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NHS could begin to provide treatment for problem gamers

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The World Health Organization has included the diagnosis of ‘gaming disorder’ in the new draft of the International Classification of Diseases (ICD-11), the definitive compendium of medical conditions. The WHO will direct governments to begin to provide treatment for compulsive gamers in their public health services.

Naturally, designers behind games, apps and websites work hard to keep people engaged with their service for as long as possible; in April 2017, Netflix CEO Reed Hastings half-joked that the streaming service’s main competition was “sleep”.

Now, doctors will have the power to diagnose some digitally-besotted patients with the introduction of gaming disorder into the ICD-11. Gaming disorder is an example of a behavioural addiction; unlike alcohol or drug dependencies, gaming (and gambling) disorder do not involve the ingestion of any psychoactive substances.

Gaming disorder is not a label that could apply to a typical teenager using their after-school hours to play Fortnite or Call of Duty with friends. The diagnosis is intended to be reserved for extreme cases in which a patient consistently puts gaming ahead of other activities for extended periods of time, and cannot stop playing despite serious negative consequences, such as losing relationships, being fired, or deteriorating physical health.

According to the Entertainment Software Association (ESA), the trade group representing the US gaming industry, 2.6 billion people play video games, including two-thirds of households in the US. The ESA has criticised the introduction of the diagnosis, suggesting that it could risk pathologising gaming and other enjoyable everyday activities. Meanwhile, other critics have argued that compulsive gaming is better understood as a symptom of depression, anxiety and other primary conditions (conditions for which treatment should be prioritised).

However, psychiatrists and other mental health experts who support the inclusion of the diagnosis say that very few gamers are at risk of being diagnosed with gaming disorder. Speaking to E&T in January, Dr Daria Kuss, who was involved in the WHO discussions regarding the diagnosis, commented that there are biological and neurobiological differences in the people who could be diagnosed with gaming disorder.

“The term ‘addiction’ is used in a very flippant kind of way. Just because I spend a weekend watching something on Netflix does not mean that I’m addicted to using Netflix, for example,” she said. “There has to be a significant impairment and distress on the behalf of the individual for a considerable amount of time where they lose control of their behaviours and they can’t help themselves anymore.”

The major consequences of including gaming disorder in the ICD-11, Kuss says, will be access to treatment and research funding.

Particularly in East Asia, there have been growing numbers of strict, militaristic gaming rehabilitation centres, and in South Korea the government has intervened, banning the playing of online games between midnight and 6am and subsidising clinics which treat compulsive gamers. However, there is a lack of healthcare-focused options for compulsive gamers; a Seattle-based clinic that costs nearly $30,000 for a seven-week course has a months-long waiting list, while the private Nightingale Hospital in London has long been the only place in the UK to offer specialised treatment for technology addicts.

Now, the WHO is expected to notify governments that they should begin to incorporate support for gaming disorder patients into their public health services. This could mean that the NHS will begin to roll out specialised, state-supported services to help treat compulsive gamers.

The inclusion of gaming disorder in the draft ICD-11 comes amid a long-running debate about how best to handle the excessive use of smart devices and social media, which has been linked to poor mental health. Recently, Apple – which has come under pressure to act from its investors – announced a series of new features to encourage their users to put down their devices.

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