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It was also vastly different from the cozy, medieval theme of Oblivion with the town settlements, shops and city guard etc. You could argue the Dark Bortherhood guild encourages people to become assassins but I think anyone who becomes an assassin after playing the Dark Brotherhood storyline was already heading towards that kind of profession.
Of course will be not treated well, that's the point of Shivering Isles expansion: dehumanizing, torture people on dungeons just for the lulz because Sheogorath ask it.
By the way, he say it, you can go away if you want, you are not obliged to stay in Shivering Isles.
It's like playing Borderlands 2 and complain about... IDK, why the NPCs are Borderline for the jokes instead had a serious talk about mental health, with Handsome Jack getting a hug.
As far as the question of the thread goes: I understand that the subject of mental health is a serious and delicate thing to portray. If one has had such personal experience, then this can be a very uncomfortable DLC to play, as can some books and movies.
There is nothing "badly aged" at all with this story. One just likes it or not.
With this in mind, I don't count Daedric Princes as beings with the same genetic makeup of other beings in Tamriel. This goes for their brains (or whatever they have) as well. So I never really counted Sheogorath as mentally ill, just beyond our understanding of reality in the series. The Shivering Isles isn't going to be a place with a therapy circle and cafeteria. It's chaos, like its master. And in a world like that, with a ruler like that, people are going to get hurt. Sheogorath thrives on the perversion of rules and safety. He brings in the mentally ill because it amuses him. He's not there to help them.
I assume he invites those he can toy with; people of certain conditions that he finds fun for the moment. So these people arrive with certain predilections that he abuses and disrupts. There is a book on extreme self-harm because he wanted it as so. He probably thought the book was a hoot. Big Head is probably there just so Sheogorath can take his fork and hide it.
Do note that there is a wood elf in Anvil with psychosis that speaks of dragon ships and itchy clothes scaring fish. Everyone who you can talk about him to will say he's "touched by the gods" and you should just let him be because he's not hurting anyone. He seems content. People care for him. This is a pretty positive portrayal of these people doing what they can with what they have. In the Isles, such compassion is absent.
I guess I'll end this wall of text with the summation that everyone in the Isles is there to be toyed with and manipulated. They hurt others and themselves because Sheogorath loves chaos. You don't get better under those conditions, and no matter what, the Lord demands that these people be shaped how he pleases. It's his domain. Not their's. Dehumanization is a part of his power.