From stomping on koopas and collecting coins as Mario to “catching ’em all” in Pokemon, video games have enthralled both our childhood, and countless other childhoods. It was our guilty pleasure, much to the chagrin of our parents. Media portrayed video games as bad for your mental health, with the message that video games rot your brain. While the effects of videos on mental health are more nuanced, video games’ principles may be useful for improving mental health with specific apps.

The field of mental health has witnessed a remarkable transformation with the rise of digital health solutions, particularly with mental health apps. With societal technological advancements, mental health apps have emerged as an ancillary solution to support individuals with their emotional well-being. While traditional therapeutic interventions have shown efficacy, sometimes the interventions can struggle to sustain user interest and adherence. Gamification offers a unique approach to addressing mental health issues with interventions incorporating game-like elements into non-game contexts. The interactive and immersive nature of gaming can captivate users, turning the experience into an enjoyable and rewarding journey.

Engagement and evidence-based efficacy

At the core of gamification is engagement. Mental health apps integrate play, challenge, and accomplishment elements that tap into the innate human desire for achievement, rewards, and progress. Happify has emerged as an evidence-based, gamified app that uses the power of positive psychology to empower users to take charge of their emotional well-being. The app’s effectiveness has been validated through randomized control trials, which have demonstrated improvement in depression, anxiety, and loneliness. Other features of that app, such as gratitude exercises and mindfulness techniques, further equips users with valuable tools for stress reduction.

Rewards and badges to nurture good habits

Gamification elements, such as rewards and badges, can serve as powerful motivators to nurture good habits. Apps now use a personalized and interactive approach to entice users to engage in daily activities, track their progress, and receive immediate feedback. These rewards serve as positive reinforcement, encouraging users to continue with their emotional well-being journey. One notable example is Finch, a self-care app that combines nurturing a virtual bird with caring for oneself. By completing self-written daily tasks and reflection, the users can earn higher levels for their bird companion, reinforcing the commitment to emotional well-being. However, it is essential to recognize that apps such as Finch should not replace traditional therapeutic interventions for mental health; they serve as valuable tools to augment existing interventions and establish a daily routine in users.

Encourage help-seeking and foster connections

Mental health apps extend beyond individual interventions by having a community feature, such as 7 Cups. The app provides online emotional support and counseling with trained listeners, therapists, and other individuals seeking emotional support. In addition, 7 Cups features community forums where users can interact with one another, allowing users to feel less isolated in their struggles and share experiences. Moderators are also present to guide discussions to ensure that conversations remain productive and empathetic. Ultimately, an app can also create a sense of belonging for individuals navigating their mental health struggles in a communal environment.

Finding the right mental health app

There is a plethora of mental health apps, and many use gamification to engage users. Searching for the right mental health apps can be challenging. There are curated lists of mental health apps, such as the list from UCSF. APA has created a guide to help evaluate mental health apps, known as the APP advisor. There are several healthcare organizations that utilize the APP advisor to create a database of reviews and categories of mental health apps, including the Division of Digital Psychiatry at BIDMC. In the BIDMC database, known as Mobile Health Index and Navigation Database, one can sort apps based on “gamification” and if the app has “supporting studies.” From our search on 7/31/2023, the BIDMC database had 34 apps that involved gamification and had supporting studies.

Looking ahead, the potential for gamification in mental health apps is boundless with ongoing research and technological advancements leading to more exciting possibilities.

Carter Do is a medical student. Thomas Pak is a psychiatry resident.