With the CDC`reporting a significant increase in mental health issues, it is important now more than ever for pieces of media to properly discuss mental health. But even though mental health issues are more openly talked about and accepted in society than ever before, it is still extremely common for false information and negative stereotypes to be seen in media, and video games are no exception.

Despite this, some video games in recent years have had incredible representation and exploration of mental and emotional health and wellbeing. Instead of using it as a gimmick, these games approach the topic with compassion and understanding.

Depression Quest

Created by American video game developer Zoë Quinn, Depression Quest is a 2013 text adventure game created in Twine where players control a person who is struggling with unhappiness. The game is free and has received praise from the New YOrker and others for its accurate depiction of depression.
During the game, the player decides which actions the person should take next, but some of the options are unable to be selected, which is meant to represent how depression can limit what a person is able to do. Instead of being created to entertain the player, this game was made to educate players on what it is like to deal with depression.

Spiritfarer 

Spiritfarer is a 2020 management sim where the player controls a young woman named Stella who becomes a Spiritfarer, which means that she sails the seas to find spirits, grant their final wishes, and take them to the gateway to the afterlife known as the Everdoor. With her cat named Daffodil, Stella meets and befriends various spirits while recovering memories of her past life.
This beautiful indie game focuses on the feelings of guilt and loss that come with death, and the importance of moving on. By the end of the game, Stella and Daffodil are finally able to go to the afterlife themselves.

Florence 

Originally released in 2018 for mobile phones and later ported to other devices, Florence is an interactive story that follows a 25-year-old woman named Florence Yeoh who meets a cellist named Krish. After the two enter a relationship and eventually move in together, they have a fight and break up, which leads to Florence having to find a new direction in life.
This game is about loss and the struggle to move forward when a person is stuck in a life that feels monotonous and dreary. Since the game does not have verbal dialogue, the story is uniquely told using quick minigame puzzles that help players connect with the characters without any words. Eventually, Florence manages to move on and grow into the painter she had always wanted to be but was originally afraid to try.

A very big problem for people not getting the help they need with psychological problems is often fear. Individuals fear judgment they would receive from others, change, and the unknown. There are many mental blocks and stereotypes that get stuck in our heads due to social stigmas that need to be removed. However, this is not an easy process. In the following, a few creative solutions will be presented.

Campaigns

Educational campaigns serve to disseminate information about specific facts, products or regional conditions in a targeted and widespread manner. In the area of health, the aim is to educate/inform about health risks that result from a certain behavior, are associated with the consumption of certain products or arise from regional conditions. At the same time, information is usually given on recommended behavior.

The Austrian Federal Association for Psychotherapy has launched #mehrpsychotherapiejetzt.

The Campain Goals are:
More places for psychotherapy financed by health insurance funds
The destigmatization of mental illnesses, because going to psychotherapy is as normal as treatment for physical illnesses.
Psychotherapy for all on a health insurance voucher, i.e. a complete abolition of quotas.

Let´s Talk in an illustrated Mental health Campaign.

It´s natural for feelings, thoughts, and emotions to build uo over a period of time.
This can create, loneliness, feelings of isolation and stress amongst many other things.
The illustrator  Nayantara Surendranath worked with Disney Star on their mental health campaign to address these very issues, to encourage people to voice their feelings and to speak to a mental health professional should they need to.

Books

Picture books are a great tool to educate children in particular and to prevent stigma and prejudice against therapy.

Keith Negley – Tough Guys (have feelings too)

A boldly illustrated picture book read-aloud about how everyone gets sad—ninjas, wrestlers, knights, superheroes, everyone . . . even daddies have emotions to show destigmatize men not having feelings.
Did you know that wrestlers have feelings? Knights do too. Even superheroes feel sad sometimes. In fact everyone has feelings – even dads who love their children!
Children will love to recognise the feelings in Keith Negley’s bold illustrations which accompany a fun-to-read aloud narrative. Parents can enjoy and engage with children in a light-hearted discussion about emotions and how they affect us all.

Exhebitions

Interest in the use of museums to address mental health stigma seems to be growing. In its 2022 Trendwatch report, the American Alliance of Museums devoted an entire section to how museums can be community pillars in the realm of mental health, and another section to how museums can be pillars for the education of children and also for adults.

Mental Health: Mind Matters

A new traveling exhibit called Mental Health: Mind Matters, which has just opened at Museum of Science Bosten, points toward a potentially different way to initiate conversations about mental health issues that can engage parents and children alike. Addressing stigma among children is especially important since we know that negative stereotypes are absorbed during childhood as part of the socialization process (including from popular media such as movies), such that they are considered to be part of the general knowledge about the world that one takes for granted by the time one reaches adulthood.

MENTAL: Colours of Wellbeing

MENTAL: Colours of Wellbeing is not an exhibition about mental illness, treatments or cures. It is a welcoming place where you can confront societal bias and stereotypes around mental health. MENTAL invites you to embark on an intimate and personal journey that explores the many different ways of being, surviving and making connections, that have become of increasing importance to us all.
This exhibition features 24 interactive exhibits, art projects and large-scale installations by international artists, makers, scientists and designers that reflect a range of perspectives on mental health and ways of being. In addition, there are seven artworks by Singaporean and Southeast Asian artists that explore mental health from a uniquely Southeast Asian perspective.

A large proportion of people who develop a mental illness still do not seek professional help. When it comes to therapy, there are many prejudices, expectations and myths that fuel fear of psychotherapy. Individuals fear judgment, change, the unknown, and what they might discover in therapy. Some people are too prideful to admit they need help. Others would like to have therapy but lack the monetary means to afford it. Or they have to wait forever to get into therapy.

Fears and stigma

Sometimes the way to psychotherapy can be complicated by thoughts like ” My environment will think I’m crazy”. Isn’t therapy only something for people who are crazy or simply weak? In fact, such prejudices still exist in society today. This can create a fear of being judged for seeking therapy.
On the other hand, the fact that the decision to undergo psychotherapy is actually a courageous step is rarely acknowledged – and certainly not in professional life. The sad consequence: psychotherapy becomes a taboo subject. Many people who are undergoing or have undergone psychological treatment try to keep this fact secret from their social environment. The prejudices associated with the word “psychotherapy” are too great, as is the fear of negative reactions

Shortage of slots

Even before the pandemic, sufferers waited an average of five months for a therapy place. During the pandemic, the need for psychotherapy places has increased further. Although the number of licensed psychotherapists is increasing, only slightly more than half are paid for by the statutory health insurance. This means there is a huge gap between demand and supply. This often leads to long waiting periods, which for some affected people are unbearable and for others are too great a hurdle to even dare to try.

Unaffordability

In contrast to doctors, where there is an agreement between the social insurance institutions and the doctors and therefore the use of a medical service does not cost anything at all, psychotherapy is basically a private service, which is NOT covered by health insurance companies.
Psychotherapy is therefore largely a private service. The fees usually range between 70.- € and 150.- € for a single session of 50 minutes. Deviations from this range of fees are possible and are agreed upon individually with the psychotherapist. However, for many people, especially young people and those with a low socio-economic status, these prices are too high and therapy is simply not affordable. Thus, the groups that are most affected by mental illnesses are the most disadvantaged.

Thus, there are many reasons why people do not seek therapy. Some are afraid of judgment or are insecure because of the stigmata attached to therapy. Others cannot afford therapy or fail to find a therapy slot. In the following blog entries we will discuss which creative, design-based approaches can help these people.

The majority of those affected do not seek treatment.

Only 19% of all 17.8 million people with a 12-month diagnosis say they have visited the health care system because of their mental health problems in the last year. 16% of these people received outpatient treatment, 2.3% received inpatient treatment, and 3.5% received services from complementary institutions (e.g., counseling centers or self-help groups). This is only about 3.4 million people.

Only one in five
of those suffering
seek treatment.

Sociodemographic differences are also evident in the utilization of the health care system. Women are more likely to seek professional help than men. Regardless of gender, older people are least likely to seek therapy (women 15%; men 4%). In the context of higher rates of illness among people of lower socioeconomic status, unemployed people are significantly more likely than employed people to report having sought treatment in their lifetime (48% vs. 38% among employed people).
Looking at the different medical conditions, differences in utilization behavior also emerge. People suffering from social phobia, generalized anxiety disorder, dysthymia, panic disorder and psychotic disorder are the most likely to report having sought treatment in the past 12 months (between 40% and 50%). Substance-related disorders and eating disorders are the groups with the lowest utilization rates (between 10% and 25%). The more diseases a person has, the more likely he or she is to seek help from the health system. Nevertheless, even with 4 or more illnesses, only about 40% of those with the illness report having sought treatment.

The utilization of the
health care system
also depends on the
condition in question.

The abovementioned data clearly indicate that mental illnesses affect large parts of the population. Some groups are particularly at risk of developing mental disorders. In addition, it is clear that many people who suffer from psychological illnesses do not get the help they need.
The reason why so few people seek treatment will be discussed in the next blog entry.

How often people develop psychological disorders is related to their sociodemographic and socioeconomic groups.

There is a particularly large difference between the sexes. One in three women and almost one in four to five men are affected. Because of this difference, psychological diseases are often referred to as “women’s diseases”. It is also striking how the disorders differ between the sexes. Women suffer about twice as often as men from anxiety disorders and affective disorders. Men, on the other hand, suffer significantly more often from substance abuse disorders. Furthermore, it should be noted that young adults are most often affected by mental illness. Older people are the least likely to fall ill. Furthermore, the frequency of mental illness follows a social gradient. The people who get sick most often are people with low socioeconomic status. Next follow people with medium status. People with high status have the lowest number of mental disorders.
In Germany, mental illnesses are evenly distributed regardless of region. However, there is an increase in the number of illnesses in metropolitan areas.

Gender differences
Epidemiological data show that women suffer from mental disorders more often than men. This difference can be explained by role stereotypes and different utilization of the health care system. Women seek treatment more often than men and are better able to remember symptoms than men, which means that mental illnesses are more likely to be recognized and diagnosed in women. The genders also deal with stressors in different ways. Women are more likely to be anxious and depressed, while men are more likely to be aggressive and prone to addictive behaviors. In addition, women are on average socioeconomically disadvantaged and thus the risk of falling ill is generally increased.

Based on the above findings, three interesting possible target groups emerge for my research question. First, people with low socioeconomic status and young adults, as these groups are the most likely to be affected. Furthermore, due to their social upbringing, men are diagnosed less often than women and are less likely to get the help they need.

Mental health problems can severely affect a person’s quality of life as well as their ability to cope with school, work or family tasks. This can also lead to physical and serious social problems.

Mental health has never occupied as much space as it does today. Even in politics, this topic is now openly discussed. In medicine, psychology, health policy and health insurance, it is generally known that mental health is the basis of a healthy life and thus a healthy society. However, mental illnesses are still associated with strong fears and stigmas, which presents a paradox in itself.

Mental illnesses are widespread diseases. More than one in four adults in Germany has the characteristics of a pronounced mental illness. Differences in the frequency of mental health problems can be observed, especially among the sexes, different age groups and socioeconomic milieus. It is assumed that only a few of those affected actually seek professional help. In recent decades, however, the number of treatments has been increasing rapidly.

Per year, more than
one in four adults meets
the criteria of a mental illness.

Frequency of mental illness

Epidemiological studies in Germany show that 27.8% of the adult population is affected by a mental illness every year. This is equivalent to the population of North Rhine-Westphalia with 17.8 million people. In Europe as a whole, the number of affected people is estimated at 164.8 million. Thus, mental disorders can be compared with other widespread diseases such as high blood pressure. According to the “Study on Adult Health” and its supplementary module “Mental Health” (DEGS1MH) of the Robert Koch Institute, anxiety disorders, affective disorders – which include depression – and disorders caused by alcohol or medication use are among the three most common types of illness. About half of those affected suffer from more than one disorder, with the combination of anxiety and affective disorders being the most common.

Comparing the figures of this representative survey with those of a previous study from 1998, it cannot be stated that mental illnesses have increased altogether. Nevertheless, health insurance data from the last 20 years show a noticeable increase in diagnoses, treatments and sick days due to mental illness. This contrast of facts derives from the change in the importance of mental health in our society. Mental disorders are now recognized as such due to an increasing sensitivity, a growing impairment due to the individual consequences of the disorder as well as more and better therapeutic offers, and the number of diagnoses is approaching the actual number of people suffering from disorders.