Mental Health in 3D

A Dimensional Model of Mental Illness Representation in Digital Games



Mental illness, digital games


There is a wealth of research on the depiction and impact of mental health representations in traditional media; however, less is known about video games. As the dominant form of media in the 21st century, video games uniquely portray mental illness in traditional ways as well as in ways unique to video games, such as in-game mechanics (e.g., sanity meters) and player-driven decision making. This paper outlines the importance of cultural messages relating to mental illness as conveyed through video games in terms of content and influence and presents a multi-dimensional model of analysis for the representation of mental illness in digital games. The aim of this paper is to provide a foundation for understanding how mental illness is represented in digital games, provide a new perspective for thinking critically about representation of mental illness in games, and overview a new framework for assessing video game content in this area.

Author Biographies

Kelli Dunlap, American University

I’m a clinical psychologist and game designer. I work full-time as a therapist practicing in Maryland and teach each Spring and Fall as adjunct professor of game design at American University’s Game Lab. I am the community manager for Take This, a games-focused mental health non-profit, and the chair of the International Game Developers Association’s Mental Health special interest group. My research for the past 10 years has focused on the intersection of games and mental health with a focus on the use of games in therapeutic settings as well as the portrayal of mental illness in games.

Rachel Kowert

Rachel Kowert, Ph.D is a research psychologist and the Research Director of Take This. She is a world-renowned researcher on the uses and effects of digital games, including their impact on physical, social, and psychological well-being. An award-winning author, she has published a variety of books and scientific articles relating to the psychology of games and, more recently, the relationship between games and mental health specifically. Her published works include peer-reviewed books such as Video Game Debate, Video Game Debate 2, and Video Games and Well-being: Press Start, as well as community-focused books such as A Parent’s Guide to Video Games, and Pragmatic Princess. Recently, she founded her YouTube channel Psychgeist, which serves to bridge the gap between moral panic and scientific knowledge on a variety of psychology and game-related topics.  Dr. Kowert has been featured in various media outlets, including NPR, the Washington Post, the Wall Street Journal, the Atlantic, Wired, and video game publications such as Kotaku and Polygon.