In a review of previous studies, a Johns Hopkins Children’s Center team concludes that some video games created as mental health interventions can be helpful – if modest – tools in improving the mental well-being of children and teens with anxiety, depression and attention-deficit/hyperactivity disorder (ADHD).

An estimated 20% of children and teenagers between the ages of three and 17 in the U.S. have a mental, emotional, developmental or behavioural disorder. Suicidal behaviours among high school students also increased by more than 40% in the ten years before 2019, according to a report by the Agency for Healthcare Research and Quality. Other studies provide evidence that the COVID-19 pandemic’s disruptions worsened these trends, and while research suggests parents and other care givers are seeking out mental health care for children, wait times for appointments have increased.

“We found literature that suggests that even doubling the number of pediatric mental health providers still wouldn’t meet the need,” says Barry Bryant, M.D., a resident in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine and first author of the new study.

In a bid to determine if so-called “gamified digital mental health interventions,” or video games designed to treat mental health conditions, benefited those with anxiety, depression and ADHD, the research team analyzed their use in randomized clinical trials for children and adolescents.

Bryant and child and adolescent psychologist Joseph McGuire, Ph.D., identified 27 such trials from the U.S. and worldwide. The studies included 2,911 participants, about half of whom were boys and half of whom were girls, between the ages of six and 17.

The digital mental health interventions varied in content, but were all created with the intent of treating ADHD, depression and anxiety. For example, for ADHD, some games involve racing or splitting attention, which requires the user to pay attention to more than one activity to succeed in gameplay. For depression and anxiety, some of the interventions taught psychotherapy-oriented concepts in a game format. All games were conducted on technology platforms like computers, tablets, video game consoles and smartphones. The video games are available to users in various ways — some are available online, while others required access through specific research teams involved in the studies.

Outcome measurements varied depending on the study. However, the Johns Hopkins research team was able to standardize effect sizes using a random-effects model so that a positive result was indicated when interventions performed better than control conditions. Hedges g, a statistic used to measure effect size, was used to quantify treatment effects overall in the studies reviewed.

Researchers also examined factors that led to improved benefit from digital mental health interventions. Specific factors related to video game delivery (i.e., interventions on computers and those with preset time limits) and participants (i.e., studies that involved more boys) were found to positively influence therapeutic effects. Researchers say these findings suggest ways to improve the current modest symptom benefit.

“While the benefits are still modest, our research shows that we have some novel tools to help improve children’s mental health — particularly for ADHD and depression — that can be relatively accessible to families,” says Joseph McGuire, PhD, an author of the study and an associate professor of psychiatry and behavioural sciences in the school of medicine. “So if you are a paediatrician and you’re having trouble getting your pediatric patient into individual mental health care, there could be some gamified mental health interventions that could be nice first steps for children while waiting to start individual therapy.”