A randomized clinical trial of 532 high school students aged 16 to 19 found that a video game designed for mental health prevention produced measurable reductions in depressive symptoms one year later. The study, published in JAMA Network Open, was conducted by researchers at Dartmouth College's play2PREVENT Lab led by Lynn Fiellin.
Students were recruited from school-based health programs in Connecticut between October 2021 and February 2024. Eligibility required recent substance use or heightened depressive symptoms; those with prior opioid misuse were excluded. About 53% of participants were male, 45% Black, and 38% Hispanic.
The intervention group of 269 students played PlaySmart for about one hour weekly after school for up to six weeks. The control group of 263 students played commercial role-playing games without therapeutic content. Both groups were followed for 12 months.
PlaySmart presents interactive scenarios based on real teen experiences, asking players to identify signs of depression, choose whether to seek help from trusted adults, and navigate substance-related decisions. Players can review choices and explore alternative outcomes. The game is fully self-guided with no clinician involvement.
One year post-trial, the PlaySmart group scored 1.12 points lower on the PHQ-8 depression scale (range 0-24) than the control group. This effect size matches or doubles typical universal prevention programs, which average only 0.1-point reductions at one year. Benefits appeared consistent across sex, race, grade level, food insecurity, and family substance-use history.
After just six weeks of gameplay, PlaySmart participants also reported more positive attitudes toward seeking psychological care. A companion study in Nature Health found the game increased awareness of opioid-related harms.
Fiellin noted that most adolescent mental health programs show modest, short-lived effects. PlaySmart's sustained impact at one year, delivered digitally in schools without specialized staff, addresses barriers including stigma, limited provider access, and low help-seeking recognition.
The game is one of five developed by Fiellin's lab and distributed through Playbl, a spin-off company independent of Dartmouth. It is currently deployed as a universal prevention tool in several school districts and youth organizations.
Video games built for prevention can reduce teen depression
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