The good is GREAT, but the bad truly sucks. In the end, a few simple changes could have made it more appealing.
GOOD STUFF...
1) REEELY creepy environment.
2) The inhabitants of Innsmouth freaked me out.
3) 'Insanity' aspect is a cool (if sometimes, frustrating) innovation.
4) 'Medical supplies' aspect provides a more realistic challenge to staying healthy.
5) Scarcity of ammo provides a delightful level of anxiety.
BAD STUFF...
1) Too many situations that require a trial-and-error approach to memorize some kind of timed-sequence 'paltform jumping' solution. Scenarios that could have been satisfyingly intense end up being frustratingly difficult, requiring multiple re-starts which ultimately erodes the intensity. (NOTE...this is probably my biggest gripe with the game.)
2) During the first 1/3 of the game, I can't even pick up a stick to defend myself! (In real life, I'd run away from the freaks in Innsmouth...I don't want to spend my game-time doing it as well.)
3) What starts out feeling open-ended quickly becomes pretty linear and tightly scripted.
BOTTOM LINE...
I really wanted to like this game, and it started out being everything I could hope for. Unfortunately, it didn't hold up. Die hard stealth-horror-survival fans will get a kick out of it, and if that's YOU, then by all means, pick it up. But more main stream gamers will probably find it so frustatingly difficult and slow-paced, they'd be better off looking elsewhere.