As a medical doctor (and gamer) with a background in design and product development, I have had the opportunity to work with game developers to help them incorporate important serious themes into their games. I believe that videogames have the potential to not only entertain, but also educate and inspire players to make positive changes in their lives.
(refer to watch instead of read? Check out the topic explored on my games for health YouTube channel...or continue reading on!)
One of the main challenges in developing games with serious themes is ensuring that the game mechanics, narrative, and art style effectively serve the core thematic messages of the game, while also staying true to the overall design and intent of the game. For example, in a fantasy or make-believe world, it may not be necessary to depict mental health in a direct, 1:1 manner, but it is important for the developers to have a good understanding of the realities of mental health in order to make informed decisions about which elements to incorporate into the game, or which elements to adapt to better fit the particular game's world.
Additionally, some themes may require a more sensitive approach, such as suicide or eating disorders, which require a delicate balance between conveying a serious message while not trivializing it, over-simplifying it, or relying on stereotypes to represent it. In general, my advice is to not include these types of disorders into a game unless it directly serves the game's narrative or characters. It is also best practice to work with experts, such as doctors, mental health professionals, or organizations in the field, to ensure that the game's depiction of these themes is respectful.
It is important to strike a balance between delivering educational or meaningful content in an engaging way without compromising the artistic vision of the game developers. This can be challenging, particularly when working as an outside consultant and providing suggestions for a game that many people are deeply invested in both professionally and emotionally. Good communication and understanding of each other's perspectives is crucial in order to ensure that the final product is a harmonious blend of artistic vision and meaningful content. In my consulting work, I employ a strategy which I call the 10% approach. This means that if I am brought in as a consultant, especially during later stages of development, I aim to identify and make small changes that will improve the overall impact by 10%, and preserve the original artistic vision as much as possible. I find this approach much more successful than attempting to redefine entire aspects of a game, even if they may be flawed.
One easy 10% implementation is to provide warnings, resources, or guidance for players who may be affected by the themes in the game. It is important that the game doesn't just raise awareness but also provides pathways for players to seek help and support. Of course, the best practice is to involve experts in the game-development process as early as possible, so that we can be proactive in creating the best design and game direction decisions, and have a greater impact on the overall game experience.
In my role as a game design consultant, I collaborate with developers to align the gameplay mechanics and design elements with the intended themes and goals of the game. As an example, I once was brought into advise on a game set in the Viking age that tackles difficult themes, including ones of mental health, like depression and self-harm. I worked closely with the developers to portray these themes in a sensitive and appropriate manner, while also making the game immersive and engaging for players. To achieve this, we modified certain gameplay mechanics, such as changing a "sanity meter" that inflicted a mental illness on a character if it dropped to zero to a "trauma meter" that caused a character to experience negative mental health symptoms if it reached a high level. The shift from portraying mental health disorders to instead portraying much more relatable, and widely experienced, mental health symptoms, not only was a more appropriate way to tackle the topic, but also better served the game world and the intensions of the creators. This decision not only avoids offensive or polarizing portrayals of mental health, but also helps players better relate to and engage with the game.
One recent videogame that I believe does an excellent job of dealing with a serious topic and using gameplay to convey that topic is Sea of Solitude - a game that explores the theme of loneliness and its impact on mental health. The game follows the journey of a young woman named Kay, who has turned into a monster as a result of her loneliness and isolation. As players guide Kay through a flooded and abandoned city, they must confront her inner demons and help her come to terms with her emotions. The gameplay includes elements of exploration and puzzle-solving, as well as emotionally charged moments that allow players to connect with Kay and understand her struggles. Most definitely, one of the reasons that the game is so compelling is due to the fact that the developers worked with mental health professionals and individuals who have experienced loneliness to ensure that the themes and content were accurate and meaningful. By combining compelling gameplay with a poignant narrative, "Sea of Solitude" succeeds in being a memorable and fun game that simultaneously raises awareness about the importance of mental health and to encourage players to seek support when needed.
Working with game developers to incorporate themes of health or serious topics into their games is incredibly rewarding and meaningful. It allows me to use my skills and expertise to make a positive impact on players, and to help developers create games that have the power to inspire and educate. It's a unique opportunity to bridge the gap between the worlds of videogames and health, and to use the power of interactive storytelling to make a difference in the lives of players.
As someone with both a background in health and game design, I have been fortunate to collaborate with game developers to best incorporate themes of health or serious topics into their games. I have found my background, as someone who can both speak the language of health and designer, extremely useful in taking extreme care not intrude on the original vision of the game while still implementing constructive changes and consultation. By working closely with developers, and by using the power of interactive gameplay to deliver impactful and meaningful content, I have been lucky to aid in the creation of videogames that have the power to entertain, educate, inspire, and make a difference in the world, and something that I hope I will be able to do much, much, more of.
About The Author:
Dr. Amiad Fredman is a health designer and content creator who specializes in the medical design of digital health products, digital therapeutics, and games for health. He is the co-founder and Chief Product Officer of Aegis Digital Health, where he is working to revolutionize the remote patient monitoring space for diabetes patients and their healthcare providers. In addition to his work at Aegis, Amiad is an active speaker and opinion leader on the topics of health design and games for health. He hosts his own YouTube channel, Digital Doc Games, and writes a health design blog, where he shares his insights and expertise. Amiad is passionate about using his skills and knowledge to create effective and engaging health solutions that improve patient outcomes and experiences.
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