What if we could revolutionize the future of mental healthcare? What if, instead of treating mental illness - we could prevent it? What if we could do this through games, seamlessly integrating therapeutic elements into compelling narratives and engaging mechanics - building a foundation for resilience and improved mental health without the player even becoming aware of it?
As the individual who first conceptualized the Innovajoy Project in its current form, that is the mission of myself and my team: to expand the provision of mental health care through the use of games.
We've all heard of the negative effects of stress - how it impacts personal stability, has huge economic costs, and in cases of prolonged exposure, can even trigger mood disorders. Indeed, the World Health Organization has named stress the "Health Epidemic of the 21st Century."
But stress does not have to be harmful - and is not harmful, if it is coherent, according to Aaron Antonovsky, who studied stress and its related outcomes. From his research, if one's stressors were comprehensible (predictable and understandable), manageable (you have the skills or resources to manage your stress - and its associated stressors), and most of all, meaningful (either interesting in their own right or endured for a higher purpose), then one could remain healthy - and even thrive - in a high stress environment.Of these, the last is most important, as a sense of meaning gives people the motivation to comprehend and manage events in their lives - that gives rise to good health, as he would put it, leads to a salutogenic response.
Journey to the West
The first of the games under development as part of the Innovajoy project, Journey to the West aims to instill this sense of coherence in college students through cognitive behavioral therapy, packaged in the form of a mobile-optimized RPG, with compelling narratives and uniquely engaging mechanics. It is designed around a "Journey to the West," with the journey of the characters reflecting the usergroup's separation from their established social networks, and their struggle to engage and find acceptance. Indeed, surveys of college students from around the world cite social isolation as their #1 stressor - and a powerful one, with with 60% of this population suffering from stress-related mood or sleep disorders, and 1 in 5 deaths in this population resulting from suicide.
Uniquely, Journey to the West is presented as a mobile game that targets the general college student - not solely students who have already been diagnosed with a condition and who are seeing a provider, as previous apps have been. This population rarely uses health apps (save perhaps exercise apps such as the acclaimed Zombies, Run!), and just as rarely seeks therapeutic intervention when stressed (whether due to stigma, time constraints, or inadequate provision of care).
Thus, unlike most mHealth apps, which simply present exercises as something to be done in very set, prescribed fashion, Journey to the West weaves them into a dynamic, changing whole, utilizing the context of the story and game genre (RPG - role playing game) to present them in a non-threatening way. For example, to encourage deep breathing, proper breathing is tied to the activation of certain magical skills - appropriate because in Asian cultures, mastery of one's breath is the underlying principle behind medicine, martial arts, meditation – even magic.
This allows the user to practice this skill without the anxiety of learning a health intervention, with the avatar's role as a surrogate of self (reinforced through customization and growth - cosmetic options and learned skills) encouraging its use. Further, this virtual surrogacy allows interactions and connections with virtual companions to take on new meaning, allowing users to learn more effective skills for social engagement - as well as how to recognize warning signs in others.
Journey to the West is currently a work in progress, but has been recognized as addressing a topical issue in a number of publications and has won several awards for innovation and potential market impact.
Lee, M. (2014). Sticky Ends: Employing Thinly-Sliced Narratives in Serious Games for Mobile Platforms. International Journal of Multimedia and Ubiquitous Engineering, 9(10), 349-362. doi: 10.14257/ijmue.2014.9.10.34
Lee, M & Hanrahan, N. (2014). A Story in Slices: Designing Narrative-Based Serious Games for Mobile Platforms. In Proceedings of the Serious Games Conference 2014: Bridging Communities, Harnessing Technologies and Enriching Lives, Ilsan KINTEX, Korea [CD]. Singapore: Gyeonggi Content Agency, Korean Game Society, & Research Publishing.
Lee, M., Kang, L., & Hanrahan, N. (2014). Addressing Cultural Contexts in the Management of Stress via Narrative and Mobile Technology. In Widerhold, B., & Riva G (eds). Annual Review of Cybertherapy and Telemedicine 2014 (pp. 173-177). Amsterdam: iOS Press. doi:10.3233/978-1-61499-401-5-173
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