Mental Health Professionals' Views on Gaming to Inform Game-Based Interventions: Qualitative Cross-Sectional Study

Few game-based digital mental health interventions have been adopted in clinical practice, where mental health professionals (MHPs) play a critical role in the uptake of new technologies. Existing evidence suggests that MHPs' views on game-based interventions and entertainment video games are mixed, reflecting broader tensions surrounding video games, which are perceived as both harmful and beneficial. However, the underlying reasons for these perceptions have remained unclear, even though they may substantially influence MHPs' willingness to adopt or refuse new clinical solutions.

This qualitative cross-sectional study investigates how MHPs view entertainment video games and gaming in clinical contexts. By examining these perceptions, the study aims to inform the implementation of game-based digital mental health interventions in health care.

This study combined 3 qualitative interview datasets (n=19, n=16, and n=6) capturing Finnish MHPs' views on video games and gaming, resulting in a combined sample of 41 participants, of whom 56% (n=23) were women and 59% (n=24) reported playing games. The interview data were analyzed using reflexive thematic analysis. Additionally, 2 post hoc analyses were conducted with complementary qualitative questionnaire data (n=80) collected alongside the first dataset.

In total, 3 themes were generated to reflect the MHPs' views. First, personal recreation, clinically harmful: MHPs demonstrated a self-client attitude asymmetry, describing their own gaming primarily as positive and recreational, while associating clients' gaming with problems. Second, adverse technology and meaningful culture: MHPs expressed attitudinal ambivalence, making sense of gaming through conflicting frames as both potentially harmful technology and meaningful culture. Third, holistic exploration of clients' gaming: MHPs evaluated their clients' gaming within the broader context of the clients' lives. The first post hoc analysis reinforced the observed self-client attitude asymmetry, showing that MHPs associated their own gaming experiences with more positive and fewer negative meanings compared to their clients' gaming. The second post hoc analysis suggested that MHPs expected game-based interventions to be approachable, motivating, and complementary to other treatments, and particularly suited for children and youth, people with strong digital competencies, and clients who were withdrawn.

Existing qualitative research on MHPs' perceptions of video games remains limited and has not examined clinicians' broader sense-making of gaming to inform the implementation of game-based interventions. This study identifies how clinician education can build on MHPs' existing perceptions while addressing potential misconceptions by clearly differentiating game-based interventions from entertainment games, clarifying their clinical aims and mechanisms of action, situating them within clients' broader care and recovery processes, and challenging narrow assumptions about their target audience. Together, these contributions address a critical gap in the literature and inform strategies to improve clinician education, communication, and the adoption of game-based interventions in mental health care.