Sanitarium is a psychological horror adventure game, developed by DreamForge and released in 1998. A game I have, for many years, seen sitting in that murky middle section of adventure game lists. I've seen it go on sale probably a hundred times over the years, always considering it but passing up it's slightly too high price point in favour of other games. But I recently took the plunge, and while I don't think it quite holds up today, it's an enjoyable ride worth taking for adventure game fanatics that want an interesting take on the genre not explored in many other games.
Sanitarium's story begins very jarringly: upon opening the game, you're immediately thrown into an FMV of the protagonist getting into a wreck before suddenly waking up in an insane asylum. From here, the game falls into a rhythm; a section exploring the asylum, followed by falling into a macabre dreamscape. There is no rhyme or reason to the game's levels; obviously the point, although I feel they probably went a bit too far. Each individual world is often interesting in some way, but the threads tying the entire game together are relatively thin. A problem not felt early on, when the novelty of the plot is still fresh, but by the final level it had become somewhat tiresome.
As mentioned, there is an overarching plot; throughout each individual dream sequence, various bits and pieces of the protagonists memories are slowly restored. A common video game trope, but handled surprisingly well here; at the very least, I was always excited to find out more. By the standards of todays storytelling, the "truth" you unravel in the game isn't very elaborate or shocking; I had essentially surmised the entire story very early on. But the game leaves enough open that there's still room for interpretation. Without spoiling anything, the end of the game leaves a lot more open than it does closed; but perhaps that's for the best.
Sanitarium is a very pure point-and-click adventure; a no frills UI and very limited interaction with objects and the environment. This does a lot to make it beginner friendly, and also a breath of fresh air for avid adventure gamers. It maintains a level of complexity above the dialogue driven adventure games of today, but doesn't delve too deep into puzzling insanity as the games of old; to be honest, I'm surprised the "Sanitarium template" isn't what emerged as the dominant form. To draw a more modern comparison, it's very similar to the Telltale Sam and Max games. And, while tastes may vary, it lands about where I enjoy adventure games the most. In terms of the UI and mechanics, at least. For everything else, though, Sanitarium leaves something to be desired. My biggest gripe is the way the game handles signalling interaction; for any object on the screen, initially hovering over it will always result in an "Inspect" icon. To actually physically interact with anything, you must first inspect it. Not initially frustrating, but later on it reaches near pixel hunt levels of tedium. Buried in a sea of pixels, or surrounded by non-interactables, a lot of later levels become slogs if you don't have a guide with you to confirm that, yes, the thing you're trying to interact with IS interactable.
And that's the main critique of Sanitarium I would levy; without a walkthrough, the game is a slog. There's no run, and your character will endlessly repeat inspection dialogue as you click through the environment trying to see what you need. It tries, and in a lot of ways fails at being an approachable adventure. But it does have its strengths. I enjoyed pretty much every puzzle, obligatory esoteric ones aside. The game perhaps pads out its runtime a little bit too long with a few too many, especially in the final two levels. But, ultimately, for both the puzzles and the pure adventure segments, I think the good outweighs the bad. When you're just talking to the varyingly insane denizens of each world, the game is at its best. And those highs linger with me, despite the bad parts surrounding them. And in that way, the game definetly met the high expecations I had.
The game mostly uses an isometric perspsective, rendered in a very lovable low resolution, throughout most of the levels. Certain puzzles will switch to a first person, interactable image in the vein of Myst, and the occasional third person FMV is thrown in for important visual moments. As mentioned earlier, the UI is sparse; but very well designed and immersive, for the most part. The main menu theme is a particular joy: a very eerie and retro design, complete with creepy girl audio naming whatever button you hover over. The environmental and character design does not dissapoint, either. While rather tame by the standards of modern horror, the various environments and semi-frequent depictions of gore and violence was probably shocking to gamers of the time. It certainly exceeds the standards of even today's adventure games, for sure.
The music was something I didn't find very noteworthy. It serves its purpose well, but there wasn't any standout tracks I would recommend. The only one I distinctly remember is the very odd attempt at a humorous track that plays during the credits, that overlays tracks and voice clips from the game. Distinctly rememberable because it's probably the worst attempt I've ever heard at that sort of collage. Other than that, nothing else is particularly unbearable. Although there is a definite lack of musical variety; every area features a somewhat short, looping background track, without much variation. If a particular track offends you, be prepared to endure it for the entire length of the level.
I can speak much more positively about the voice acting and sound design, though. While it has a fair amount of ham and cheesiness, the game's actors mostly have good performances. And the game is fully voiced, too, somewhat irritating when you're trying to figure out puzzles and have to listen to repeated dialogues but a pleasure elsewhere. The game isn't a high budget affair, and none of the VA's were (to my knowledge) high profile or have become so in later years. Many of them seem to be company employees moonlighting in side roles; amusingly, Paul Crocker, who would later go on to write for some of the Arkham games and Halo: Infinite does some VA work here.
Overall, the aesthetics of Sanitarium are really what drew me in and kept me playing. Through the games shortcomings in gameplay and design, the unique and macabre environments kept me intrigued. The game has a wonderfully mundane way of depicting horror; a relatively straightforward and unimaginative carnival has the backdrop of a corpse-filled harbor, for example. It really captures a dreamlike feeling, even if I wish it tapped into horror elements a bit more.
To put it flatly, Sanitarium didn't live up to the huge amount of hype I've seen around it on the internet. While I commend it for not relying at all on cheap horror or jumpscares, as someone playing it decades later it leaves it feeling like a horror movie without the horror. The plot is too often servicable rather than great for me to praise it extensively, and the gameplay have moments of greatness punctured by tropey adventure game segments. But I still had a lot of fun playing it, and in several years I think it'll probably still linger in my mind. It, in a lot of ways I think, fails to live up to it's own self-set expecations. It sets up payoffs that are never really delivered. But if you go into it with those sorts of expectations, I think you'll be pleasantly surprised. Ultimately, the list of horror adventure games is surpisingly short, so if that subgenre is of any interest, if nothing else I think you'll find historical value in Sanitarium. Newcomers, too, might appreciate the very approachable level of challenge the game offers. My final verdict: 6/10.