
The year is 1923—step inside Castle Woods Sanatorium, where care and cruelty blur together. Disguised as a doctor, you’ll diagnose and treat patients using a deck of symptoms, tests, and outdated therapies. But tread carefully: one wrong move could expose you as an impostor.
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“Sanatorium: A Mental Asylum Simulator Is One of the Most Unique Games I’ve Ever Seen” - VICE
It’s the roaring twenties, an age of technological progress and social upheaval. As the city around you expands, you feel left behind: a weary journalist burdened by debt and drifting purpose. Then, out of the blue, a cryptic message arrives from a childhood friend—perhaps the tip of a lifetime. It points to the infamous Castle Woods Sanatorium. A mystery waits there, and you can’t shake the urge to uncover it. It may be nothing more than a hunch, but it feels like a secret that could change everything. Even you. The decision is made: you pack your bags and set out for Castle Woods.

Test your wit and intuition. Every week, new patient files present new puzzles to be solved as you decide which tests to use to uncover symptoms and which treatments you prescribe to cure them. Decide whether you want to follow the rule book or try out experimental new treatments with unknown outcomes. Do you want to be kind or cruel? Business savvy or risk-taking?
Uncover dark secrets behind the squeaky-clean facade of Castle Woods' walls. Meet helpless patients, ruthless opportunists, and an array of other intriguing characters. Collect clues and piece together the shocking truth about the Sanatorium and your own past.

Card-driven workplace sim — step into the role of a doctor in 1923, where every action is bound by the outdated tools and beliefs of the era.
Diagnose, “treat,” or withhold — decide whether to follow harsh, archaic methods or act with compassion, knowing both choices carry consequences.
Every patient is a puzzle — files unfold as layered card sets, with symptoms hidden, revealed, and misinterpreted through limited knowledge.
A full campaign across 4 chapters — uncover the secrets of Castle Woods and the lives caught within its walls.
Branching paths, multiple endings — your decisions shape not only patients’ outcomes, but your own fate as an impostor.
Over 100 cards to chart — symptoms, illnesses, tests, and treatments drawn from the unsettled history of psychiatry.
Evolve your treatment plan — upgrade treatments toward more humane practices, or double down on methods that protect your cover at any cost.

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Genres
Stats
All-time low is the lowest price we've recorded for this game since we started tracking it.
Languages: English, French, German, Spanish - Spain, Japanese, Korean, Portuguese - Brazil, Simplified Chinese, Italian, Russian
Engagement
Hours played at review time, across 40 reviews with recorded playtime.
Reviews
Themes across 40 recent reviews and how positive each mention is. A keyword signal, not full sentiment analysis.
positive critical· bar length = how often the theme comes up
Reviews
Очень классная игра, интересный сюжет и механики, но я в пятый раз из-за багов не могу пройти игру до конца. Застреваю то тут, то там. Сейчас забаговалось на 4 отделении. Потенциал супер, но количество багов все убивает.
Отвратительный интефейс. Играть крайне не удобно.
Still extremely buggy. It's a fun concept, and has great potential, but it is not at all ready for release.
This game was super fun to play. Would definitely play through again!
Багованая, но тем не менее крайне интересная игра, которая отвлечет на 10-20 часов
I enjoyed this game. It has a great atmosphere; the gameplay is simple but surprisingly difficult; the story got me invested AND had me genuinely thinking about the consequences of my actions. Not only obviously story-related actions either, but gameplay choices, like if I would administer a treatment I know to be unethical for the sake of points and money. I really would recommend it... but only to people who I know. This game is BUGGY. It can get to the point of being nearly unplayable. Dialogue frequently doesn't trigger, I get achievements I didn't earn and lack achievements I did, and my inventory is confusing and inconsistent, which wouldn't be horrible if restarting the game to fix the issues wasn't such a chore. There's no manual saves, so you will almost always have to restart the day. And if something goes wrong earlier in the Ward, you have no way to go back only a few days to fix it-- you have to play an extra day so you can fail on purpose (very tedious) and restart the Ward. So many of the sequences that build atmosphere, like the slow pan before the 'treatment' phase, get boring when you have to go through them again and again like this. I'm not a hard sell on games. I still very much enjoyed this one, and I expect parts of it to get patched in time. But before you buy, consider your tolerance for bugs.
This game is so good, but there are really just so many bugs that I can't recommend it unless you're fine with restarting many days because you clicked something too fast or the game didn't expect you to do something. It's very annoying, but like I said, it's a great game.
I want to recommend this game so badly but I can't in its current state. I have unfortunately run into a game breaking bug in ward 2 that won't let me progress any further in the story. What I have been able to play has been amazing and so much fun. I hope to be able to come back and edit this soon once they have fixed it so I can continue playing.
A wonderfully, frustrating, twisted game, that all i can say is in the end i loved every single second of it.
Super jeu, mais quelques bug comme par exemple perdre les cartes de son inventaire on ne sait pas ou, ce qui bloque un peu la progression du jeu car on passe a côté de quelques missions c'est dommage.
Related
Related
Trends
Concurrent players on Steam, sampled daily since tracking started.
Audience
Estimated from the language of this game's reviews — a proxy for where players are, not official Steam demographics.
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