I'd be interested to hear how or if other players and groups use the Madness and Injury cards. My group members, other than myself, hardly ever take one. They'd rather lose halt their items and clues, sit out the next turn and pay the $2.
Personally I'm a cautious player, usually emphasizing the evading abilities when I can and seldom go unconscious or insane, but usually take a card if I do.
I wish the cards were mandatory, maybe even in addition to the normal penalties. As you can imagine, not everyone (anyone?) agrees. In their current form they make the game easier IMO most of the time.

