Since the World Health Organisation classified gaming addiction as a mental health disorder in January 2018, it’s been at the heart of an ongoing conversation. About its extent – how many gamers are undiagnosed addicts? – the nature of its treatment, and in some quarters, about its validity as a recognised disorder.
As if that conversation wasn’t knotty enough, it’s happened in tandem with Fortnite’s ascension beyond gaming popularity and into the kind of social phenomenon that’s referenced by footballers’ celebrations in the World Cup final and, inevitably, vilified by the tabloid media. While the WHO’s classification cast previously accepted gaming habits under new scrutiny, front page newspaper headlines like ‘Fortnite made me a suicidal drug addict’ seem intent on sending gaming to the guillotine before the debate about addiction has really begun in earnest.
There’s a danger of these two separate entities – the medical world recognising a new disorder and the tabloid media recognising a new villain for its front pages – becoming conflated in popular consciousness. A danger that we dismiss the notion of gaming addiction out of hand, because of the absurdity of its depiction in tabloid stories. And perhaps even a danger that we see the disorder, like the salacious headlines, as a phase, a ‘trending’ mental health condition, the causes and effects of which will all die down once the bubble of Fortnite’s mainstream relevance bursts. That’s a myopic view, and one that fails to acknowledge that gaming addiction was being recognised and treated before the WHO’s updated International Classification of Diseases (ICD) last January.
“Like most diagnostic labels,” counsellor and psychologist Mike Evans tells me, “gaming addicts have had to source developing specialists in the field.” Evans says before the WHO classification in 2018 there were roughly 10 addiction specialists who’d started to gather evidence of gamers’ potential to become dependent on their games, and the impact that might have on the personal, social, financial and moral aspects of their lives. He too worked in a clinic that specialised in addiction, and would meet clients for whom gaming had become a problem.
“Quite often I would hear from families that they sensed they were losing their relative to the game, and that the strong family connection they once felt had changed its allegiance to the game.
“They would recall how their relatives’ behaviour changed over time, with dishonesty about the amount of time spent gaming becoming a key factor in family disputes.”
Dishonesty. There’s a crucial distinction here when it comes to diagnosing gaming addiction, because it’s tempting to want to put a numerical value on it. An ‘hours per week’ figure with a clear threshold between enthusiastic hobby and debilitating addiction. But diagnostic criteria doesn’t work like that – it’s about the individual’s gaming as much as it’s about how , and if they’re being dishonest about the time they spend playing that’s an indicator of something unhealthy.
In those days prior to WHO’s updated ICD, Evans tells me it was “hard for families to find help”.
“Because of the novel nature of the presentation, and a lack of understanding from professionals about gaming in general, the social [aspect] of gaming and the impact this can have on socially isolated individuals.”
It may still be difficult for people to find help. Diagnosis is still something of a controversial topic among psychologists, and recognition of the disorder’s existence is not unanimous in the mental healthcare world. One prominent dissenting voice against the WHO’s recent reclassification is Dr Christopher J Ferguson, a psychologist with years of research into gaming behaviour who believes it’s a premature move influenced by politics more than science.
But there is agreement, at least, that help should be made available to an individual once they have been diagnosed. “The other positive aspect,” says Evans, “is that services then have to upskill themselves in order to provide appropriate assessment and access to services.”