its third person, but seriously don't play the game its so messed up. Its not like the horror fps games its just basically constant creepiness where fear and resident evil and etc have like pop out scary, Silent Hill is like i want to leave this place and never come back scary.
The scariest part of the game really isn't the monsters, its more the setting, and the things that happen to you.
(and the radio.... oh god, every time the radio went off i just wanted to cry and hide in a corner)
Edit: Wow, and i forgot about the sound of the Pyramid head's sword dragging on the ground when he was close... knowing that you couldn't kill him made it so much worse...