions, for better or for worse, and the seriousness given to your approach is what makes it something special. The interesting characters and dialogue were surprising, engaging, and oftentimes incredibly easy to empathize with, so playing through multiple times isn’t something you have to do, it’s what you’ll want to do. Mind Scanners is available for PC on Steam or GOG. (*storyline-dependent)