Digital storytelling and video game-based mental-health interventions

Besides offering pure entertainment, video games can provide players with a sense of community and help them with stress management, all while improving skills such as communication, cognitive ability, hand-eye coordination, decision-making and team building.

At the same time, video games have been shown to be useful in enhancing health outcomes, specifically with psychological therapy for children and teen.[1].

Strongly committed to enhancing access to care, treatment and client engagement with digital-health-intervention services, HBHL-funded researcher Manuela Ferrari—Assistant Professor in the Department of Psychiatry at McGill—is developing a unique research program that uses digital narratives, including video-game-based interventions, for mental health treatment and anti-stigma campaigns.

The interventions Ferrari and her team are creating are unique in their use of co-design. As she explains, this process brings together researchers and external specialists. “We work with young people, usually gamer-experts in their field, who help us adapt existing video-game interventions that have already been tested or develop new ones,” Ferrari said. “This process can open the door to new experiences and new therapeutic models that can be delivered through video games”.

Specifically, Ferrari’s group is working on “serious video games,” a subgenre of games designed for purposes other than just entertainment. These games promote learning and entertain players, while attempting to modify or assess certain aspects of their health behaviour. They can also provide a new treatment platform for youth with mental health conditions. This concept—using game elements (like point scoring or specific rules) to increase engagement in non-game contexts—is called gamification.

Video games and health education

Youth between the ages of 14 and 24 are the most at risk for developing psychosis for the first time.[2]

This is an age demographic that is likely to have grown up around video games. Additionally, statistics show that between 10% and 20% of Canadian children and youth may develop mental health problems[3] and, in Quebec alone, 85% of youth consider themselves gamers[4]―making them a key target for video-game-based interventions.

With several studies suggesting that playing video games can be critical for emotional and social wellbeing and learning[5], games represent an interesting platform for delivering mental-health interventions. In fact, clinical research suggests that “gaming technology can be used to treat adolescents’ depression (along with cognitive behavioural therapy (CBT)) to enhance therapeutic interventions and to increase appropriate help-seeking behaviours among players of the game”[6].

Thanks to HBHL funding (as well as funding from provincial and federal programs, and industry partners), Ferrari was able to set up the Ludic Mind Studio, a digital-media and mental-health studio that explores the role technology plays in mental-healthcare settings. As Ferrari describes it, Ludic Mind is “a place where art and science come together.”

Located at the Douglas Mental Health University Institute, Ludic Mind focuses on three areas of research and development: digital interventions, e-assessment and monitoring, and digital education.

The studio aims to increase ease of access and quality of care for patients, as well as create a new model for mental-healthcare services enhanced by digital technologies.

Early on in the COVID-19 pandemic, Ferrari and her team developed a new game called “The Road Ahead,” which aims to promote social change, civic engagement and experiential learning. The game has a strong educational and therapeutic focus; it represents the first in-depth investigation of a participatory and game-making process that translates the experience of personal and social disruption due to COVID-19 into a video game. “This game is made by youth for youth,” explained Ferrari. “All the visual assets, the music, the coding and the storyline are made by young people”.

Ferrari’s team is also working on adapting other, already established, serious video games. The most notable of these is Sparx-R, a game-based mental-health-intervention program designed to help young people with mild-to-moderate depression, stress or anxiety[7] and gives the player access to a CBT program. Ferrari’s team is now focused on assessing Sparx-R’s effects on improving symptoms of psychosis, while also evaluating the capacity to offer this digital intervention within mental-healthcare settings.

Ludic Mind is focusing its future research on investigating the impact of serious games and how the messages promoted in games can reduce the stigma associated with mental illness. As Ferrari explains it, video-game interventions represent a great opportunity to “explore new ways to deliver help, support and treatment to young people while they are in an environment that makes them comfortable and more willing to disclose their feelings”.

Watch the full interview with Manuela Ferrari