Portrayals of Mental Health in Video Games: Protocol for a Scoping Review

Digital games are increasingly influential in shaping public perceptions of mental health due to their interactive and narrative nature. While serious games designed for therapeutic use have been studied, less is known about how mental health challenges are portrayed in mainstream video games for leisure and the impact of these portrayals on players.

This scoping review aims to explore how academic studies address the representation of mental health challenges in contemporary video games for leisure, with particular attention to game design features, depictions of coping or living with a mental health condition, recovery, and intervention.

The review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) methodology and applies the population, concept, and context framework. A comprehensive literature search was conducted across 6 databases (PubMed, Scopus, ProQuest, ERIC, IEEE Xplore, and Web of Science) in July 2024 and will be updated to include studies published until November 2025. Eligible studies include peer-reviewed original research on the portrayal of mental health in mainstream digital games. Screening and data extraction were conducted independently by 2 reviewers using Rayyan and NVivo software. Data synthesis will be narrative, focusing on themes of representation, game mechanics, recovery, and audience impact.

As this is a protocol, no empirical results are available. The completed review will map how scholarly studies conceptualize and analyze portrayals of mental health in video games, identify recurring thematic and design patterns, and synthesize trends in how researchers frame the relationship between gameplay and mental health representation.

By systematically mapping the current literature, this review will contribute to a deeper understanding of how mental health is depicted in mainstream games and will highlight areas for future research, including ethical considerations and opportunities for more informed, empathetic, and responsible game design.