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I've recently started playing role-playing games again, and my current group are excellent in that they are very conscious of eachother's mental well-being. We openly discuss what we are and aren't ok with happening 'at the table' (we play by chat, but that is not relevant), which has made me more aware of my choices and checking in on my fellow players on a regular basis.

It's made me want to think about running my own games, either by post, by chat, in person or otherwise.

However, I'd like to make sure the games I'm in (as a player or GM) accommodate other's mental health and avoid anything distressing by bringing it up in a session zero. However, the last in person group I played with has never heard of session zero, and I don't know that they are all ok to openly talk about their own mental health in a group setting (even though at least one of them has opened up to me in the past in private).

How can I bring up this aspect of session zero, or should I avoid it entirely/drop hints in the hopes somebody speaks up if they feel the need? I want to avoid the bystander effect making it so nobody wants to speak up first.

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    \$\begingroup\$ @JeffZeitlin Please don't answer in comments (including partial or speculative answers). You could use this as a starting point for your own answer. \$\endgroup\$ Dec 21, 2021 at 14:30
  • \$\begingroup\$ Possibly related: rpg.stackexchange.com/questions/30906/… \$\endgroup\$
    – Raj
    Dec 21, 2021 at 14:56
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    \$\begingroup\$ There are already great answeres, but I was wondering if they know each other or not? If I would play with friends I wouldnt mind talking about it with everyone or the GM in private (though I dont think there is anything in DND that would bother me). I did play with people I didnt know and I wouldnt want to talk openly about my problems with them. I dont even think I would want to talk to the DM about it. \$\endgroup\$
    – bibleblade
    Dec 23, 2021 at 9:00

5 Answers 5

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Do not force people to open up

or even appear to force

I have a depression and I started diagnosis for ADHD and autism (process stalled by pandemic and overload of psychical healthcare). And a couple of minor issues I'm not willing to disclose. So I'm talking from my experience. I also played with people I know to have issues.

Mental health still comes with stigma. People are afraid they will be judged for it or treated differently if it'll become known. And for the most part they are right about that! Ridicule is bad, but things like pity or excessive cautiousness are hardly better. Asking about mental health problems is, in some ways, more rude than asking someone "Hey, do you maybe have an erectile dysfunction?".

Be delicate with preemptive questions

If you will ask "Does any of you have a depression? Because if so, I'll make this campaign happy and bright!" I will get up and leave, or outright lie to you in your face. There are two things you can, and should ask:

  1. There are some things in my campaign that I think may be uncomfortable or cause distress for some people. Here is the list. Are you OK with them? Do you need some accommodations? Or something must go or else you don't play?

  2. Do you need, or want, some accommodations I might not know about? Like topics you want to avoid, foods you are allergic to, breaks every ___ minutes? Anything? Feel free to tell me now or message me in private.

You can only prepare so much

So be prepared to solve things as you go. Don't get angry at your ADHD friend for not taking his meds and getting distracted (if that happens; it doesn't have to), if your depressed player stays in bed allow her to play via webcam or allow her character to stay in the town too, and don't make her lag behind with XP, if someone asks for a break and seems serious then stop everything and make that break, and so on.

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  • \$\begingroup\$ This is an excellent answer, and one that resonates as I have also had a very staggered ADHD diagnosis/medication schedule in part due to the pandemic. I'm going to wait a short while, but I'm likely to accept this. \$\endgroup\$ Dec 21, 2021 at 22:20
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    \$\begingroup\$ I think it is sometimes legitimate to leave the table if you do not have mental health issue but some other people do. This is because you might have different requirements for the game you want to play and it is not possible to satisfy both. This is another thing apart from stigma that people might be afraid of experiencing as they start blaming themselves whereas it's no one's fault in particular. \$\endgroup\$ Dec 22, 2021 at 1:50
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    \$\begingroup\$ @AndrewSavinykh it's always OK to leave the table over different requirements and expectations. But the underlying reason of those differences is largely irrelevant. \$\endgroup\$
    – Mołot
    Dec 22, 2021 at 7:52
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    \$\begingroup\$ I would also add that you should state that if anyone is feeling uncomfortable, he has the right and no one will judge him to either ask the game for a pause or to temporary or permanently leave the table. \$\endgroup\$
    – RomainL.
    Dec 22, 2021 at 13:14
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    \$\begingroup\$ Those two questions are great. Some people might have diagnoses, some might not, some might suspect they do. This doesn't matter. What matters is what they need, what they want, what they're OK with. The exact reason why is seldom important in that situation. One person might not want excessive violence in the game because of past trauma while another might not want it because they simply don't enjoy that style of storytelling. For the game and the person running it the result is the same. \$\endgroup\$
    – Szandor
    Feb 25 at 10:47
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Speak to every player individually.

After the typical "session zero", you may want to talk to each player individually, if they feel comfortable. Someone may not be comfortable saying that they're uncomfortabable with a certain topic in front of others, for a variety of reasons, but may feel more inclined to do so in a more private setting.

As Molot said in his excellent answer, you cannot force people to open up, even in a private setting. But you could ask them if there were certain topics, which they may have issues with, perhaps even mentioning that it's okay that they didn't speak up publicly about them.

Make sure your players know they can approach you.

I've had several different GMs and they all reacted differently to criticism. And by "criticism", I mean any form of expressed desire to divert from where things are going now. It doesn't matter if the topic was "Could we please reduce the amount of sexually explicit content?" or "Could we please have more exploration?", GMs will react differently. Some may be very open to suggestions, others may feel like you're indirectly telling them that they're not doing a good job.

Telling your players outright that, if they have any issues with any topics presented, they can always come to you and speak about it, can go a long way. Asking for feedback after every session or every other session can help as well. For example, just casually asking "So how do you like how things are going right now?", either to the group or individual players, can help people get the foot in the door to open up about potential issues.

Accept that you cannot do everything for everybody.

This may be a hard thing to do, especially if you know that someone has mental health issues, and even more especially if it's someone you care about a lot.

When you GM for a group of players, the most you can do is attempt to accomodate everyone. You can offer people to speak about potential problems they may have, but you cannot "force" players to take you up on that offer.

For example, if one of your players has a personal issue with a given topic and they don't bring it up at any point, or even reaffirm that they're okay with it, then suddenly decide to drop out of the group because it's too much for them - don't take it personally. There is nothing you can do about it, you're not at fault for including it in your campaign. It is simply an unfortunate turn of events.

You can't look into other people and know for certain what they think and feel. Only they have the ability to vocalize their feelings, and if they refuse to do so, then that's unfortunate, but there is nothing anyone can do.

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    \$\begingroup\$ This is, in itself, a fantastic answer. Thank you for posting! \$\endgroup\$ Dec 22, 2021 at 4:14
  • \$\begingroup\$ @AncientAwordRage I'm glad it was useful to you. I hope it'll help you in your future endeavors. \$\endgroup\$
    – MechMK1
    Dec 22, 2021 at 4:39
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I think your concern will be addressed with a Safety Tool, such as Lines and Veils. According to a guest blog on roll20:

Safety tools are a resource for the players and GMs to communicate and check-in before, during, and after a game. This is to ensure that everyone is still having fun, and to provide the right support when needed.

Dicebreaker has this to say:

Lines and veils can be as general or specific as each player desires. They are discussed so that everyone can be aware of them and understand how the world will work, never to be questioned or interrogated. Additionally, after the session and at any point afterwards, players can contact the DM to add to the list, or make specifications or alterations to existing ideas.

Sly Flourish also discusses safety tools:

Humans are complicated creatures. We've all led unique lives and many of us have dealt with trauma from a wide range of potential sources, situations, or phobias. Whatever these experiences are, we don't need to bring them into our D&D games when we're all just hoping to sit around the table (virtual or physical) and have a few laughs with our friends.

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  • \$\begingroup\$ This is a great answer, but feels it would be better placed on a different question. \$\endgroup\$ Dec 21, 2021 at 22:16
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    \$\begingroup\$ I see this as a frame-challenge, which is fine: "here's how you address mental health -- one could be a session-0 thing but probably not, the other isn't". But the last quote puzzles me -- it seems to be saying that the trick to avoiding mental health issues is to avoid anything questionable, making your game light-hearted and silly. \$\endgroup\$ Dec 22, 2021 at 1:28
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Ask before, Ask during, Ask After

I've made up a list of questions to send to my players before session zero; it's not super long (I'll try to dig it up for this answer, but for now I'll just go off memory), but it addresses a few things.

Some of these things are declarations from me (for example, no sexual assault), and some of these things are questions, such as "is it okay if racism is addressed?".

Before: I sent this list out before session zero, asking that it be looked over and reported back to me about.

During: We talked about what I'd received (anonymously) during session zero.

After: And after our first gameplay, I asked the players again.

Your mileage may very, but I had good results, with admittedly a good group of people.

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  • \$\begingroup\$ Is there any part of this that's mental health specific? \$\endgroup\$ Dec 21, 2021 at 14:31
  • \$\begingroup\$ @AncientSwordRage specifically, no, but it can be used for trigger topics (i.e. sexual assault), or accommodations - we played with someone with Tourette's syndrome and made sure to give that person a little extra understanding. \$\endgroup\$
    – goodguy5
    Dec 21, 2021 at 14:36
  • \$\begingroup\$ So is the advice actually not to bring it up? Or to bring it up if you think it's relevant? Like "Hi everybody, this is Brian. He has Tourette's, which gets worse when stressed, so if he asks for a time out to control that, let's all be respectful of that request."? Or do you wait for somebody to offer that their depression might make them miss some sessions? \$\endgroup\$ Dec 21, 2021 at 14:40
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    \$\begingroup\$ My recommendation is to ask about it before session zero, if they'd like to talk to you about it privately. Address anything publicly during the session that can be "If you need to step away from the table, that's okay" - "we all have lives and might miss some sessions, please just let the group know before the day of", etc. \$\endgroup\$
    – goodguy5
    Dec 21, 2021 at 14:47
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"Session 0" gets used as a blanket term for things to do before the game starts, but that's not what it really is. Session 0 is a session -- you get together and decide on things that need back-and-forth and general agreement with the whole group. It's often as simple as making sure at least one person has good healing skills, there's a stealth person, and a pilot. If 3 of us decide we were in the same unit in the war, maybe the mage asks to be worked into the unit as well and is given some extra military support spells. If 3 players want to be barbarians, the person who wants to be a spell-caster can change to a barbarian shaman.

Then more general stuff: what levels do we want to start at? Are we all working with the rebels, or just free-lancers who will eventually end up on the empire's naughty list. High-magic or low-magic? Are we using the extended source-books? Will it be single-mission oriented or more sand-boxy? How much player conflict?

This is all give-and-take stuff that involves discussion. If everyone else wants to be in a circus, righting wrongs in every new town -- maybe I don't love that, but I've always wanted an excuse to play a monk and the GM promises there will be enough combat and everyone is cool with me being the star in fights. Good we all got together and hashed that out.

But things which can be done without the group should be done without the group. You wouldn't invite Ben and Kathy, who hate each other, to session 0 and say "OK, only one of you can play, let's decide". Do it beforehand. Likewise, suppose a player doesn't want any NPC's as battered spouses. That's not something to negotiate about, so there's no point bringing it up in a group session.

To sum up, if it's confusing then don't say "session 0". Say the first session is to roll up characters. That's something easy everyone can understand and it gets across the idea you're doing it as a group, for reasons. Then use that wording as the GM -- mental health isn't under the general heading of "rolling up characters" and as you note, it isn't something everyone should be talking over together, so handle it elsewhere. Yes, it's somewhat mixed -- if the players talk themselves into being former child soldiers of the evil overload and one player is squirming, oops, sorry. But it's not like you said "child soldiers -- I need everyone to publicly give their opinion".

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