In a comprehensive review of past studies, researchers from Johns Hopkins Children’s Center have found that video games specifically designed as mental health interventions may serve as modest but beneficial tools for improving the well-being of children and teenagers struggling with anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD).
The findings were published on September 23, 2024, in JAMA Pediatrics, following an analysis of studies from peer-reviewed journals between 2011 and March 20, 2024. The report highlights the potential of these “gamified digital mental health interventions” to offer some relief to a growing population of young individuals facing mental health challenges.
According to the Agency for Healthcare Research and Quality, an estimated 20% of U.S. children and teenagers aged 3 to 17 have a mental, emotional, developmental, or behavioral disorder. This statistic is concerning, especially when considering that suicidal behaviors among high school students increased by over 40% in the decade before 2019. The disruptions caused by the COVID-19 pandemic have only exacerbated these issues, leading to longer wait times for mental health appointments, despite increased efforts by parents and caregivers to seek care.
Dr. Barry Bryant, a resident in the Department of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine and the study’s lead author, expressed concern over the insufficient number of pediatric mental health providers to meet the growing demand. “Even doubling the number of pediatric mental health providers still wouldn’t meet the need,” he stated.
In their study, Dr. Bryant, along with child and adolescent psychologist Dr. Joseph McGuire, reviewed 27 randomized clinical trials involving 2,911 participants aged 6 to 17 years old from the U.S. and other countries. The trials focused on the use of digital mental health interventions—specifically video games designed to treat ADHD, depression, and anxiety.
These video games were diverse in content, targeting specific conditions with different approaches. For instance, games for ADHD involved activities that required players to split their attention between multiple tasks, while those for depression and anxiety incorporated therapeutic concepts into the gameplay. The interventions were delivered through various platforms, including computers, tablets, video game consoles, and smartphones.
The Johns Hopkins research team standardized effect sizes using a random-effects model to evaluate the effectiveness of these interventions. Their analysis revealed that video games designed to address ADHD and depression provided modest improvements in symptoms such as sustained attention and reduced sadness, with an effect size of 0.28. However, games targeting anxiety showed little to no benefit, with an effect size of 0.07.
Further analysis identified factors that positively influenced the effectiveness of these digital interventions. For example, games delivered on computers or with preset time limits, as well as those involving more boys, were associated with better outcomes. These insights suggest potential avenues for enhancing the current modest benefits observed in digital mental health interventions.
“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,” said Dr. McGuire, an associate professor of psychiatry and behavioral sciences. He noted that gamified mental health interventions could serve as an initial step for children awaiting more traditional therapy.
The study authors also cautioned that their review did not pinpoint why certain video game interventions were more effective than others. Additionally, they noted that the studies varied in their use of outcome measures, some relying on parent- or child-reported outcomes rather than standardized clinician assessments. The researchers also acknowledged that many of the games studied are not readily accessible, often being behind paywalls or available only through specific research teams.
Despite concerns about video game addiction and excessive screen time, the study found that children who engaged with these interventions in a structured, time-limited manner tended to benefit the most. “If a child has a video game problem, they are often playing it for several hours a day as opposed to a gamified digital mental health intervention that might be 20-45 minutes, three times a week,” Dr. Bryant explained.
Dr. McGuire emphasized the importance of having a variety of tools to address the increasing demand for child mental health care. The study was funded by generous donors and Johns Hopkins Medicine, with no conflicts of interest declared by the Johns Hopkins-affiliated authors.
Conclusion
As mental health challenges among children and teenagers continue to rise, innovative solutions like gamified video games offer a promising, albeit modest, approach to providing support. With further research and development, these digital interventions could become a valuable component of comprehensive mental health care for young people.