Digital Game Interventions for Youth Mental Health Services (Gaming My Way to Recovery): Protocol for a Scoping Review

Manuela Ferrari, Sarah V McIlwaine, Jennifer Ann Reynolds, Suzanne Archie, Katherine Boydell, Shalini Lal, Jai L Shah, Joanna Henderson, Mario Alvarez-Jimenez, Neil Andersson, Jill Boruff, Rune Kristian Lundedal Nielsen, Srividya N Iyer, Manuela Ferrari, Sarah V McIlwaine, Jennifer Ann Reynolds, Suzanne Archie, Katherine Boydell, Shalini Lal, Jai L Shah, Joanna Henderson, Mario Alvarez-Jimenez, Neil Andersson, Jill Boruff, Rune Kristian Lundedal Nielsen, Srividya N Iyer

Abstract

Background: Digital or video games are played by millions of adolescents and young adults around the world and are one of the technologies used by youths to access mental health services. Youths with mental health problems strongly endorse the use of technologies, including mobile and online platforms, to receive information, support their treatment journeys (eg, decision-making tools), and facilitate recovery. A growing body of literature explores the advantages of playing digital games for improving attention span and memory, managing emotions, promoting behavior change, and supporting treatment for mental illness (eg, anxiety, depression, or posttraumatic stress disorder). The research field has also focused on the negative impact of video games, describing potential harms related to aggression, addiction, and depression. To promote clarity on this matter, there is a great need for knowledge synthesis offering recommendations on how video games can be safely and effectively adopted and integrated into youth mental health services.

Objective: The Gaming My Way to Recovery scoping review project assesses existing evidence on the use of digital game interventions within the context of mental health services for youths (aged 11-29 years) using the stepped care model as the conceptual framework. The research question is as follows: For which youth mental health conditions have digital games been used and what broad objectives (eg, prevention, treatment) have they addressed?

Methods: Using the methodology proposed by Arksey and O'Malley, this scoping review will map the available evidence on the use of digital games for youths between 11 and 29 years old with mental health or substance use problems, or both.

Results: The review will bring together evidence-based knowledge to assist mental health providers and policymakers in evaluating the potential benefits and risks of these interventions. Following funding of the project in September 2018, we completed the search in November 2018, and carried out data screening and stakeholder engagement activities during preparation of the protocol. We will conduct a knowledge synthesis based on specific disorders, treatment level and modality, type of service, population, settings, ethical practices, and user engagement and offer recommendations concerning the integration of video game technologies and programs, future research and practice, and knowledge dissemination.

Conclusions: Digital game interventions employ unique, experiential, and interactive features that potentially improve skills and facilitate learning among players. Digital games may also provide a new treatment platform for youths with mental health conditions. Assessing current knowledge on video game technology and interventions may potentially improve the range of interventions offered by youth mental health services while supporting prevention, intervention, and treatment.

International registered report identifier (irrid): PRR1-10.2196/13834.

Keywords: biomedical technology; mental disorders; mental health; mental health services; video games; virtual reality.

Conflict of interest statement

Conflicts of Interest: None declared.

©Manuela Ferrari, Sarah V McIlwaine, Jennifer Ann Reynolds, Suzanne Archie, Katherine Boydell, Shalini Lal, Jai L Shah, Joanna Henderson, Mario Alvarez-Jimenez, Neil Andersson, Jill Boruff, Rune Kristian Lundedal Nielsen, Srividya N Iyer. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 24.06.2020.

Figures

Figure 1
Figure 1
Model 1 adaptation of the traditional stepped care model. CBT: cognitive behavioral therapy.

References

    1. Patel V, Flisher AJ, Hetrick S, McGorry P. Mental health of young people: a global public-health challenge. Lancet. 2007 Apr 14;369(9569):1302–13. doi: 10.1016/S0140-6736(07)60368-7.
    1. Henderson JL, Brownlie EB, McMain S, Chaim G, Wolfe DA, Rush B, Boritz T, Beitchman JH. Enhancing prevention and intervention for youth concurrent mental health and substance use disorders: the Research and Action for Teens study. Early Interv Psychiatry. 2019 Dec;13(1):110–119. doi: 10.1111/eip.12458.
    1. Henderson JL, Chaim G, Brownlie EB. Collaborating with community-based services to promote evidence-based practice: process description of a national initiative to improve services for youth with mental health and substance use problems. Psychol Serv. 2017 Aug;14(3):361–372. doi: 10.1037/ser0000145.
    1. Henderson JL, Cheung A, Cleverley K, Chaim G, Moretti ME, de Oliveira C, Hawke LD, Willan AR, O'Brien D, Heffernan O, Herzog T, Courey L, McDonald H, Grant E, Szatmari P. Integrated collaborative care teams to enhance service delivery to youth with mental health and substance use challenges: protocol for a pragmatic randomised controlled trial. BMJ Open. 2017 Dec 06;7(2):e014080. doi: 10.1136/bmjopen-2016-014080.
    1. Hetrick SE, Bailey AP, Smith KE, Malla A, Mathias S, Singh SP, O'Reilly A, Verma SK, Benoit L, Fleming TM, Moro MR, Rickwood DJ, Duffy J, Eriksen T, Illback R, Fisher CA, McGorry PD. Integrated (one-stop shop) youth health care: best available evidence and future directions. Med J Aust. 2017 Nov 20;207(10):S5–S18.
    1. Iyer SN, Boksa P, Lal S, Shah J, Marandola G, Jordan G, Doyle M, Joober R, Malla AK. Transforming youth mental health: a Canadian perspective. Ir J Psychol Med. 2015 Mar;32(1):51–60. doi: 10.1017/ipm.2014.89.
    1. Malla A, Iyer S, McGorry P, Cannon M, Coughlan H, Singh S, Jones P, Joober R. From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people. Soc Psychiatry Psychiatr Epidemiol. 2016 Mar;51(3):319–26. doi: 10.1007/s00127-015-1165-4.
    1. Malla A, Shah J, Iyer S, Boksa P, Joober R, Andersson N, Lal S, Fuhrer R. Youth mental health should be a top priority for health care in Canada. Can J Psychiatry. 2018 Dec;63(4):216–222. doi: 10.1177/0706743718758968.
    1. McGorry P, Bates T, Birchwood M. Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. Br J Psychiatry Suppl. 2013 Jan;54:s30–5. doi: 10.1192/bjp.bp.112.119214.
    1. Campbell NC, Murray E, Darbyshire J, Emery J, Farmer A, Griffiths F, Guthrie B, Lester H, Wilson P, Kinmonth AL. Designing and evaluating complex interventions to improve health care. BMJ. 2007 Mar 3;334(7591):455–9. doi: 10.1136/.
    1. McGorry PD. The specialist youth mental health model: strengthening the weakest link in the public mental health system. Med J Aust. 2007 Oct 01;187(S7):S53–6.
    1. Rickwood DJ, Telford NR, Parker AG, Tanti CJ, McGorry PD. headspace - Australia's innovation in youth mental health: who are the clients and why are they presenting? Med J Aust. 2014 Feb 3;200(2):108–11.
    1. Singh SP. Transition of care from child to adult mental health services: the great divide. Curr Opin Psychiatry. 2009 Jul;22(4):386–90. doi: 10.1097/YCO.0b013e32832c9221.
    1. Das JK, Salam RA, Lassi ZS, Khan MN, Mahmood W, Patel V, Bhutta ZA. Interventions for adolescent mental health: an overview of systematic reviews. J Adolesc Health. 2016 Oct;59(4S):S49–S60. doi: 10.1016/j.jadohealth.2016.06.020.
    1. Iyer SN, Boksa P, Joober R. Editorial: How youth mental healthcare is being transformed in diverse settings across Canada: reflections on the experience of the ACCESS Open Minds network. Early Interv Psychiatry. 2019 Jun;13 Suppl 1:8–11. doi: 10.1111/eip.12811.
    1. Malla A, Iyer S, Shah J, Joober R, Boksa P, Lal S, Fuhrer R, Andersson N, Abdel-Baki A, Hutt-MacLeod D, Beaton A, Reaume-Zimmer P, Chisholm-Nelson J, Rousseau C, Chandrasena R, Bourque J, Aubin D, Levasseur MA, Winkelmann I, Etter M, Kelland J, Tait C, Torrie J, Vallianatos H, ACCESS Open Minds Youth Mental Health Network Canadian response to need for transformation of youth mental health services: ACCESS Open Minds (Esprits ouverts) Early Interv Psychiatry. 2019 Jun;13(3):697–706. doi: 10.1111/eip.12772.
    1. Franke S. Current realities and emerging issues facing youth in Canada: an analytical framework for public policy research, development and evaluation. Ottawa, ON: Government of Canada, Policy Research Initiative; 2010. Jan, [2020-05-18]. .
    1. Organisation for Economic Co-operation and Development OECD work on youth. [2020-05-18]. .
    1. Yakob R. Grown up digital: how the net generation is changing your world. Int J Advertising. 2015 Jan 07;28(1):182–184. doi: 10.2501/s0265048709090490.
    1. Lal S, Dell'Elce J, Tucci N, Fuhrer R, Tamblyn R, Malla A. Preferences of young adults with first-episode psychosis for receiving specialized mental health services using technology: a survey study. JMIR Ment Health. 2015;2(2):e18. doi: 10.2196/mental.4400.
    1. Mental Health Commission of Canada . E-Mental Health in Canada: Transforming the Mental Health System Using Technology: A Briefing Document. Ottawa, ON: Mental Health Commission of Canada; 2014. [2020-05-18]. .
    1. Wozney L, McGrath P, Newton A, Hartling L, Curran J, Huguet A, Rao S. RE-AIMing e-Mental Health: A Rapid Review of Current Research. Ottawa, ON: Mental Health Commission of Canada; 2017. Jul,
    1. Lal S, Adair CE. E-mental health: a rapid review of the literature. Psychiatr Serv. 2014 Jan 1;65(1):24–32. doi: 10.1176/appi.ps.201300009.
    1. Apolinário-Hagen J, Kemper J, Stürmer C. Public acceptability of e-mental health treatment services for psychological problems: a scoping review. JMIR Ment Health. 2017 Apr 03;4(2):e10. doi: 10.2196/mental.6186.
    1. Boydell KM, Volpe T, Pignatiello A. A qualitative study of young people's perspectives on receiving psychiatric services via televideo. J Can Acad Child Adolesc Psychiatry. 2010 Feb;19(1):5–11.
    1. Gaebel W, Großimlinghaus I, Kerst A, Cohen Y, Hinsche-Böckenholt A, Johnson B, Mucic D, Petrea I, Rössler W, Thornicroft G, Zielasek J. European Psychiatric Association (EPA) guidance on the quality of eMental health interventions in the treatment of psychotic disorders. Eur Arch Psychiatry Clin Neurosci. 2016 Mar;266(2):125–37. doi: 10.1007/s00406-016-0677-6.
    1. Naslund JA, Marsch LA, McHugo GJ, Bartels SJ. Emerging mHealth and eHealth interventions for serious mental illness: a review of the literature. J Ment Health. 2015 Aug 19;:1–12. doi: 10.3109/09638237.2015.1019054.
    1. Ootes STC, Pols AJ, Tonkens EH, Willems DL. Where is the citizen? Comparing civic spaces in long-term mental healthcare. Health Place. 2013 Jul;22:11–8. doi: 10.1016/j.healthplace.2013.02.008.
    1. Hollis C, Falconer CJ, Martin JL, Whittington C, Stockton S, Glazebrook C, Davies EB. Annual research review: digital health interventions for children and young people with mental health problems: a systematic and meta-review. J Child Psychol Psychiatry. 2017;58:474–503. doi: 10.1111/jcpp.12663.
    1. Abdel-Baki A, Lal S, D-Charron O, Stip E, Kara N. Understanding access and use of technology among youth with first-episode psychosis to inform the development of technology-enabled therapeutic interventions. Early Interv Psychiatry. 2015 May 22; doi: 10.1111/eip.12250.
    1. Horgan A, Sweeney J. Young students' use of the Internet for mental health information and support. J Psychiatr Ment Health Nurs. 2010 Mar;17(2):117–23. doi: 10.1111/j.1365-2850.2009.01497.x.
    1. Granic I, Lobel A, Engels RCME. The benefits of playing video games. Am Psychol. 2014 Jan;69(1):66–78. doi: 10.1037/a0034857.
    1. Boot WR, Blakely DP, Simons DJ. Do action video games improve perception and cognition? Front Psychol. 2011;2:226. doi: 10.3389/fpsyg.2011.00226. doi: 10.3389/fpsyg.2011.00226.
    1. Jackson M. Making visible: using simulation and game environments across disciplines. On Horiz. 2004 Mar;12(1):22–25. doi: 10.1108/10748120410540463.
    1. Read JL, Shortell SM. Interactive games to promote behavior change in prevention and treatment. JAMA. 2011 Apr 27;305(16):1704–5. doi: 10.1001/jama.2011.408.
    1. Barnes S, Prescott J. Empirical evidence for the outcomes of therapeutic video games for adolescents with anxiety disorders: systematic review. JMIR Serious Games. 2018 Feb 28;6(1):e3. doi: 10.2196/games.9530.
    1. Cheng VWS, Davenport T, Johnson D, Vella K, Hickie IB. Gamification in apps and technologies for improving mental health and well-being: systematic review. JMIR Ment Health. 2019 Jun 26;6(6):e13717. doi: 10.2196/13717.
    1. Fleming TM, Bavin L, Stasiak K, Hermansson-Webb E, Merry SN, Cheek C, Lucassen M, Lau HM, Pollmuller B, Hetrick S. Serious games and gamification for mental health: current status and promising directions. Front Psychiatry. 2016;7:215. doi: 10.3389/fpsyt.2016.00215. doi: 10.3389/fpsyt.2016.00215.
    1. Fleming TM, Cheek C, Merry SN, Thabrew H, Bridgman H, Stasiak K, Shepherd M, Perry Y, Hetrick S. [Serious games for the treatment or prevention of depression: a systematic review] Rev Psichopatol Psicol Clin. 2015 Jan 15;19(3):227. doi: 10.5944/rppc.vol.19.num.3.2014.13904.
    1. Lau HM, Smit JH, Fleming TM, Riper H. Serious games for mental health: are they accessible, feasible, and effective? A systematic review and meta-analysis. Front Psychiatry. 2016;7:209. doi: 10.3389/fpsyt.2016.00209. doi: 10.3389/fpsyt.2016.00209.
    1. Li J, Theng Y, Foo S. Game-based digital interventions for depression therapy: a systematic review and meta-analysis. Cyberpsychol Behav Soc Netw. 2014 Aug;17(8):519–27. doi: 10.1089/cyber.2013.0481.
    1. Li J, Theng Y, Foo S. Effect of exergames on depression: a systematic review and meta-analysis. Cyberpsychol Behav Soc Netw. 2016 Jan;19(1):34–42. doi: 10.1089/cyber.2015.0366.
    1. Ferrari M, Suzanne A. Youth mental health, family practice, and knowledge translation video games about psychosis: family physicians’ perspectives. J Can Acad Child Adolesc Psychiatry. 2017;26(3):184–189.
    1. Anderson CA, Bushman BJ. Effects of violent video games on aggressive behavior, aggressive cognition, aggressive affect, physiological arousal, and prosocial behavior: a meta-analytic review of the scientific literature. Psychol Sci. 2001 Sep;12(5):353–9. doi: 10.1111/1467-9280.00366.
    1. Gentile D. Pathological video-game use among youth ages 8 to 18: a national study. Psychol Sci. 2009 May;20(5):594–602. doi: 10.1111/j.1467-9280.2009.02340.x.
    1. Kardefelt-Winther D. A conceptual and methodological critique of internet addiction research: towards a model of compensatory internet use. Comput Hum Behav. 2014 Feb;31:351–354. doi: 10.1016/j.chb.2013.10.059.
    1. Kardefelt-Winther D, Heeren A, Schimmenti A, van RA, Maurage P, Carras M, Edman J, Blaszczynski A, Khazaal Y, Billieux J. How can we conceptualize behavioural addiction without pathologizing common behaviours? Addiction. 2017 Oct;112(10):1709–1715. doi: 10.1111/add.13763.
    1. Bower P, Gilbody S. Managing common mental health disorders in primary care: conceptual models and evidence base. BMJ. 2005 Apr 9;330(7495):839–42. doi: 10.1136/bmj.330.7495.839.
    1. National Institute for Health and Care Excellence . Depression: Management of Depression in Primary and Secondary Care. Clinical guidelines CG23. London, UK: NICE; 2004. Dec 06,
    1. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005 Feb;8(1):19–32. doi: 10.1080/1364557032000119616.
    1. Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69. doi: 10.1186/1748-5908-5-69.
    1. Iyer SN, Shah J, Boksa P, Lal S, Joober R, Andersson N, Fuhrer R, Abdel-Baki A, Beaton AM, Reaume-Zimmer P, Hutt-MacLeod D, Levasseur MA, Chandrasena R, Rousseau C, Torrie J, Etter M, Vallianatos H, Abba-Aji A, Bighead S, MacKinnon A, Malla AK. A minimum evaluation protocol and stepped-wedge cluster randomized trial of ACCESS Open Minds, a large Canadian youth mental health services transformation project. BMC Psychiatry. 2019 Sep 05;19(1):273. doi: 10.1186/s12888-019-2232-2.
    1. Bean AM, Nielsen RKL, van Rooij AJ, Ferguson CJ. Video game addiction: The push to pathologize video games. Professional Psychol. 2017 Oct;48(5):378–389. doi: 10.1037/pro0000150.
    1. van Rooij AJ, Ferguson CJ, Colder Carras M, Kardefelt-Winther D, Shi J, Aarseth E, Bean AM, Bergmark KH, Brus A, Coulson M, Deleuze J, Dullur P, Dunkels E, Edman J, Elson M, Etchells PJ, Fiskaali A, Granic I, Jansz J, Karlsen F, Kaye LK, Kirsh B, Lieberoth A, Markey P, Mills KL, Nielsen RKL, Orben A, Poulsen A, Prause N, Prax P, Quandt T, Schimmenti A, Starcevic V, Stutman G, Turner NE, van Looy J, Przybylski AK. A weak scientific basis for gaming disorder: let us err on the side of caution. J Behav Addict. 2018 Mar 01;7(1):1–9. doi: 10.1556/2006.7.2018.19.
    1. McGowan J, Sampson M, Salzwedel DM, Cogo E, Foerster V, Lefebvre C. PRESS Peer Review of Electronic Search Strategies: 2015 guideline statement. J Clin Epidemiol. 2016 Dec;75:40–6. doi: 10.1016/j.jclinepi.2016.01.021.
    1. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016 Dec 05;5(1):210. doi: 10.1186/s13643-016-0384-4. doi: 10.1186/s13643-016-0384-4.
    1. McGorry PD, Mei C. Early intervention in youth mental health: progress and future directions. Evid Based Ment Health. 2018 Nov;21(4):182–184. doi: 10.1136/ebmental-2018-300060.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336–41. doi: 10.1016/j.ijsu.2010.02.007.
    1. AGREE Next Steps Consortium Appraisal of Guidelines for Research and Evaluation II: AGREE II Instrument. 2017. Dec, [2020-05-18]. .
    1. Gee JP. Learning by design: games as learning machines. Interact Educ Multimedia. 2014;8:15–23.

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