Mental Health Gaming as a Mental Health Tool?

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The controversy over the pros and cons of video games and mental health has raged for decades. Now in 2022, at least one Internet startup has launched a gaming “mental health tool” to assist mental health practitioners with delivering mental health gaming services as an augmentation to their service offerings. On one side of the controversy is the issue of whether gaming addiction qualifies as a formal diagnostic category of “gaming disorder.” In 2018, it was formally recognized by the World Health Organization (WHO) in its International Classification of Diseases (ICD-11). The diagnostic criteria were described as follows: 

…a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.

The WHO was careful to stipulate the studies at the time suggested that IGD only affects a small proportion of people who enjoy gaming activities. However, on the other hand, the controversy continues in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which didn’t assign a diagnostic code to gaming disorder. It did mention gaming as a possible addiction, however. To try and clarify the issues involved with the controversy, significant research has been dedicated to the differences between the ICD-11 and DSM-5 diagnostic criteria for the two classification systems, including large-scale studies of international populations.*

In more consumer-related healthcare websites, the controversy continues, but in a milder form. For example, in an October 2021 WedMD article, the benefits of gaming were outlined, including some aspects that support gaming for mental health. The article states:

The truth is that video games have many benefits, including developing complex problem-solving skills and promoting social interaction through online gaming. Video games can be a great way to stimulate your mind and improve your mental health. 

Video Games and Mental Health

The WebMD article has reported several ways video games improve mental health, including mental stimulation, feelings of accomplishment, and increased social interaction. Claims are also made that some video games can assist with reducing anxiety, depression, attention deficit hyperactivity disorder, and post-traumatic stress disorder. The article explains that a game that requires players to solve problems and make decisions may improve mental agility and problem-solving skills. The article states that gaming may help people process information faster in both the game and real-world circumstances. Visual cognition also may improve as gamers become more proficient at distinguishing relevant from irrelevant details.

Advocates of gaming for mental health also suggest that playing digital games forces players to set goals, and achieving those goals can lead to a feeling of accomplishment and well-being. Playing online with multiple partners reportedly leads to better socialization as people learn to trust and cooperate in a non-threatening environment. They claim that gaming can help players try out new relationships with people they don’t know. The ups and downs of playing are posited to help players, especially children, in how to deal with failure, pick themselves up and get on with it. Though some video games may improve mental health, such advocates often mention that care must be taken to avoid addiction or to escape everyday problems.

As the industry evolves, controversy aside, it seems clear that using gaming for mental health benefits can only occur when time limits are set to avoid playing for extended periods. Many studies have clearly shown the downside to gaming, including the rise of anxiety, isolation, and sleeplessness, which ICD-II and DSM-5 identify as indicative of addiction. 

The Future of Mental Health Gaming

The controversy in professional circles has not stopped technology companies from developing gaming platforms that offer the possibility of creating “mental health tools.” An example is Deepwell, a self-funded business started by a group of gaming and medical professionals. According to a TechCrunch report, the company will study and develop mental health gaming exploiting the overlap between cognitive behavior therapy and gaming for role play. The TechCrunch article mentioned above cites Co-founder Mike Wilson as pointing to the complexities of mental health gaming because of its need to consider the ethical and legal aspects of serving as a tool for gaming mental health. The goal reportedly is to ensure that the games are compelling so that people want to engage with them and reap the benefits. 

Telehealth.org readers are encouraged to review the information. The company hopes to change the jaded view that the media has presented about gaming as a waste of time or simply dangerous. They hope to better harness the advantages that media can play in our lives. The company’s website explainer text states, “DeepWell DTx unlocks the potential of video games to deliver widespread access to powerful mental health treatments at scale.” The website invites interested parties to join its ranks, including a mailing list. Healthcare professionals are identified as potential contributors. 

*NOTE: The DSM-TR revision published in March of 2022 has not been accessed to give an update on the issue. Readers are invited to comment below if they have seen relevant research or other tech companies touting the benefits of mental health gaming. They will undoubtedly be leaders in this field, but who they are and what they have to offer to behavioral professionals is yet to be identified.

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