I am so sorry I didn't see this sooner, since the game has been on a bit of a hiatus recently I stopped checking itch.io as often.
Yes, the game stemmed from my desire to represent mental illness in a realistic way, being someone who has struggled with it for as long as I can remember. Thank you for your kind words on the characters, the music, the presentation.
The game has the structure of an otome game - it expects you to enter one of the six routes by the end of the introductory week so the later story makes sense. For that reason, I had to block players after the first week if they didn't meet the requirements for one of the routes - otherwise, the plot wouldn't make sense and the whole experience would be dragged down. The way to get on one of the patient routes is to spend five sessions in total with them, so one every day of the first week, and choose the options that show that you understand them and are taking steps to get them to trust you (which are highlighted by hearts, or affection indicators). There is also Dr. Sharpe's route (spend an equal amount of time with all patients) and Elizabeth's route (spend all breaks you can with her without meeting the criteria for any of the other routes). I realize that the route system might put some people off, but being on a route does not force you to enter any kind of relationship with that person, contrary to standard otome games. It just means that you form a meaningful enough relationship with them to see that character develop over the course of the game.
Thank you, once again, for your kind words, it's been difficult to find the strength to work on the game due to matters beyond my control, but once it's over in May I will gladly turn all of my attention to finishing Absolution.
Lots of love
~ Navypink