Addictive behaviours around gaming are well documented – with gaming disorder now recognised and treated by the NHS. But can gaming be beneficial to people’s mental health?
The video game industry is now bigger than both the movie and music industry combined, and it continues to grow. There are over three billion gamers around the world right now. That’s almost 40 per cent of the world's population. However, this increased in popularity has brought with it a host of new habits and behaviours, including risks to mental health.
In 2019, the NHS opened a specialist clinic to treat gaming disorders. Its founder and director, Professor Henrietta Bowden-Jones, recently told The Guardian: “The desperation of the families trying to address the disruption that gaming harms have had on their children is extreme. I was not prepared for what we came across, with violence within the home and refusal to go to school being prominent.”
The National Centre for Gaming Disorders, based in London, has had nearly 800 referrals in three years – many more than were expected. The centre offers treatment ranging from a one-off session to family therapy lasting over a year. The average age of a gamer seen by the clinic is 17.
“The pattern of harm often starts with a change of circumstance,” said Bowden-Jones. “It may be a move between schools or a change of home and therefore a geographical distancing from real-life friends. Gradually, the child’s online life becomes a support structure, something to make real life easier to bear. I have met children who felt they would rather be dead than not game and said so to their parents. Doors, objects, possessions, things get broken in fits of rage. Sometimes people get hurt.”
Such stories paint a bleak picture of gaming, but they also suggest that social issues are often a key factor in this kind of disorder. Which begs the question: is gaming really to blame?
For Kit Dunstan, video games provided an important lifeline in his path to recovery. He developed borderline personality disorder after suffering from domestic abuse and being diagnosed with cancer. He now offers peer support to others through West Sussex Mind and Peer Hub.
“When I was going through chemotherapy, gaming was invaluable for keeping me connected to the outside world,” says Kit. “I couldn't go out. I couldn't really do much. And so actually having the gaming console there gave me the ability to communicate with a lot of my friends. It also gave me the inspiration to try and fight and come through.”
“I had been in an abusive relationship and then I was struggling with cancer. I felt like I didn't want to be around people at all. But I was able to pull myself out of [this frame of mind] by communicating with people online, and realising that not everyone's out to get you. Working with other players gave me the confidence to be able to communicate with people offline, in the real world.”
As Kit points out, there are many healthy benefits to gaming. Studies have found that video games can improve troubleshooting and leadership skills as well as fostering teamwork and critical thinking. In Kit’s case, success at playing games helped him find his way in the wider world.
“I now hold world records in Grand Theft Auto Online,” he says. “I built up skills that essentially I didn't have before and it’s shown me that I can actually reach to the top of something, and succeed in life. In the games, I would guide my crew, say, in GTA, through the missions or whatever. And I guess because of that, it’s got me to a stage now where I’m actually able to facilitate support groups and things like that. It really has transferred over into me going down the volunteering line and progressing to getting proper paid employment.”
Nevertheless, stereotypes around gaming – which often hark back to the era of home computers and arcade machines – are hard to shift. The moral panics that accompanied the early days of video games, however, have given way to a new wave of research, no doubt inspired by gaming’s precipitous rise in popularity.
Last year, a study by Oxford University found no causal link between gaming and poor mental health. It was the largest-ever survey of its kind and tracked the habits of 40,000 gamers over six weeks. The researchers flagged up an important distinction between the experience of gamers who play ‘because they want to’ and those who play ‘because they feel they have to’, but ultimately concluded that time spent playing video games has no effect on people’s wellbeing.
Even so, arguing for the upside of gaming is a challenge, given many parents’ ongoing battle with limiting screen time. Addiction is a serious problem. But it’s important to make a distinction between different types of games, and to recognise which features of games are most harmful.
Many current games are deliberately modelled on addictive feedback loops, offering loot boxes and new skins to keep players hooked, with micro-transactions and gambling elements built into the gameplay. According to Professor Henrietta Bowden-Jones: “The need for money is at the root of some of the domestic violence we see. When no money is available, the most impulsive of patients have stolen it, by spending on their parents’ bank cards.”
Kit is also aware of these problems: “Addiction is definitely out there. Because games are giving you those dopamine hits, they can also pull you over into the addiction side, and people obviously need to regulate that. But at the same time, games do get misrepresented and vilified. All I've ever had in my experience of gaming is the positives.”
Game companies and industry regulators need to do a lot more to ensure that problematic elements of gaming are kept in check. Meanwhile, any attempt to safeguard wellbeing must develop a nuanced approach to the topic of video games. Mental health workers should be alert to the dangers while appreciating the possible rewards, and pleasures, of gaming for some people.
If you are struggling with how you are feeling, find sources of local support on this website.
