Gaming Addiction and the World Health Organisation
The World Health Organisation (WHO) is a specialised agency of the United Nations that is concerned with international public health. It was established on 7th April 1948 and is based in Geneva, Switzerland. As a body it has been instrumental in the eradication of smallpox. Its current priorities include communicable diseases, in particular HIV/AIDS, Ebola, malaria and tuberculosis; the mitigation of the effects of non-communicable diseases; sexual and reproductive health, development, and ageing; nutrition, food security and healthy eating; occupational health; substance abuse; and driving the development of reporting, publications, and networking. Recently, unlike other health institutions, WHO has chosen to address the thorny issue of gaming addiction; a condition that is still heavily disputed and lacks a universally agreed definition.
WHO formally listed gaming addiction as a mental health condition in May 2019. According to their criteria based upon extensive research, gaming addiction it as a pattern of persistent or recurrent gaming behaviour so severe that it takes "precedence over other life interests". This definition, as stipulated by WHO, correlates with several other countries that have already identified this addiction as a major health issue. There are already private addiction clinics that “treat” this condition and the actions of WHO have certainly brought this particular health issue to the wider public’s attention. By adding gaming addiction to the latest version of the International Classification of Diseases, it removes some of the incredulity that the condition has met from certain health bodies.
The WHO guide contains codes for diseases, signs and symptoms and is used by doctors and researchers worldwide to track and diagnose disease. The guide suggests that abnormal gaming behaviour should be in evidence over a period of at least 12 months "for a diagnosis to be assigned" but has stipulated that period might be shortened "if symptoms are severe". At present the symptoms for gaming addiction include impaired control over gaming (frequency, intensity, duration), increased priority given to gaming and continuation or escalation of gaming despite negative consequences. Some healthcare professionals have welcomed the decision to recognise the condition. Dr Richard Graham, lead technology addiction specialist at the Nightingale Hospital in London said “It is significant because it creates the opportunity for more specialised services. It puts it on the map as something to take seriously”. However, he also stated that he would have sympathy for those who do not think the condition should be medicalised because he did see scope for misdiagnosis at present. "It could lead to confused parents whose children are just enthusiastic gamers."
It is this point that seems to be the biggest stumbling block for the universal acceptance of a medical condition of this nature. How exactly do you verify that the alleged addiction is actually taking up all available “neurological real-estate” and dominating thinking and becoming a total preoccupation for the patient? Because fandom per se can at time mirror these qualities. Subsequently, many psychiatrists currently refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM), in which internet gaming disorder is listed as a "condition for further study", meaning it is not officially recognised. Because of this reasoning and prevailing attitude, it is clear that WHO may find their perspective challenged for the present. However, irrespective of the medical and semantical disputes, the field of game related addiction is still being scrutinised around the world. South Korea has introduced a legislation banning access for children under 16 from online games between midnight and 6:00 AM although effectively enforcing such regulation is difficult.
There has also been a degree of pushback from those in the video games development and retail industry. Naturally, as interested parties they are concerned about misdiagnosis and scope for ill-conceived legislation that may be rushed to address public concerns and tabloid campaigning. The Entertainment Software Association (ESA) trade group released a statement downplaying the WHO's concerns about addiction to video games and stated "Just like avid sports fans and consumers of all forms of engaging entertainment, gamers are passionate and dedicated with their time. Having captivated gamers for more than four decades, more than 2 billion people around the world enjoy video games. The World Health Organisation knows that common sense and objective research prove video games are not addictive. And, putting that official label on them recklessly trivialises real mental health issues like depression and social anxiety disorder, which deserve treatment and the full attention of the medical community. We strongly encourage the WHO to reverse direction on its proposed action."
It is clear that the video game industry is concerned about regulation and the potential impact the public perception of gaming addiction may have on sales. The problem lies in how to reconcile the positions of both WHO and bodies such as ESA. Both groups have genuine concerns. However, self-regulation and consumer concerns can often conflict with corporate interests and we have seen in the past several industries that do have harmful side effects fight tooth and nail to refute such claims. There is also the issue of once a universal definition for gaming addiction has been established, exactly what needs to be done to address the matter. So far, the most practical ideas are based around labelling and providing health warnings both on physical media, its packaging, as well as via digital platforms. Automated messages based upon time spent in-game as well as FAQs on logon screens are other possible avenues. Raising public awareness through labelling and media campaigns has proven beneficial with other health issues such as diet and alcohol consumption.
Another concern regarding gaming addiction is the creation of yet another “label” that can be either misdiagnosed, appropriated incorrectly or used pejoratively by the tabloid press. The symptoms of gaming addiction according to the WHO as they currently stand, could be ascribed to many children. Yet there are those who would argue such behaviour may be down to poor parenting which is theoretically a lot easier to correct. Using handheld devices and consoles as surrogate babysitters is no different from using the TV thirty years ago. There is also the possibility that gaming addiction could become the new “darling” of compensation culture and personal accident claims. I don’t think it is outside the realm of possibility that we could see a substantial class action against a game major publisher at some point. Then of course there is a risk that the average gamer could find themselves tarnished by fear and prejudice associated with gaming addiction, regardless of whether they personally are or not. Many gamers already do not include gaming as a hobby or pastime of their CV, for exactly that reason. It isn’t too much of a stretch to imagine certain quarters of the press trying to label all gamers as potential addicts and an employment risk.
Irrespective of whether you personally agree with the definition of gaming addiction as stated by WHO, I believe that the very fact that they’ve tried to address the issue is a positive thing and that there will now be a lot more research into the condition. In the fullness of time, we may finally arrive at an agreed and succinct set of criteria or we may find the complete opposite is true. That gaming addiction ultimately stems from an addictive personality per se, and that playing games is merely a conduit. Under such circumstance, addiction may occur via any leisure activity, thus exonerating gaming. Either way it is important that such matters are properly understood so appropriate treatments can be established. Also, fully understanding the situation means that the industry can work to accommodate addiction, rather than ignore it or exploit it directly. We may see some governments implement impractical knee-jerk rules and regulations, but we may also see the matter tackled in a mature and measured way by more progressive administrations.