gamemd.exe & MentalOmegaClient.exe make sure you set them to use Compatability Mode for Windows XP Service Pack 3 & Run as Administrator
That will resolve the "requires elevation" as it means that the current directory it is running from is not able to run as admin due to permissions of the directory usually this will be the case for "Program Files" & "Program Files (x86) if on a 64bit OS.
If running Windows XP then just make sure it can run as Admin and your account is an Admin account.
Black screen not sure but probably because of the above but make sure under the launcher options you are using "TS-DDRAW" & might need the " Back Buffer in Video Memory" option checked.
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