Previous research showed that there are clear limits to the effectiveness of existing depression prevention programmes: improvements to those programmes were insufficient, and they still did not effectively reach all young people. Tuijnman’s research focused on the social context of depression: “A lot is happening in young people’s social lives. Friends are becoming increasingly important, but this also increases the impact of rejection on mental health,” Tuijnman explains. “I wanted to see whether we could develop materials that help and support young people and make the path to help easier. My attention soon turned to video games. We were inspired by games such as Stardew Valley and Animal Crossing, but also Dark Souls, which we know have a positive effect on many people. A game can be an environment where you meet like-minded people, for example. But it can also be a place where you learn to cope with difficult moments.”
Two games
To test this hypothesis, Tuijnman worked with developers on two applied video games: Moving Stories and ScrollQuest. In ScrollQuest, an action game, four players work together to defeat monsters and collect gold while responding to various social situations in the game’s story. Tuijnman had fathers and sons play the game together to see how they responded to those situations. “In the game, players are rejected. We investigated whether fathers could guide their sons in dealing with that rejection. An initial study showed that the game could successfully evoke feelings of rejection, and that the presence of fathers could alleviate negative feelings. But a genuine learning moment did not yet arise. A second study showed that when young adults played the game alone against other players online, they could also feel rejected, but at the same time were motivated to keep playing. We also found differences between young people who were more or less sensitive to rejection.”
In Moving Stories, players worry that Lisa, their fictional niece, is depressed. Players sit with her in a house and try to help her. They are presented with various options for helping Lisa, to which the virtual avatar then provides feedback. Tuijnman: “We had an entire class play Moving Stories, and afterwards organised a question-and-answer session with someone with lived experience for the students. We saw that participation partly reduced stigma surrounding mental health at secondary school. We also saw conversations developing between students about the subject.”
(Not yet) a treatment tool
It is not the intention for the two games to be used directly in their current form, Tuijnman explains. “If you want to do that properly, you need more budget and time. However, ScrollQuest and Moving Stories do provide us with valuable insights for research and practice. They demonstrate that games have a great deal of potential for mental health.”
Tuijnman, who is now affiliated with the Trimbos Institute, is currently researching, among other things, ways to help children and young people find a healthy digital balance in their lives.