UCSF

More than one in five adults in the United States live with a mental illness where it is difficult to access care due to lack of affordable and available mental health services. Discriminatory social and cultural ideologies surrounding mental illness that lend themselves to broader mental health stigma further prevent people from seeking treatment and add to the isolation and exclusion already felt by those grappling with mental illness. Popular media serves as one such arena that can deeply impact stigmatized views of mental health, in whether and how it stereotypically or thoughtfully surfaces and depicts the often hidden and invisible experience of mental illness. Commercially available digital games, those played by hundreds of millions of people in the United States, has a history of leaning on stereotypes that lack depth and exacerbate stigmatizing views toward mental illness. At the same time, digital games can also approach mental health in more thoughtful and nuanced ways and thus might also serve to directly counter and shift perceptions away from harmful and exclusionary stigmatized views toward mental health. Rather than situating digital games as either ‘good’ or ‘bad’ for mental health, this dissertation takes a sociological approach to understanding how people interact with digital games toward broadly crafting meanings and reflections toward their mental health and illness. Using constructivist grounded theory, I conducted 49 in-depth interviews with people who play video games and self-identified as experiencing mental illness, explored digital game content through close play, and piloted an experimental observational interview method with a subset of five participants. This study reveals a social alchemy that occurs between players and digital games in ways that affect mental health. I describe how players weave together digital game content and narratives with the lived experiences that they bring into their gameplay, to create an interactive and immersive space to play with multiple understandings of and perspectives on mental health. I illustrate how players embody digital game characters and their biographies to reconfigure their sense of self and feel differently outside of their everyday struggles with mental illness. I explore how players used digital games to escape from these struggles but do so intentionally to escape into particular emotions and ways of being that counter specific stressors and symptoms. Virtual embodiment here also involved players inhabiting characters, but at a distance, in order to embed and enmesh their mental health with that of the characters’ narratives to experience and interact with similar but separate versions of themselves toward developing compassion and understanding for their own mental health. I next show how players also construe digital game characters as distinct social actors, ones with whom they can build bonds with and find social support related to their mental illness. I describe how finding experiential similarities in digital game characters offers players validation, coping strategies, and an alternative vision for their own futures and do so by not only identifying with character biographies but also viscerally feeling these connections through the simulated experiences produced by digital games’ participatory and tactile affordances. Finally, I focus on digital game environments and explore player encounters with their grief and loss. I examine how interactions with grief in game worlds suffused and shaped participants’ engagement with games, and in turn, the metaphors and symbols within gameworlds that players interpreted as related to loss influenced how they understood and made sense of their own loss and grief. In full, this project expands on sociological, science and technology studies, and game studies literature to analyze interactions with mental health and digital games with a focus on the lived experiences that players themselves bring to these settings. I elucidate the ways in which individuals shape technologies as much, if not more, than technologies socially shape them and illustrate single-player digital games as important arenas for engagement with sense of self in a relatively safe and judgement-free virtual environment away from the mental health stigma and discrimination found in everyday life. This research contributes to ongoing discourse concerning digital gaming’s impact on mental health; conversations that tend to villainize games or valorize only those games that are specifically designed to be therapeutic. Instead, it points to the agency of individuals in enmeshing their lived experiences and contexts into existing digital game content and narratives toward crafting an experience wholly unique to themselves. In doing so, the resulting social alchemy allows players to engage with, reflect on, and transform their relationship to their mental health on their own creative terms.