Insanity, Horror, and the Outer Beings in Mystara:
by Geoff Gander
Adding insanity and horror rules to the Mystara setting,
The Outer Beings and Insanity:
Although Mystara is considered by and large to be a world of epic fantasy, a realm of bold warriors and cunning
sorcerers, a place of magic and wonder; it also harbours dark secrets. The threat posed by the Outer Beings
since their imprisonment so long ago by the Old Ones, while indirect, is very real. Some of their lesser servitor
races are known to inhabit certain less-frequented regions of the planet, and small portions of the indigenous
races of Mystara have sworn allegiance to these utterly evil entities. Knowledge of the Outer Beings and their
foul machinations has always existed among the various peoples of Mystara, in one form or another, though in
more recent times that knowledge has begun to spread. Rumoured sightings of strange creatures are also on the
rise, though many still dismiss these as products of overactive imaginations, or at worst sightings of humanoids
mistakenly identified as something else.
Making matters all the more suspicious is the appearance of the Day of Dread. On that day, the absence of
magic is thought by some to temporarily weaken the seals on the Outer Beings' prisons, even though those were
not fashioned with mortal magic. On those days, mental illnesses are believed to worsen overall, and the
prevalence of nightmares increases.
Treatment and Therapy for the Mentally Insane:
Charitable organisations, temples, and the like have noted increasing numbers of people seeking counsel and aid
against "horrible monsters" and "things which should not be". Some of these are surely the products of overactive
imaginations, or chance encounters in dark alleys, but others continue to boggle observers and scholars.
Although most people coming to these facilities are in a state of mild shock, or otherwise stunned, others have
been admitted as raving lunatics, screaming about things they have seen that are just too horrid to behold,
creatures that do not even remotely resemble any normal creature they have seen. In more developed nations,
where there are means to care for such individuals, some of these victims might be treated, and possibly cured.
In less-developed nations, such raving madmen are often abandoned, and left to wander the streets.
Availability of Treatment:
In a medieval world such as Mystara, there are few places where those who are driven insane may find
treatment. In most cases, the life of a madman is cruel, and short. Most people tend to shun them, seeing them as
cursed, or possessed by evil spirits or in the service of some evil Immortal, but this unfriendly treatment can
extend all the way to open hostility towards the insane person, or treating them as some sort of amusement.
Nations where treatment is available may not view the insane any more kindly - they may even consider
treatment facilities as a means of getting rid of the problem - but the facilities are there for those who can afford
them. Exceptions to this include sanctuaries run by religious orders or charities. In the former case, services might
be provided in exchange for conversion to the faith providing the treatment, the provision of an annual tithe to the
church or temple, or the performance of various tasks benefiting the religious order. Charities are much rarer,
being run by wealthy "philanthropists" as a means of reducing their tax burden (in nations where tax deductions
are given for charitable acts), or out of an honest desire to help others. In the latter case, such operations often
survive through frequent donations, and their stability is tenuous at best, or, in very rare cases, a true humanitarian
is providing some of his or her own wealth to run the facility.
In addition to these, some facilities are also run by wizards, though not for the benefit of the patient. Scattered
across the more developed nations of the Known World are institutions run by wizards whose sole aim is to
perform heinous experiments on their patients, out of a morbid curiosity concerning their insanities and how they
might have been caused. In these places, patients are considered little more than test animals, and they are
treated as such; the wizards who run them know that few people will care whether a mentally ill person lives or
dies, and so they operate with impunity in many nations.
In the Known World of Mystara, the following nations are sufficiently developed to provide psychiatric treatment
of the sorts described above, on a wide scale (ie: one facility available per 10,000 people):
Alphatia, Darokin, Glantri, Shadowelven Kingdoms, Thyatis, Ylaruam.
The following nations can provide psychiatric treatment of the type described above on a moderate scale (ie: one
facility available per 20,000 people):
Alfheim, Heldannic Territories, Kastelios, Minrothad Guilds, Rockhome, Wendar, Yavdlom.
The following nations can provide psychiatric treatment of the type described above on a low scale* (ie: one
facility per 40,000+ people):
Five Shires, Karameikos, Hule, Ierendi, Sind.
*Please note that "low scale" does not imply a lack of social development. The nation might be too poor to make
such facilities financially feasible, or the population base is not large enough to support them. Other reasons could
include a low incidence of insanity among the populace, different methods of treating insanity that do not require
formal care, or a reverence of insanity as an exalted state of being (as might be the case in Hule). This also
applies to nations not listed here.
DMs should also note that, just because a given nation has a stated availability of treatment, this does not mean
that such treatment is readily available at that level, or even affordable. For example, Darokin is listed as being
capable of supporting one facility per 10,000 people, such that, for a city like Selenica (pop.: 40,000), there may
be up to four asylums within its walls. It could only have one asylum, though, and even then, that one asylum
could be a small one, capable of treating only up to 30 people. The figures given above should be considered as
a guideline; just because a person is in a developed nation, it does not mean that treatment will be accessible, or
affordable.
Type of Treatment:
The types of treatment available to the insane at these facilities is quite different from that we come to expect in
our own world. In a world of magic, there would be very little incentive to develop medicinal or surgical
techniques to resolving the problem. In those countries where psychiatric care is more widely available, there are
growing fields of research in the areas of the causes of insanity, its effects on the average person, and magical
cures to aid victims in recovering from the illnesses. The length of treatment can vary, depending on the nature of
the ailment, but as a general rule, it lasts at least 3d6 months, and possibly as long as a year or more.
Magical treatment can consist of regularly-prescribed potions or salves, and can extend to spells cast upon the
victim. Nonmagical treatment, where it exists, would consist of regular interviews or discussions with the patient,
in which the therapist attempts to help the patient deduce what is bothering him or her, and find a way of
resolving it - psychoanalysis. In facilities run by religious groups, insanity is sometimes attributed to heresy, and
only through conversion or the admission of sins will it be cured. In Sind, where emphasis is placed upon sound
minds and bodies, some monasteries have been known to shelter the insane, using yogic exercises and meditation
to treat people, sometimes with miraculous results.
As a final note, "quackery" is rife in Mystaran psychiatry, with roving "experts" travelling the byways of the
Known World, plying their "magical" cure-alls and imploring upon the Immortals to cure the afflicted, all in
exchange for readily available sums of money. Some of them have been known to falsely diagnose people of
mental problems they did not know they had (and which do not even exist), in order to boost their own
standards of living. Due to the relative novelty of psychiatry on Mystara, no nation has yet enacted a series of
laws, or a code of conduct, by which all psychiatrists and therapists must act. As such, quackery is not illegal in
itself, but the associated acts (theft, wilful deceit, peddling without a license) most certainly are.
The Typical Asylum:
Most facilities for treating the insane are simple affairs: average-sized buildings containing living quarters for
patients, and offices and general purpose rooms for the usage of staff. Living conditions in these asylums vary
greatly, ranging from comfortable in well-funded facilities, to abysmal in those that have fewer resources. The
better-equipped, and more expensive, facilities often have large walled enclosures surrounding the building itself,
where patients can walk outside and relax, or exercise. In most cases, well-funded asylums are kept separate
from urban areas, in order to isolate the patients from the rigours of the city, as well as keep them out of sight.
Asylums in urban areas, especially those that are squalid, offer little insulation for their patients, and in some
cases, cityfolk will visit these places as a means of amusing themselves, by watching the insane go about their
activities.
Most asylums tend to be rather small, being capable of treating 11-30 (10 + 1d20) patients at any one time, plus
a few rooms for overnight staff (in case patients get violent during the night). Staff is also quite small, being
roughly 3-8 people (1d6+2) in most asylums, most of these being caregivers or supervisors. In all asylums there
is at least one psychiatrist, or at least a general theoretician in the study of mental illnesses. This person may or
may not be a magic user or cleric. In larger facilities, there is also a small group of administrative clerks as well,
who balance the books and maintain records of each patient's progress. Where there are not enough resources
to hire such people, the caregivers or supervisors themselves will take on these jobs.
Cost of Treatment:
Due to its rarity on Mystara, psychiatric care, even that of poor quality, is very expensive. Even in developed
nations, most people would have to travel considerable distances to find an asylum, and even then their capacity
to handle patients is very limited. Most average-sized asylums could not greatly exceed their maximum capacity,
before the workload would begin to exhaust the staff. Fees are usually assigned on a weekly or monthly basis,
covering accommodation, food, staff salaries, and treatment. Most asylums will "encourage" payment in advance,
for a specified period of time according to a contract, as well. This of course does not apply to those facilities run
by wealthy philanthropists, or religious groups, who will provide services for a nominal fee, or a tithe or
conversion in the latter case. If the facility in question is not run by a wealthy religious group or a philanthropist,
funding is always a concern. There are always problems in ensuring staff is paid regularly, and enough food is
available for the patients. Some facilities, desperate to make ends meet, or morally bankrupt, have been known
to sell their "hopeless" patients - those they do not think they will be able to cure - to any who offer a decent
price. All too often, these patients are sold to wealthy, misanthropic wizards, some of whom run asylums of their
own. As mentioned above, life in these facilities is anything but pleasant, nor is it likely to be very long.
In general, the basic cost of caring for a patient depends on the location of the asylum. In large urban areas,
where resources are abundant, the cost will tend to be lower than in isolated locations. The chart below provides
some guidelines for determining the monthly costs of treating someone, based on the type of locale and size of
facility:
Type of Locale*
Size of Facility**
Minimum Monthly Cost of Treatment***
Urban
Small
4 gp
Rural
Small
6 gp
Urban
Medium
7 gp
Rural
Medium
10 gp
Urban
Large
12 gp
Rural
Large
20 gp
*The type of locale is divided into urban and rural regions. "Urban" is defined as a region in which the population
is centred on a settlement that is town-sized or larger (1,000 inhabitants or more). "Rural" is defined as a region
in which the local population is less than 1,000.
**The size of the facility is subdivided into "small", "medium", and "large" facilities. Small facilities can house
11-30 (10 +1d20) patients, and have 3-8 (1d6+2) staff members. Medium facilities can care for 21-40 people
(20 +1d20), and have 8-16 (8 + 1d8) staff members. Large facilities can accommodate 31-70 (30 + 2d20)
patients, and employ 16-25 (15 +1d10) staff members.
***By adventurers' standards, these fees may seem small, but they are very expensive to the average peasant.
Large, well-equipped facilities charge more per month than many families make in an entire year. This cost takes
into account salaries for staff (with psychiatrists being the most expensive, and large facilities possibly attracting
spellcasters willing to spend a few hours per month providing magical aid), food, the cost of accommodation
itself, and other factors. Although a larger size does defray some of the costs, having a larger number of patients
erodes much of the advantage.
Some asylums have been known to offer their services in exchange for services rendered, especially to those
families clearly in need, yet lacking the necessary money. As a rule, this happens rarely, but when it does,
relatives of the patient often find themselves performing menial tasks the staff do not wish to do.
Horror Ratings & Horror Checks:
Mystara is a world of magic and wonder, but it still contains its menaces. Though adventurers become
accustomed, over the course of their careers, to monsters of many types, there are still some creatures that
fundamentally disturb even the staunchest minds. Many of these creatures are the foul progeny of the Outer
Beings, while others have their origins in the Dimension of Nightmares. Regardless, all of these creatures have
certain attributes which, for whatever reason, have been known to disturb fundamentally the mental balance of
many people.
The table below classifies each otherworldly or horrifying creature according to a "Horror Rating", which is
measured on 1d20. When such a creature is encountered, the DM makes a secret "Horror Check" by rolling
against the creature's Horror Rating. If the number rolled is equal to or less than the creature's Horror Rating
score, the person who met the creature may develop an insanity as a result of the encounter. Please note that the
descriptions of the creatures listed here are available in the source indicated.
Creature
Source
Horror Rating
Athach
Rules Cyclopaedia
4
Beholder (& Undead Beholder)
Rules Cyclopaedia
6
Brain Collector (Neh-Thalggu)
AC 9: Creature Catalogue
10
Diabolus
Wrath of the Immortals
2
Hag, Sea
Rules Cyclopaedia
7
Haunt
Rules Cyclopaedia
3
Lich
Rules Cyclopaedia
3
Malfera
Rules Cyclopaedia
11
Medusa
Rules Cyclopaedia
4
Minion of Rasthz the Many-Mouthed
The Book*
4
Mummy
Rules Cyclopaedia
3
Nekrozon (Catoblepas)
Rules Cyclopaedia
2
Nuckalavee
Rules Cyclopaedia
6
Outer Being
The Book*
20
Phantom
Rules Cyclopaedia
3
Servitor of Ubbeth
The Book*
2
Servitor of Yurrgh-Thal, Greater
The Book*
13
Servitor of Yurrgh-Thal, Lesser
The Book*
7
Soul Render
The Book*
7
Spectral Hound
Rules Cyclopaedia
3
Spirit
Rules Cyclopaedia
5
Zhochal (Minion of Akh'All)
The Book*
3
*"Geoff's Big Book of Unspeakable Outer Being Lore" - available on several websites.
Other Ways of Triggering Horror Checks:
Encountering frightening creatures is not the only means by which a Horror Check can be triggered; situations
can also cause them. The list below contains events that could, at the DM's discretion, force a person to make
one. This list should by no means be taken to be exhaustive:
Event
Horror Rating
Seeing a corpse for the first time
2
Seeing a horribly mutilated corpse or severed body part for the first time
4
Witnessing the murder of a loved one
4
Undergoing extreme torture
3
Being subjected to fleshcrafting (minor alteration)
4
Being subjected to fleshcrafting (major alteration)
8
Being subjected to a Shadow Master's harrowing power
5
Determining Insanity:
Having determined whether or not a person has failed their horror check, the DM must then find out what sort of
insanity will be inflicted upon the victim. This is determined in part by the creature's Horror Rating, as well as
other modifiers, which are described below:
Horror Rating Modifier:
This modifier, positive or negative, reflects how frightening or otherworldly the creature in question appears.
Negative modifiers derive from low Horror Ratings, and reflect beings that either do not appear very frightening
(or they just appear "odd"), or their forms do not deviate very much from what most people interpret as
"normal". Positive modifiers are the result of higher Horror Ratings, which signify that the creature is either very
horrible to look at, or their appearance is just so bizarre that people have a great difficulty reconciling its
existence in a "rational universe". The simple table below presents the various Horror Ratings, as well as the
modifier that is derived from them.
Horror Rating
Insanity Check Modifier
1-2
-20%
3-6
-10%
7-9
NA
10-14
+10%
15-18
+20%
19-20
+30%
Wisdom Modifier:
This modifier reflects the bonuses derived from having a high Wisdom. Those with high Wisdom scores are
blessed with more common sense, and have a greater ability to see through illusions to the truth the lies
underneath. Such people, given their greater mental fortitude, know that there are certain things in the universe
that conventional knowledge does not touch; they are better able to rationalise the existence of "darker"
creatures. The table below presents the Wisdom modifiers for use in an Insanity Check:
Wisdom Score
Insanity Check Modifier
3
+15%
4-6
+10%
7-8
+5%
9-12
NA
13-15
-5%
16-17
-10%
18
-15%
Other Modifiers:
The table below, by no means exhaustive, presents other modifiers the DM may wish to consider in rolling an
Insanity Check. These modifiers are situational, and cumulative:
Situation
Insanity Check Modifier
Victim is already suffering a mental disorder
+10%
Victim has lost 50% of hit points or more
+5%
Victim has already made a successful Horror Check*
-10%
Victim has been blessed
-5%
Victim is carrying a holy symbol of some form
-5%
Per level of experience
-1%
Victim is an Illusionist or Phantasmer
-15%
*This bonus is applicable only in Horror Checks against that same creature, not against a different one; it is not
cumulative. For example, a PC encounters a Zhochal for the second time in one day. In the first encounter with
these creatures, a Horror Check was made successfully, and thus the PC gains a bonus of -10% to the Horror
Check against this particular Zhochal. If he or she makes this Horror Check and encounters a third Zhochal, the
PC does not gain a -20% bonus. If the second creature encountered is different, this bonus does not even apply.
If, in subsequent encounters, the Horror Check is failed, this bonus is lost, and must be regained by passing a
Horror Check once more.
Once all of the relevant modifiers have been summed, that final number is the modifier that is applied against an
Insanity Check. The base chance of suffering some form of mental malady as a result of the encounter is 50%. If
the number rolled is less than the modified Insanity Check score, the person in question momentarily loses their
sanity, and may suffer some form of ailment afterwards.
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