Playing at understanding psychosis
One of the most widespread myths in mental health is the link between psychosis and violence or loss of control. This myth has been fueled over the years by the cultural and journalistic industries and has gradually permeated people's mindsets. However, there is no evidence that people with psychosis are more violent than people without this disorder. They are just as likely to experience violent episodes as anyone else. On the contrary, they are more vulnerable to becoming victims of violence and other types of crime than people without a mental health disorder.
The fight against the stigma associated with this connection is being waged in numerous areas and with different strategies based on reliable information. Some of these strategies have educational or therapeutic objectives, and this is where serious games can play a relevant role.
What are serious games?
These are games, digital or analog, designed for educational or therapeutic purposes . They use narrative, rules, and interactivity to explain complex concepts, train skills, and foster empathy. So… can they help us better understand psychosis and support recovery? They are a complementary tool, never a substitute, that can make mental health care more accessible, motivating, and less stigmatizing.
Games are a universal language, capable of reaching very broad audiences, especially young people, who often struggle to connect with more traditional educational or therapeutic approaches. Serious games , therefore, become allies. They allow us to talk about what costs money, and to do so in an interactive, engaging, and less stigmatizing format.
Video games have a unique value: they combine narrative, interactivity, and emotion in a unique way.
Benefits of using serious games in mental health:
- To facilitate the understanding of what it means to live with a mental health disorder, by recreating sensory and emotional experiences that are difficult to explain in words.
- Encourage empathy from family, friends, and professionals, who can, in some way, put themselves in the shoes of the person experiencing it.
- Breaking down barriers and opening up conversations about mental health in a friendly and engaging environment.
- To support recovery by offering motivating and accessible tools that complement clinical care.
Experiences with serious games on psychosis
To date, the field of serious games applied to psychosis has been largely unexplored. Most mental health experiences have focused on neurodevelopmental disorders, especially in children and adolescents, such as autism or ADHD. In the latter case, there is even a video game approved by the Food and Drug Administration (FDA), the U.S. federal agency that regulates the safety and efficacy of food and health products, as a safe treatment for children.
New technologies in the diagnosis and treatment of ADHD
In contrast, in the field of psychosis, we are only just beginning to understand it. At the Sant Joan de Déu Health Park, in collaboration with the company Delaguila Games , a pioneering project is underway to promote symptom recognition, teach how to act in everyday situations, identify risk and protective factors, and reduce the stigma surrounding psychosis. Most importantly, it is being developed with the direct involvement of people with lived experience, ensuring a close and realistic reflection of the daily challenges they face.
Playing can also become a way to break the stigma and open new opportunities for recovery.
Outside of clinical settings, one of the best-known video games is Hellblade: Senua's Sacrifice . Although not originally conceived as a therapeutic tool, it was created in dialogue with people who have experienced psychosis and with mental health professionals. Its protagonist hears voices, perceives nonexistent figures, and undergoes an emotional journey marked by pain and hope. Thanks to its narrative and immersive sound design, it allows players to gain insight into what it means to live with hallucinations. Its impact has been global: millions of players have been able to approach a more human and empathetic view of psychosis.
Another example is the virtual reality game developed by Isabelle Amado 's team, designed to train cognitive functions in people with schizophrenia or schizoaffective disorder. Through immersive environments, skills such as memory and attention are developed.
These examples illustrate the diversity of approaches: from outreach and awareness-raising to cognitive training and psychoeducation. In all cases, video games become a bridge to understanding and recovery.
Benefits and evidence of the use of serious games
Serious games applied to psychosis are not just a suggestive idea: research is gradually beginning to show that they can offer real benefits. Although the field is still in its early stages, promising results are already being observed in several areas:
- Motivation and continuity of care. Many traditional interventions are perceived as lengthy or unappealing, especially for young people. Video games, thanks to dynamics of challenge, overcoming obstacles, and progress, increase engagement and make it easier to learn and maintain care routines.
- Empathic understanding. Games like Hellblade have shown that an immersive experience can bring the general public closer to what it means to live with voices or visions. This fosters empathy, helps reduce prejudice, and contributes to breaking down stigma.
- Skills training. Several projects based on virtual reality programs, such as those developed in Spain with the Wii® console or SocialVille , have shown improvements in memory, attention, reasoning, and interpersonal skills—areas that are often affected in psychosis.
- Hope and recovery. Some pilot projects, such as OnTrack > The Game , have explored how a game-based format can be used to support recovery in people experiencing a first psychotic episode. Initial results suggest that this approach reinforces the idea that progress and improvement are possible.
Beyond the specific results, many studies agree that these tools are accessible, engaging, and relatable for those who sometimes feel disconnected from more conventional approaches. And, above all, they don't replace traditional care, but rather complement it with an innovative and motivating approach.
Challenges and limitations
While serious games offer enormous potential, it's also important to recognize their limitations. Most studies conducted to date have used small sample sizes and short follow-up periods, making it difficult to determine whether the benefits are sustained long-term. More robust research is needed to confirm their effectiveness.
Another challenge lies in implementing these techniques in clinical practice . Not all mental health services have the necessary technology, nor do all professionals feel prepared to integrate video games into their daily work. There may also be some resistance: how do you explain to a person or their family that a game can be part of their recovery process? This cultural shift requires time and support.
Furthermore, there are potential adverse effects. Although very rare, some people may experience discomfort or dizziness in virtual reality environments, or feel overwhelmed by overly intense experiences. Therefore, it is crucial to design sensitively and co-create with people who have experienced psychosis, to prevent the game from being counterproductive or stigmatizing.
In short, serious games are not a magic bullet. They are a tool that must be carefully integrated, always in coordination with standard treatments. The challenge lies in finding a balance between innovation and safety, so that digital technology adds value, but never detracts from it.
Beyond the games
The potential of digital technology in mental health is not limited to a single format. Tools such as virtual reality, mobile applications, and interactive digital environments facilitate communication with healthcare teams. They also allow for the recreation of everyday situations or experiences that are difficult to address in real life, offering a safe space to practice skills and cope with challenges.
However, video games have a unique value: they combine narrative, interactivity, and emotion in a singular way. Thanks to this, they not only inform or train skills, but also engage people, generate motivation, and open up difficult conversations using a relatable and accessible language.
This potential makes serious games a promising approach within the field of mental health innovation. Furthermore, it's not just video games that have this reach: board games are also opening up new possibilities, with initiatives like the card game Andy's Mind , a co-created project designed to promote learning about psychosis. Currently in the evaluation phase, it has received very positive feedback from participants in the tests conducted so far.
Serious games represent a new way of approaching psychosis : more humane, more empathetic, and more appealing to those seeking to learn or recover in a different format. They don't replace therapy or medication, but they can provide motivation, understanding, and hope.
By allowing users to step into someone else's shoes, recreate experiences that are difficult to describe, and train skills in a playful way, video games become a bridge: between people being cared for and professionals, between young people and adults, between science and society.
The challenge now is to continue researching, co-creating, and rigorously evaluating these proposals. Only in this way will we stop seeing play as something frivolous and recognize it for what it truly can be: a powerful tool for understanding, supporting, and caring.
Ultimately, playing can also become a way to break the stigma and open new opportunities for recovery.
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