Scientists have determined that certain video games designed as mental health interventions can serve as useful, though somewhat limited, aids in enhancing the mental health of children and teenagers suffering from anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD).
A team from the Johns Hopkins Children’s Center reviewed earlier studies and found that some video games made for mental health purposes can be beneficial, albeit moderately, for improving the mental state of kids and teens facing anxiety, depression, and ADHD.
This review, which focuses on research from peer-reviewed journals dated between 2011 and March 20, 2024, was published on September 23, 2024, in JAMA Pediatrics.
It is estimated that 20% of children and teenagers in the U.S. between the ages of three and 17 have a mental, emotional, developmental, or behavioral disorder. Additionally, a report from the Agency for Healthcare Research and Quality noted that suicidal behavior among high school students rose by over 40% in the decade leading up to 2019. Other research indicates that disruptions caused by the COVID-19 pandemic have exacerbated these issues, and while families are seeking mental health care for their children, wait times for appointments have become longer.
“We found literature suggesting that even if we doubled the number of pediatric mental health providers, it still wouldn’t meet the demand,” says Barry Bryant, M.D., a resident in the Psychiatry and Behavioral Sciences Department at Johns Hopkins University School of Medicine and lead author of the study.
To explore whether “gamified digital mental health interventions”—video games aimed at addressing mental health issues—were effective for those struggling with anxiety, depression, and ADHD, the research team evaluated their use in randomized clinical trials involving children and teenagers.
Bryant and psychologist Joseph McGuire, Ph.D., identified 27 relevant trials conducted in the U.S. and elsewhere. These studies collectively involved 2,911 participants, evenly split between boys and girls aged six to 17 years.
The digital mental health interventions varied in nature but were all designed to target ADHD, depression, and anxiety. For instance, some games addressing ADHD included racing or multitasking elements, requiring players to focus on multiple tasks to succeed. In cases of depression and anxiety, these interventions presented psychotherapy concepts in a gaming format. These games were accessible on various tech platforms including computers, tablets, gaming consoles, and smartphones, with some available online, while others were provided through specific research teams involved in the studies.
The studies measured outcomes differently. However, the Johns Hopkins researchers standardized the effect sizes using a random-effects model, allowing them to ascertain when the interventions were more effective than control conditions. They utilized Hedges g, a statistical measure for effect size, to evaluate treatment impacts across the reviewed studies.
The analysis revealed that video games aimed at ADHD and depression resulted in modest improvements (with an effect size of .28) in symptoms related to these disorders, such as enhanced attention and reduced feelings of sadness, as reported by participants and their families. By comparison, games targeting anxiety did not manifest significant benefits (with an effect size of .07) in alleviating anxiety symptoms, according to feedback from families and participants.
The researchers also explored which elements contributed to greater effectiveness in digital mental health interventions. They found that specific video game delivery methods (such as using computers and imposing set time limits) and participant characteristics (notably involving more boys in the studies) positively affected therapeutic outcomes. These insights highlight potential ways to enhance the current modest benefits observed.
“Although the effects remain limited, our findings indicate that we have some new tools available that can help improve the mental health of children, particularly those dealing with ADHD and depression, which are relatively easy for families to access,” says Joseph McGuire, Ph.D., an author of the study and an associate professor of psychiatry and behavioral sciences. “So, if you are a pediatrician struggling to get your young patient into individual mental health treatment, there could be some gamified mental health interventions worth considering as starting points while waiting for individual therapy.”
The research team emphasized that their review does not clarify why certain video game interventions were more effective than others. They pointed out that some of the included trials relied on outcomes reported by parents or children, rather than standardized clinical assessments, and did not consistently examine the same factors, like participant engagement or social activities, which could have influenced treatment effectiveness. They also noted that some video games used in the trials are not readily accessible, as they may not be available online or could be behind paywalls.
While acknowledging concerns regarding video game addiction and excessive screen time, researchers noted that children who participated in the studied games under structured, time-limited conditions typically fared better. “Children with video game problems often play for several hours daily, unlike gamified digital mental health interventions, which might involve 20-45 minutes of play, three times a week,” states Bryant.
“Having a variety of tools at our disposal can be beneficial in addressing the growing demand for child mental health services,” adds McGuire.
Morgan Sisk from the University of Alabama at Birmingham also contributed to the study.
The research was funded by generous donations and Johns Hopkins Medicine.
The authors affiliated with The Johns Hopkins University disclosed no conflicts of interest according to their university policies.
