Dangerous game
Should video game addiction be classified a mental health disorder? The World Health Organisation believes so, but the gaming industry says that would be an economic disaster.
His video game habit started in middle school. His bedroom door was always locked, and when his grandmother stood on the veranda and peered through his window, he was invariably engrossed in an onscreen gunfight.
He eventually began disappearing to play at internet cafes. Night after night, she would search for him, and he would try to evade her.
The South Korean is now 21 and unemployed. In June at his grandfather’s funeral, he played games on his phone.
‘‘There wasn’t a day he’d go without playing,’’ said his grandmother, who raised him and felt so ashamed by his situation that she would speak only on condition that her family not be named. ‘‘Games ruined the child.’’
That’s a controversial opinion in South Korea these days. Video games are practically the national pastime, played by the majority of adults and more than 90 per cent of adolescents. Rising concerns over the effects of games on mental health have been met with scepticism and disdain by the US$13 billion gaming industry.
The debate intensified in May after the World Health Organisation (WHO) added ‘‘internet gaming disorder’’ to the 2022 edition of its International Classification of Diseases, which sets global standards for diagnosis.
That was a welcome development to many of South Korea’s mental health professionals, who say the classification will broaden understanding of the problem and improve treatment. They point to multiple incidents of gamers dying after playing for days with little food or sleep. In 2009, a couple became so consumed by games that they allowed their infant daughter to die of malnutrition.
The South Korean government, which has assembled a panel of experts and industry insiders to study the issue, could add ‘‘gaming disorder’’ to its own diagnostic classification as soon as 2025.
But the country’s gaming industry argues that the classification will have dire economic consequences.
Only the United States, China and Japan have bigger gaming sectors than South Korea, which exported US$6b in games in 2017. ‘‘It’ll be a disaster,’’ says Kim Jung-tae, a professor of game studies at Dongyang University and a veteran game developer who signed on to a task force pledging to fight the disease classification. ‘‘The entire ecosystem of the game industry could collapse.’’
He calls the push to recognise problematic gaming as an addiction a ‘‘witch hunt’’ perpetrated by psychiatrists and bureaucrats who stand to profit from funding for research and treatment, as well as parents eager to explain away their children’s academic failures.
South Korea’s Ministry of Culture, Sports and Tourism, which promotes and supports the gaming industry, has estimated that the gaming disorder designation will reduce revenue by US$9b over the next three years and cost 8700 jobs. It has lobbied the WHO to drop the classification and urged South Korea
to reject it, putting it at odds with the health ministry.
Mental health advocates say concerns that the industry will come crashing down are overblown.
‘‘Alcoholics don’t blame the company that makes the liquor,’’ says Roh Sung-won, an addiction specialist and professor of psychiatry at Hanyang University Hospital in Seoul. ‘‘You don’t stop manufacturing cars because there are automobile accidents.’’
Roh says one of his patients was a video game addict who needed a month of psychiatric care in hospital after the owner of an internet cafe got worried about him and called police. The man had been playing for 72 hours straight.
Still, there are divisions among mental health experts over whether excessive gaming should be classified as a mental disorder.
In New Zealand, University of Auckland professor Peter Adams says he would not classify gaming as an addiction, instead calling it ‘‘problematic gaming’’.
It is important to look at how the product is delivered and marketed, especially towards young people. ‘‘The games are being designed by people with features that are designed to engage.’’
The most important consequence of gaming is how it affects relationships, he says. ‘‘How does this play out in a young person’s capacity to form meaningful relationships?
‘‘When you’re spending time on gaming, you’re not spending time with friends or family. People can become socially disconnected.’’
Aaron Drummond, of Massey University’s school of psychology, says ‘‘gaming addiction’’ is uncommon. ‘‘It is important to understand that some people are heavy users, but that this does not interfere in their day-to-day lives.
‘‘The best estimates I have seen suggest that fewer than 1 per cent of players display problematic engagement that interferes in their lives.
‘‘Where problematic use exists, it is still unclear why this occurs, but is often accompanied by depression and anxiety. It may be that many cases of excessive use are a symptom of underlying depression, anxiety, or other mental health issues.’’
Dr Allen Frances, who chaired the task force that oversaw the production of a past edition of the Diagnostic and Statistical Manual of
Mental Disorders, the bible of US psychiatry, has tweeted that recognising gaming disorder could help some people but also carries the risk of mislabelling ‘‘millions of normal recreational gamers’’.
South Korea has long been at the vanguard of concern about addiction to video games. In 2011, it passed the so-called Cinderella Law, requiring games to include automatic midnight shutdown for children 15 or younger. Teens quickly found workarounds using VPN connections or signing on as their parents.
Two years later, a lawmaker proposed legislation classifying games alongside alcohol, drugs and gambling as major addictions to be battled by society. The proposal was debated for years before fizzling out.
In response to growing concerns, the video game industry established a Game Culture Foundation to promote the idea that gaming is a cultural asset rather than a social ill. The foundation set up five clinics to treat what it calls ‘‘game overindulgence’’. In the past five years, they have treated 17,000 people, according to researchers.
For the 21-year-old raised by his grandmother, visits to hospitals and clinics never worked. He’d give up after one or two sessions.
Addiction ran in the family. His grandfather was an alcoholic. The parallels seemed obvious to the woman who lived with both of them: the constant need for a fix, the deceit involved in hiding their habits, the inability to quit.
Her grandson disputes the idea that he was ever addicted to video games, even though he routinely missed school because he would play for 12 hours at a stretch.
Many of the video games he played featured the opportunity to buy ‘‘loot boxes,’’ which contain randomised prizes. It wasn’t much of a leap into another addiction that he readily acknowledges: gambling. He began dabbling in offshore sports betting websites. In recent years, he resorted to petty fraud to get gambling cash – such as selling his motorcycle to multiple people online.
He was arrested in July on fraud charges related to his gambling debts and is currently in jail awaiting trial.
He now says he doesn’t think much about video games any more. ‘‘I just played whenever I felt empty and depressed.’’
His grandmother has been travelling an hour and a half every day, taking a bus, a train, then another bus to visit him. She often finds herself thinking back to his primary school days, when a soccer coach suggested that he had talent and that she should sign him up for lessons. The family couldn’t afford it – but now she wonders whether it would have made all the difference. –