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Voice Awards Blog Week - Friday

We Need to Talk About Video Games
From Mental Health America: 
Outside of having a friend or family member with a mental health condition, or personal experience, oftentimes people learn about the issue of mental health through mass media. Films, television shows, radio, and even social media often come to mind first as major forms of mass media.

But what about video games?

Video games are growing exponentially as a form of media. An estimated 150 million Americans played video games and about 42% of Americans play regularly, or at least three hours per week. That means roughly 1 in 3 Americans play video games.

The medium has grown so significantly that no one can dismiss gaming anymore as the hobby of a niche group of people. Not only are gaming communities growing, the technologies used to produce video games are also increasingly allowing developers to weave intricate storytelling and lifelike visuals into their puzzle and combat mechanics. They have the potential to become powerful tools that can be used to change the way we think about mental health. Games present an experience like no other – the player is forced into a reality that is not their own and must interact with the environment to progress through the character’s story.

Video games are a powerful instrument for influencing the way we perceive mental health. But with that power comes questions about the roles and responsibilities of video game developers as they craft their narratives.

More than a plot device

When done right, games can be a transformative way to teach about mental health conditions and how people experience them.

The key phrase here is “when done right.”

Developer Ninja Theory’s Hellblade: Senua’s Sacrifice is an excellent example of how developers, experts, and those with mental health conditions can come together to great an innovative awareness tool.

Given the troublesome history of depictions of mental health conditions in games, it can be easy to fall into the perception that an individual living with psychosis would be dangerous, given the necessity for combat.
However, by working together with mental health experts and those with lived experience, Hellblade not only depicts the symptoms of psychosis in a realistic and vivid way through gaming mechanics, but also depicts that recovery is possible through education, experience, and learning coping skills.

Hellblade’s developers do not attempt to “fix” the character’s psychosis. This reinforces that idea that recovery is not a straight path forward, and that the condition is not something that can be fixed with a simple solution, but rather something that the character has learned to live with.

While not all games need to have characters as complex and rich as Hellblade’s Senua, it is important that developers are mindful of how they represent characters - whether major or minor - who have mental health conditions, so they are not reduced to a personification of symptoms rather than a whole person.

Teaching empathy

In Harper Lee’s To Kill a Mockingbird, Atticus Finch says, "You never really understand another person until you
consider things from his point of view - until you climb inside of his skin and walk around in it."

One of the hardest – if not the hardest – skills to teach and learn is empathy. This is not to be confused with sympathy. Sympathy conveys compassion, sorrow, or pity for the hardships of another person, but empathy is putting yourself in their shoes. Understanding someone else’s experiences – especially when it comes to “invisible illnesses” like mental health conditions, is incredibly hard if you have not experienced it yourself.

Video games transport you to a world like no other form of media. Films and television shows are a one-way relationship between two groups of people: the creators and the video game consumers. You consume the media that is created for you and are at a distance. No matter how engaging the content may be, you’re still at arm’s length. You can close your eyes, turn off the screen, and walk away at any time without affecting the story.

However, content creation doesn’t happen like that anymore. In the 21st century, consumers are producers and vice versa. When it comes to games – you are the protagonist. The character is you. Your decisions affect the story. They completely transport you into a new reality using auditory, visual, and even tactile effects, and that experience may be a transformative way to educate others on the experience of having a mental illness.

Beyond awareness and towards wellness

In recent years, more and more wellness tracking apps and games designed for treatment have proliferated the healthcare landscape. The problem is that most developers who want to create games and apps for mental health don’t have much knowledge in the subject, and mental health experts are not skilled at creating engaging and interactive forms of play.

Disillusionment with telehealth and treatment games stems from lack of continued use or engagement despite their positive effects on individuals who have used them. Some games whose end goal is not particularly mental health and wellness can bleed into the mental health and wellness realm due to the nature of the game design itself. Games like Pokemon Go or Geocaching get people moving outside while providing them with challenges to overcome and achieve – a great way to help someone who may be experiencing depression. iThrive Games has a wealth of guides and tools for both game developers to create more prosocial outcomes and for clinicians to design more engaging games. Bringing these two worlds together could mean reaching young people and millions of other gamers, teaching social and emotional learning, and showing that the process of recovery is exciting and attainable.

Games are not the enemy

Developers such as Ninja Theory are to be commended for their efforts in this arena and we hope to see more studios take note. Additionally, more and more mental health professionals are understanding the value of interactive play when it comes to mental health. The mental health field should take advantage of the breadth of technology and creativity available to developers and use it to potentially close treatment access gaps and integrate in learning environments.
Standards, however unspoken, exist in traditional media – film, journalism, TV, and more – around respectfully and accurately addressing mental health issues. We need to have a new conversation around establishing the same standards in video games.

Jennifer Cheang is the Digital Marketing Manager at Mental Health America and assists with the development and implementation of online marketing strategies to promote programs, web-based resources and the website.

Sachin Doshi has been involved with MHA since 2015, after foregoing a career in medicine in favor of solving more systemic issues. As Director of Development, Sachin explores ways that MHA can work with corporations, foundations, and public-sector stakeholders to transform mental health in the United States. Sachin is passionate about space exploration, storytelling, jazz, and emerging technologies to drive 21st-century quality-of-life improvements.

Note: This blog post was created as Mental Health America (MHA)'s contribution to SAMHSA’s Voice Awards Blog Week effort around a variety of challenges in the mental health realm. The topic for July 20th is Entertainment Depictions of Behavioral Health