I do. Remember that painting we saw in the Silent Hill Historical Society of PH holding his smexy spear, to which James comments that "It's him..."? This indeed proves that others can see Pyramid Head besides James and Maria. After all, Pyramid Head is basically an executioner designed to punish those who are overwhelmed with guilt. In this case. Adam Shepherd was confronted with guilt when he was forced to act enigmatically toward his son while the other was left with all of his love and attention. This eventually lead to Joshua's death and Alex's sending to a mental hospital, which caused him more guilt, which lead PH to appear, which lead to his own demise.
I do, however, do not agree that Pyramid Head should have been in the movie, as there wasn't really a point other than fanservice.
Anyone else agree with me?