Vir­tual life de­liv­ers tools for a real life

A new on­line com­puter game aims to teach young peo­ple about men­tal health is­sues, writes Lyn­nette Hoff­man

The Weekend Australian - Travel - - Health -

MISSY Hig­gins is singing her heart out. The playlist moves from R&B to rap to al­ter­na­tive — it’s all de­cid­edly hip and there’s good com­pany about, but this is no big night out.

It’s a vir­tual world called Reach Out Cen­tral, a free on­line com­puter game cre­ated to teach teenagers some of the same sorts of re­silience and cop­ing skills a psy­chol­o­gist might — and get them to seek help if needed.

De­void of guns, guts and gore, and no high­speed chas­ing, ROC is a role play­ing game set in sub­ur­bia with a web of char­ac­ters to ri­val Neigh­bours . The premise is that you’ve just moved into a new town, and as you nav­i­gate the neigh­bour­hood build­ing friend­ships and help­ing char­ac­ters through typ­i­cal life strug­gles such as deal­ing with di­vorce or low self­es­teem, you will ac­tu­ally learn tried and true cog­ni­tive be­hav­iour ther­apy prin­ci­ples you can ap­ply to your own life.

Reach Out Cen­tral was launched in Septem­ber by the not-for-profit In­spire Foun­da­tion in an ef­fort to reach young peo­ple — es­pe­cially those in the 16 to 25 age bracket, young men in par­tic­u­lar, who are no­to­ri­ously re­luc­tant to seek help from a health pro­fes­sional for men­tal health is­sues.

A team of 80 youth am­bas­sadors gave a young per­son’s per­spec­tive as the game was be­ing de­vel­oped, and have been in­volved with the mar­ket­ing con­tent for the pro­gram as well.

Ac­cord­ing to the latest fig­ures, one in five ado­les­cents ex­pe­ri­ences a men­tal health is­sue in any given year, and fewer than 40 per cent get help from a health pro­fes­sional. When they do seek help it’s of­ten for phys­i­cal symp­toms, so any un­der­ly­ing men­tal health prob­lem can get missed or take a long time to be di­ag­nosed.

That was ex­actly the case for Queens­land stu­dent ‘‘ Mike Jones’’ (not his real name). Jones had al­ways been a so­cial per­son, and had taken on the role of school cap­tain when anx­i­ety struck a few years ago. He ‘‘ freaked out’’ when­ever he was around peo­ple — speeches that once made him ‘‘ a lit­tle ner­vous’’ were now ‘‘ com­pletely over­whelm­ing’’. Nausea, sweaty palms, a rac­ing heart and shal­low breath­ing were be­com­ing ev­ery­day ex­pe­ri­ences — and when he de­cided to see his GP, those were the symp­toms he com­plained of.

And so Jones was sent for a string of blood tests and even a gas­troscopy, all of which proved neg­a­tive, be­fore Jones him­self sug­gested to the GP that per­haps he needed to be re­ferred to a psy­chol­o­gist. He says it took only a few ses­sions of learn­ing cog­ni­tive be­hav­iour ther­apy to get him­self back on his feet.

‘‘ I stopped be­ing re­ac­tive and started to make changes,’’ he says. ‘‘ I was able to re­de­fine who I was — some­times I was fak­ing it, be­ing re­ally pos­i­tive even when I didn’t feel that way, but now it’s what peo­ple ex­pect me to be.’’

It’s those sorts of cop­ing skills — and aware­ness about when a men­tal health is­sue is too much to han­dle on one’s own — that the game is de­signed to com­mu­ni­cate.

A 2006 na­tional sur­vey of 14,700 young peo­ple be­tween the ages of 11 and 24 by Mis­sion Aus­tralia found sui­cide was among their top five con­cerns — in par­tic­u­lar, nearly 30 per cent of 11 to 14-year-olds and al­most 28 per cent of 15 to 19-year-olds said it was ‘‘ a ma­jor con­cern.’’ Cop­ing with stress was the top is­sue 15 to 19-year-olds were con­cerned about, and over­all two in five young peo­ple were ‘‘ sig­nif­i­cantly con­cerned’’ about de­pres­sion. A 2005 sur­vey by the Aus­tralian Democrats found 57 per cent of the young peo­ple knew a young per­son who had at­tempted or com­mit­ted sui­cide.

Young peo­ple are wait­ing an av­er­age of any­where from five to 15 years to do some­thing about men­tal health is­sues, leav­ing them­selves open to prob­lems such as de­te­ri­o­rat­ing re­la­tion­ships and prob­lems with school and work, says doc­tor Jane Burns, di­rec­tor of re­search and pol­icy at the In­spire Foun­da­tion.

Of­ten they are con­cerned about con­fi­den­tial­ity, or think see­ing a health pro­fes­sional is a waste of time, Burns says. In­stead they are more likely to speak to friends or fam­ily who of­ten ei­ther un­der­es­ti­mate the prob­lem, or are ill-equipped to deal with it.

‘‘ Peo­ple still have stig­ma­tised at­ti­tudes, or they may not recog­nise how se­ri­ous the prob­lem is, so they tell the per­son to ‘ snap out of it’ or ‘‘ get out there and pull your socks up’,’’ she says.

There’s also a ten­dency, es­pe­cially in young men, to try to mask the prob­lems with drugs and al­co­hol, says as­so­ci­ate pro­fes­sor Ma­ree Teesson, act­ing Di­rec­tor of the Na­tional Drug and Al­co­hol Re­search Cen­tre.

‘‘ One third of young men with anx­i­ety or de­pres­sion and one in four women with ei­ther anx­i­ety or de­pres­sion, or both, will also have an al­co­hol or drug prob­lem,’’ Teesson says. ‘‘ When you think of the typ­i­cal per­son with an al­co­hol prob­lem, what do you think of? An older male? Most peo­ple do — but the per­son most likely to have an al­co­hol-use dis­or­der in Aus­tralia is ac­tu­ally a young male be­tween the ages of 18 to 25.’’

It’s for those rea­sons that there has been grow­ing in­ter­est in us­ing al­ter­na­tive me­dia to reach young peo­ple who ei­ther have or are at risk of de­vel­op­ing de­pres­sion, anx­i­ety or other men­tal health prob­lems, says He­len Christensen, di­rec­tor of the Cen­tre for Men­tal Health Re­search at Can­berra’s Aus­tralian Na­tional Univer­sity.

In the last decade there have been about 25 re­search tri­als look­ing at the ef­fec­tive­ness of in­ter­net-based in­ter­ven­tions — but nearly all have fo­cused on adults rather than specif­i­cally tar­get­ing young peo­ple, Christensen says.

That’s just now be­gin­ning to change, with re­searchers at ANU in the fi­nal stages of a study that tri­alled the in­ter­net-based MoodGym, a self-help pro­gram that teaches CBT in a non-game for­mat.

The study com­pared anx­i­ety and de­pres­sion lev­els in 14 to 16-year-old stu­dents at 30 schools across Aus­tralia, where half were given the stan­dard cur­ricu­lum the schools would nor­mally pro­vide, and the other half were given MoodGym. ‘‘ There was an in­crease in over­all men­tal health well-be­ing and re­duced lev­els of anx­i­ety and de­pres­sion af­ter six months in the stu­dents who ac­cessed MoodGym,’’ Christensen says.

Video games have been used to pro­mote se­ri­ous mes­sages be­fore — two ex­am­ples are a UN World Food Pro­gram game to ed­u­cate young peo­ple about world hunger, and a US Army re­cruit­ment game sim­u­lat­ing the ex­pe­ri­ence of a sol­dier.

But Reach Out Cen­tral is the first to do so in the area of men­tal health. It will be eval­u­ated for ef­fec­tive­ness by Swin­burne Univer­sity later this year.

Pro­fes­sor Ge­orge Pat­ton, di­rec­tor of ado­les­cent health re­search at the Cen­tre for Ado­les­cent Health, says that even while longterm ef­fec­tive­ness re­mains to be seen, the po­ten­tial ben­e­fits and low costs make web­based in­ter­ven­tions a worth­while ven­ture.

‘‘ There’s good ev­i­dence that they work in the short term for up to about 12 months,’’ Pat­ton says. ‘‘ We don’t re­ally know how ef­fec­tive they are in the long term, but they don’t cost any­thing much at all — it’s ba­si­cally the start-up and that’s it — and we know the big­gest users of the in­ter­net are th­ese younger groups, so web-based pro­grams could be even more use­ful for them.’’

Pic­ture: Alan Pryke

Am­bas­sador: Nathan Ber­ton was one of 80 young peo­ple who worked on Reach Out’s con­tent and mar­ket­ing

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