Could playing online games improve mental health services for young people?

Researchers are asking young people in Nottingham, Oxford and Manchester to test an interactive, online game, which they say could improve healthcare services for those who experience mental health concerns such as anxiety and depression.

SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) is an interactive game consisting of seven levels and will be accessible to young people online. Participants undertake various challenges in a virtual fantasy world, then apply those learned skills to real life.

The skills learned in each module are based on the well-evidenced principles of Cognitive Behavioural Therapy (CBT), which focus on supporting an individual to understand their experience and to better manage their symptoms.

The prevalence of mental health concerns, particularly anxiety and depression, amongst young people continues to rise in the UK. As a result, waiting lists for child and adolescent mental health services (CAMHS) has surged due to the increased pressures placed upon healthcare services, especially post-pandemic.

The SPARX-UK trial, which is part of the UK Research and Innovation’s Medical Research Council-funded Digital Youth programme, aims to understand the acceptability of SPARX in the UK’s adolescent population before conducting a larger trial in the future.

It will be led by Chris Hollis, Professor of Child & Adolescent Psychiatry at the University of Nottingham, and Paul Stallard, Professor of Child and Family Mental Health at the University of Bath. They will also work alongside collaborators from the University of Auckland and MindTech’s patient and public involvement group, Sprouting Minds, to appropriately adapt the intervention for a UK audience.

Professor Chris Hollis comments: “Unfortunately, depression during adolescence is common with up to one in seven young people suffering with depression before the age of 18. Depression is associated with self-harm and increased suicide risk and interferes with education, work, social, and family functioning.

“CBT is a recommended evidence-based treatment for depression. However, a shortage of qualified CBT specialists and huge demand for mental health services has resulted in only a minority of young people with depression being able to access timely treatment. Digital interventions, based on CBT such as the SPARX game, provide a way to bridge this treatment gap and to make evidence-based intervention more widely available.”

Professor Paul Stallard adds: “Whilst SPARX was designed as a self-directed intervention, previous research in this area has suggested that self-directed digital health interventions often experience issues with low engagement and adherence.

“To improve engagement and accessibility, the SPARX-UK trial will explore whether weekly human support from an ‘eCoach’ improves engagement with the intervention and participants can also trial an app version of SPARX.

“Throughout the trial design and beyond, we have been working with our young people’s group, Sprouting Minds, to ensure that the intervention and the trial meets the needs of adolescents.”

How to get involved

For their study researchers want young people aged 11-19 years who are experiencing mild to moderate depressive symptoms and accessing Child and Adolescent Mental Health Services (CAMHS) or school based Mental Health Support Teams (MHST) from Nottinghamshire Healthcare, Oxford Health, and Manchester University NHS Foundation Trusts. Young people from participating sites should discuss SPARX with their clinician. The trial recruitment period is currently due to end at the end of October 2024.

Once a participant has been recruited, they will be randomly allocated to one of three study arms:

Supported SPARX – The young person will receive the intervention plus weekly support sessions with an eCoach. The eCoach will not deliver any therapeutic content but will be there to engage the young person and set homework tasks.
Unsupported SPARX – The young person will receive the intervention in a self-directed manner with no human support.
Waitlist control – A comparison control group who will not receive the SPARX intervention but are crucial to understanding the experience of symptoms over time.
In time the researchers hope SPARX can improve accessibility for younger people for those in need of support as well as being offered earlier, perhaps before accessing CAMHS if deemed necessary.