It could be really neat if there was a robust system to keep track of the characters sanity and mental health that could lead to a good variety of outcomes and considerations (dialog and otherwise), but I don't think Bethesda's up to it (and it would interfere with the highly advertised "player freedom" because it would force an effect on the character, much complaining would ensue).
Voted depends on the implementation. Lots of things can go wrong with lack lustre design.