The game is up for teen depression – an app being tested across schools in Wellington hopes to reach young people and teach them coping skills as they play. Matthew Scott reports.
It’s not been easy growing up in New Zealand lately.
Coming of age under the shadow of a mercurial housing market and the unfolding climate crisis, today’s young people have reported a doubling in depressive symptoms since 2012. And then there’s the matter of the global pandemic destabilising things even further.
According to Dr Terry Fleming of Victoria University of Wellington’s School of Health, there’s been a “perfect storm” of factors causing an increased demand for mental health services in New Zealand.
“Becoming a young adult in New Zealand is challenging,” she said. “Social media is like an amplifier, you don’t go home from your problems at night anymore.”
On the brighter side, young people are also more willing to ask for help. All of these factors, however, can put strain on an already pushed mental health system.
“We have such a large increase in demand,” Fleming said. “Even with the increases in funding there are insufficient services and long waitlists in many areas.”
The answer to this problem may be found in looking for new ways to provide mental health support. More and more often, this has been through the internet.
Fleming has been on the forefront of exploring new ways to meet the needs of young Kiwis – turning to something oft blamed for depression and anxiety in the young – the ever-present phone in their pockets.
The latest project, spearheaded by Fleming and Victoria University of Wellington PhD student Russell Pine, is a game aimed at 11-15-year-olds that will teach simple mental health strategies like making room for negative thoughts and noticing your surroundings.
The game joins other digital mental health campaigns such as The Lowdown – a youth-focused website dealing with anxiety and depression that saw 65,000 visits between March and September of last year.
Mental Health Foundation chief executive Shaun Robinson says mental health has become such an immense issue for New Zealand, with a survey by the Foundation earlier this year finding a million struggling Kiwis.
He says anything that could help needs to be explored – including the digital approach.
“Mental health as an issue is the equivalent of if we had done nothing about Covid 30 years ago,” he said. “So we need all the tools available. Digital is one arm of the octopus.”
However, there are pros and cons to going digital.
Websites and apps can be available 24/7 and highly accessible while allowing young people to explore their needs confidentially and in a way they can control, Robinson says.
However, self-stigma may prevent young people from seeking help, and Robinson says you lose something in not having a one-on-one real connection with another person. “The manaaki of real people is very important,” he said.
Nevertheless, digital tools are invaluable to the Foundation, whose Getting Through Together was able to reach a third of the country in just eight months last year. “It enables us to reach literally millions of people,” Robinson said.
Fleming also sees the benefit of how many people can be reached by going digital. “We need scalable ways to meet the need,” she said. “And scalable ways are often digital.”
Fleming got into the digital side of things because she wanted to bridge the gap between where young people and mental health services are.
And where they are is video games, according to a survey last year by NZ On Air, which found nine out of 10 kids spend time gaming.
Fleming used the medium’s immense popularity as a co-developer on SPARX, a game that teaches skills derived from cognitive behavioural therapy while adventuring in a fantasy world.
Like social media, gaming can be a double-edged sword for mental health. “It’s not using it, it’s how you use it,” said Fleming. She says that while video games can be used to excess, “they also cause a lot of joy and pleasure for people”.
The new project is reminiscent of Candy Crush – a phone game called Match Emoji in which the player matches emojis to make them disappear.
Pine says they chose emojis given they’re the new symbols of emotion. “Kids said they use emojis to express how they feel,” he said.
Mental health messaging is delivered in the place of advertisements, which Pine hopes will help young people to develop an awareness of their own mental wellbeing. “Even if it just increases help-seeking, that would be huge.”
The format of a casual game was chosen due to its popularity amongst the young and their tendency to return over and over.
They had to think carefully about it not being too moreish, however.
“It’s a fine balance between making it engaging but not so addictive that it causes its own problems,” said Pine.
A casual game may also have its own built-in therapeutic qualities, he found in a recent study, which concluded they “may have promise for treating anxiety, depression, stress and low mood”.
But making sure young people want to use the app was important, as well. “There are other mental health apps that get millions of dollars put in, but only get used a few times,” Pine said.
In order to make sure their app is appealing to its target audience, Pine plans to consult with young people at a range of schools in the Wellington area directly – as well as conduct a trial to assess whether it actually helps with their mental health.
The plan is to assess the mental health of 60-80 Year 9s and 10s at a number of lower-decile schools – first before they have spent time regularly playing the game, and after.
He hopes this will be a viable tool to educate pre-adolescents about mental health – a group he says is often overlooked when it comes to conversations about anxiety and depression.
“We wait until the young person is at an age where they can articulate how they feel before we do anything about it,” said Pine.
But with the small steps or “micro-interventions” taken by the messages in the game, these young people may learn how better to deal with distress via acceptance and commitment therapy. “A lot of it is about teaching them to make room for difficult thoughts.”