High school students who played a single custom-built video game at school reported fewer depression symptoms a year later, according to a clinical trial published in the journal JAMA Network Open. Researchers at Dartmouth College tested the game, called PlaySmart, against ordinary commercial titles on 532 teenagers to measure long-term mental health impacts.
How PlaySmart Teaches Teen Mental Health Skills
PlaySmart was developed by the play2PREVENT Lab at Dartmouth’s Geisel School of Medicine to help teenagers recognize emotional distress, resist peer pressure, and ask for help. Lynn Fiellin, senior author of the study and a professor of biomedical data science and medicine, built the game using scenarios gathered from real teenagers. Players guide a main character through challenges such as spotting signs of depression in a friend’s room or deciding whether to involve a trusted adult in a difficult situation. Better choices produce better outcomes for characters in the game, and students can retrace their steps to test alternative decisions.
Did you know? PlaySmart began as a project to prevent opioid misuse.
Clinical Trial Design and Control Group Comparison
Researchers enrolled 532 students aged 16 to 19 from 15 school-based health programs in Connecticut, where Fiellin started her lab while at Yale University. Eligibility for the study required students to have recently used alcohol, cannabis, vaping, or another non-opioid substance, or to have shown heightened symptoms of anxiety or depression. Enrollment ran from October 2021 to February 2024. Half of the students were randomly assigned to play PlaySmart on iPads for 40 to 60 minutes once or twice a week for up to six weeks. The other half picked from nine commercial games, including The Sims and Papers, Please, for the same amount of time. Fiellin noted that using a rigorous comparison group ensured the observed differences stemmed from PlaySmart’s specific content rather than the general experience of playing a game or receiving attention.
One-Year Follow-Up Reveals Sleeper Effect on Depression
Students rated their depression symptoms on a standard questionnaire scored from 0 to 24, where higher numbers indicate greater severity. Both groups started with average baseline scores just under 7, placing them in the mild symptom range. Twelve months following the conclusion of the sessions, the control group scored 1.12 points higher than those who played PlaySmart, registering an average of roughly 6.4 compared to about 5.3. Fiellin described this as a modest individual effect comparable to those seen with school prevention programs districts already run, but noted it could carry meaningful public health impact if delivered at scale. The two groups’ scores diverged only at the one-year mark, pointing to a potential sleeper effect where students absorb coping skills and apply them later when real-world challenges arise.
Impact on Anxiety and Future Research Directions
The trial found no effect on anxiety symptoms among PlaySmart players. According to the research team, anxiety often requires distinct tools—such as practice facing feared situations, worry management, and relaxation techniques—which the game does not teach. Caroline Barry, the study’s first author and a postdoctoral research fellow in Fiellin’s lab, stated that the observed benefits held across all subgroups, including Black and Hispanic students who report some of the highest levels of sadness and hopelessness in national youth surveys.
Schools, districts, community organizations, and health departments can request access to PlaySmart through Playbl, the company that distributes the lab’s games, which Fiellin founded and holds a financial stake in. The research team is now developing a short digital program for families to use alongside the game to strengthen the depression effect and possibly help with anxiety too.
Frequently Asked Questions
What age group was evaluated in the PlaySmart study?
The study evaluated 532 high school students aged 16 to 19 from 15 school-based health programs in Connecticut.
Did PlaySmart reduce both depression and anxiety?
No. While students who played PlaySmart reported fewer depression symptoms a year later compared to a control group, the trial found no effect on anxiety symptoms.
How can schools access PlaySmart?
Schools, districts, community organizations, and health departments can request access to the game through Playbl, the company that distributes the lab’s games.
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