A Dartmouth trial links a teen video game to lower depression symptoms

Once a week after school, teenagers opened PlaySmart and stepped into realistic scenarios: spotting signs of depression in a friend’s room, weighing a difficult choice and deciding whether to turn to a trusted adult. In a Dartmouth clinical trial of 532 students aged 16 to 19, the game was followed by lower reported depressive symptoms one year later.

The students played for about an hour a week for up to six weeks. Of the participants, 269 played PlaySmart, while 263 played commercial role-playing games without therapeutic content. Researchers tracked both groups for a year after the trial, which ran from October 2021 to February 2024 in school-based health programs across Connecticut.

PlaySmart was built by Dartmouth’s play2PREVENT Lab, led by Lynn Fiellin, from experiences gathered from teenagers and other stakeholders. Players make choices, see positive or negative consequences and can work backward through the story to examine what happened. The game also presents recommended ways to recognize and manage depression, and to make asking for help feel like a normal decision rather than a public confession.

The study, reported in JAMA Network Open, found that the PlaySmart group’s reported reduction in depressive symptoms matched or doubled the documented effectiveness of general school-based programs, including classroom lessons and small organized conversations with teachers. After six weeks, students also reported more positive attitudes toward seeking psychological care. Exploratory analyses found no significant difference in the game’s effect based on sex, race, grade level, food insecurity or family history of substance use.

So what changes in practice? A self-guided digital tool could reach teenagers who do not receive care because of stigma, limited access to providers or a failure to recognize that help might be useful. That matters especially in communities with limited mental-health services. The study does not settle the question alone: Dartmouth describes the evidence base for serious games as still emerging, even after this trial’s 12-month follow-up. But it gives schools a tested digital tool for putting mental-health practice into an interactive activity.