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Serious games aimed at promoting well-being in youth have promising effects and potential for far-reaching impact. Considering that most mental health disorders remain untreated in youth, therapeutic games may be most valuable when they are aimed at untreated youth with internalizing symptoms. However, when targeting youth outside of a clinical setting, the first impression of therapeutic video games may determine whether and how a game is played. Thus, understanding the influence of messaging used in the promotion of therapeutic games on game choice and experience is critical. The current study examined two alternatives in promoting mental health games: one included explicit mental health messaging (e.g., learn to manage stress) and the other was a stealth promotion that did not mention mental health but highlighted the entertainment value. Young adults with mild to severe internalizing mental health symptoms (i.e., depressive, anxiety, and stress symptoms) were shown two distinct trailer designs, with random assignment determining which design held which message. Participants ( n  = 129,  M age   = 21.33,  SD age   = 3.20), unaware that both trailers promoted the same commercial video game, were 3.71 times more likely to choose what they believed was the mental health game. Additionally, an unforeseen difference in the attractiveness of the two trailer designs resulted in participants being 5.65 times more likely to select the mental health game promoted in one trailer design over the other. Messaging did not influence game experience (i.e., gameplay duration, autonomy, competence, intrinsic motivation and affect). Exploratory analyses indicated that game experience, but not game choice, was influenced by symptom severity, symptom type and the interaction between symptom severity and messaging. The present study suggests that explicit mental health messages attract youth with mental health symptoms. Ultimately, youth may be empowered to seek out mental health games if they are promoted properly, allowing for far-reaching positive influences on well-being. Toward this aim, future research is needed on the game selection process, addressing underlying motivations, the balance between explicit health and entertainment messaging, and multiple interacting influences on game selection (e.g., promotion and peers).

Explicit Mental Health Messaging Promotes Serious Video Game Selection in Youth With Elevated Mental Health Symptoms