World Health Organisation to Classify “Gaming Disorder” as a Mental Health Condition

Wednesday 3rd January 2018

Addiction to gaming will be listed as a mental health condition for the first time according to the World Health Organisation’s International Classification of Diseases (ICD).

The draft document for the ICD-11, the 11th international standard for diagnosing diseases and health related issues, the condition “gaming disorder” will also be included, highlighting the increasing treatment of video game addiction as a public health issue.

The draft document describes a gaming disorder as a “pattern” of behaviour relating to games that manifests as what the WHO describes as “Impaired control” over how games are played (how often games are played, how intensely, for how long and so on), “increasing priority” over gaming to the point that it takes over everything else in an addict’s life, and “continuation of escalation” of playing games despite negative consequences of these behaviours taking effect. The wording of the entry mirrors the entry for “gambling disorder” and as such the entry recommends that the pattern of addictive behaviour needs to be evident over 12 months to be assigned a diagnosis, whether that is

Video games and their relation to mental health is a contentious issue, and it must be noted that the WHO’s diagnosis does not include people merely enthusiastic about games, even if they play for long periods of time. It’s an addiction, so it is based on the same logic as other non-drug based addictions, such as gambling addiction. Gambling addiction has the potential for serious financial implications related to play however, which makes the consequences simpler to categorise.

Part of the complication is that “compulsion” and “addiction” are often used in video game culture in positive contexts, used colloquially for a game that a player wants to keep playing, much like the slang term “chocaholic” does not usually describe a diagnosed addiction.

Video games have been the subject of a number of controversies in recent years, with the advent of mobile gaming and increased popularity of online games has led to accusations that a number of video games are fostering compulsion in order to make additional money from children and other vulnerable persons.

Along with outright gambling websites using either virtual currency or virtual items purchasable with real money, there is the recent controversy of the loot box, a randomised selection of virtual items which are often purchased using real money. A large number of the most financially successful and visible games of the last two years have featured such a mechanic, such as Overwatch, FIFA Football’s Ultimate Team mode and League of Legends among many others.

The biggest controversy for this however came from the game Star Wars Battlefront II, published by Electronic Arts. This game became incredibly controversial during its pre-release period for including loot boxes that were purchasable with real money that randomly provided bonuses, playable characters and in-game items that would take a player a large amount of play time to acquire otherwise. This provides a double temptation to a video game addict, in that they would make the choice to either play a given game for longer to unlock an advantage or pay real money to gamble on receiving such an advantage.

This monetisation was removed, allegedly as part of a mandate by Disney, the rights holders for Star Wars, but this controversy, along with a related mechanic in the single player Lord of the Rings game Middle Earth: Shadow of War where a second ending to the game requires the player to either play a lot of repetitive missions in order to get the resources needed to win or spend money on loot boxes to get a random chance of getting the resources needed. Both examples encourage compulsive behaviour, of the compulsive spending variety and of spending large amounts of time to make it worth it.

The implantation of a video game addition diagnosis by the WHO therefore is a very important one to take care of potentially vulnerable players as an increasing number of games use gambling-esque tactics to encourage spending and extended play. The ICD-11 is currently in draft form, and is expected to be published at some time in 2018.