The new game plan for mental health and wellbeing 


Game designers are teaming up with health professionals in a whole new approach to delivering support and driving behavioural change.

Any system involving an objective, a challenge and a reward is a form of gamification.

The strategy called 'gamification' can be a deceptively simple concept. At its most basic it's about taking the methodology, psychology and technology of game design and applying them to non-gaming contexts, usually to encourage changes in behaviour or emotional states.

It isn't new by any means - you could argue that any system involving an objective, a challenge and a reward is a form of gamification. Think, for example, of a company that uses a sales leaderboard with the promise of a cash bonus to the employee with the highest sales.

Like the technology of digital gaming itself, gamification can be remarkably sophisticated. Backed by research, the videogames industry has decades of experience in making gaming experiences rewarding and compelling.

Gamification doesn't need a screen environment, it's just taking the elements of a game and applying it to a new situation

Solving problems with 'game thinking'


Al Gibb is the Head of Fashion and Digital Games at Creative Victoria and has recently returned from a sabbatical looking at excellence in gamification in Europe and the US.

'What's interesting is that gamification doesn't need a screen environment, it's just taking the elements of a game and applying it to a new situation,' says Gibb. 'Game thinking can even be applied to just part of a solution if needed.'

As Gibb suggests, gamification doesn't always mean designing something that plays like a traditional game. When it does, however, the term 'serious game' or 'serious gaming' may be used to differentiate the game with purpose from the game designed purely for entertainment.

Ron Curry is the CEO of the Interactive Games and Entertainment Association (IGEA). Curry notes that serious games are big business in Australia.

'Serious games are used in applications ranging from business to health to education and they are a huge and fast growing part of the industry,' he says. 'In fact, the IGEA's recent Digital Australia survey revealed that almost a quarter of workplaces already use games for training purposes.'

Antony Reed agrees. Reed is the CEO at Game Developers' Association of Australia (GDAA). 'Games for behavioural change are amazing and there's no question they can work,' he says. 'Even in their lightest form they can be powerful educators, whether it's history, geography or even social behaviour. Turning that to the gamification of real world issues is just the next step.'

Game Training

Gaming is an interesting vehicle for getting people to engage in some kind of health behavioural change.

Gamification in a health setting


'Gaming is an interesting vehicle for getting people to engage in some kind of health behavioural change,' says Professor Stuart Smith from Southern Cross University. 'It's not just physical health, such as rehabilitation after a stroke or reducing the risk of falls in the elderly, but increasingly we're using it in cognitive health, even social and emotional health.'

Professor Smith sits on the editorial board of the Games for Health Journal: Research, Development, and Clinical Applications, a bimonthly peer-reviewed journal dedicated to the development, use and applications of game technology for improving physical and mental health and wellbeing.

Gaming in Victoria

Even in their lightest form, [games] can be powerful educators, whether it's history, geography or even social behaviour. Turning that to the gamification of real world issues is just the next step.

Smith says he had his 'a-ha moment' about the potential for gamification to affect health outcomes 14 years ago when he was at University College Dublin.

Gaming the boredom out of rehab

'One of my psychology masters students was volunteering at a spinal rehabilitation unit. There were a lot of young men going through rehab which involved repetitive movements as they relearned to use their limbs.'

The rehab work was, well, boring and came with little or no feedback on performance improvement, leading to very low engagement from the patients. A commercially available video game console with a camera attachment that captured body movements and translated them into game controls provided the breakthrough: patients were engaged and even rewarded for doing their exercises.

'It was a simple case of asking ourselves how to encourage people to play the game and ensure that they're rewarded for that participation in a meaningful way,' says Smith.

Using gaming tactics for more reliable test results

That's also the philosophy behind Sound Scouts, an Australian-made hearing test that uses gamification to improve the accuracy of testing results in young kids.

'Hearing tests are notoriously boring and loss of attention impacts the child's results,' says Carolyn Mee, creator of Sound Scouts. 'They can sometimes appear to have a hearing loss when they don't just because they lose interest in the testing process.'

Sound Scouts uses an age-appropriate design and fun narrative to keep kids involved in the test. 'We engage them with the characters and the interactivity and this enables us to collect enough hearing data to deliver a reliable result,' explains Mee. 'Our clinical trials showed nearly 98 per cent sensitivity and specificity in detecting hearing loss over 30dB and 85 per cent over 20dB.'

One in three young people are either unemployed or under-employed and this doesn't look likely to change.

Taking a gaming approach to the support of young workers


Entering the modern workplace can be challenging and confronting for young Australians. On average it takes a young person 4.7 years to move from education to full-time employment. That's a big shift from the one year it took someone back in the mid-1980s to find a full-time job.

The years of 'young worker churn', making uncertain progress from one part-time job to the next, has a sizeable and negative impact on the mental health and wellbeing of those affected.

'The job market holds a surprising number of challenges for young Victorians these days, and those challenges result in stresses on the health and wellbeing of the whole generation,' says Irene Verins, Manager - Mental Wellbeing at VicHealth.

'The opportunity to work with Victoria's strong gaming industry to create a gamified platform that offers practical support in an engaging environment wasn't something we wanted to miss out on.'

Game on for young workers


Enter VicHealth's proposed gamification project, being developed in partnership with others, to prepare young workers for a job market that's in the midst of major upheavals and showing no signs of slowing down.

VicHealth is, in many ways, in a unique position to take full advantage of gamification. Thanks to astute investment and support from the Victorian Government, the state is home to more than half of the industry's game developers. On a national basis, the gaming industry generated close to $3 billion in revenue in 2016 .

'For 20 years, there hasn't been a year that Victoria hasn't supported the games industry and the Government is now reaping the rewards of that constant investment,' says Gibb.

VicHealth hosted a two-day exploratory workshop that was administered by Gibb in his Creative Victoria role. It brought together six members of the gaming industry as well representatives from employee-advocacy groups including the Young Workers Centre.

'The Victorian Government is in the enviable position of having a very modern sector who are willing and able to help,' says Reed. 'When it comes to working on project like this, we're there - there's no equivocation, the industry is excited to be on board.'

' are not your job, you are your skills...'

VicHealth's proposal is for a platform with a suite of interactive activities designed to attract and connect with young people, while helping them to expand their understanding of their personal value as it relates to the workforce. Players are encouraged not to define themselves by their job, but by their skills and experience.

"The concept of a 'career', as it was understood by their parents and employers, is increasingly rare for young Australians.

'Young people face a massive disconnect between what they're told to expect from the job market and what the job market is,' says Émilie Poissenot, one of the gaming representatives on the

As the director of Burning Glass Creative Poissenot has nearly a decade of experience in the gaming industry across a range of roles.

'Young people need to change their understanding of what it means to be an employed adult and they need the tools to tackle the job market - and that's how we came up with the core idea that you are not your job, you are your skills and we built the game strategy around that. This is what we kept in mind during the workshop. We wanted something that was an explorative, satisfying and stress-free experience, but also something that offered real results.'

Not a quick fix, but a long-term project


VicHealth sees the gamification solution for young workers as a long-term project, something that Gibb says bodes well for the endeavour.

'If a fix was quick and easy then this wouldn't be a problem in the first place,' he says. 'VicHealth understands that this is a long-play. Getting a pilot up, testing it in a small market, getting feedback from players - this is how you build something that works.'

Phase one involves developing the product over the course of 10 to 12 months before making the basic model available to a wide range of users. In Phase two, feedback from those users will be used to improve and integrate the ecosystem, including a focus on social media interactions. Phase three will see the addition of new modules, purpose built to engage and involve employers, parents and other mentors. It's hoped the final product will make a difference to all young workers: from creatives to tradies to would-be community workers and even professionals.

Where to next for gamification?


As for gamification itself, it will continue to follow the prevailing technologies.

'Use of gaming and in particular [the] new immersive technologies such as Virtual Reality is a fascinating way of looking at mental health challenges,' says Southern Cross University's Professor Smith.

'How do we use games, simulation environments, Virtual Reality and all of these wonderful digital tools we have at our fingertips to address health concerns, be they physical, cognitive, emotional or social? That's our next challenge.'

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