SUMMARY

What are the ethical challenges in developing digital mental health games for young people? Our new review explores how researchers have addressed or not addressed ethical issues in existing gamified interventions. We analysed research articles and conference papers published between 2015 and 2023. Out of 1815 studies retrieved from the databases Scopus, Web of Science, MEDLINE, and PsycINFO, we included 38 publications in the review.

The findings show four key areas of ethical concern: Research ethics (e.g. ethics committees‘ decisions and informed consent), ethical principles (e.g. privacy, accessibility, and cultural sensitivity), vulnerable groups (considerations related to young people at particular risk), and social implications (e.g. how these technologies integrate into therapeutic settings and the influence of economic considerations during development).

The review highlights a limited interpretation of ethics as research ethics and a lack of attention to the social implications of technologies across the included publications. It offers support to future developers of gamified interventions, through providing concrete examples of how mental health researchers and game designers have thus far mitigated ethical challenges and illustrating their reflections. In conclusion, we advocate for integrating ethical considerations throughout all stages of developing and implementing such tools to better serve young people’s needs.

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The full-text article is available in the JMIR Serious Games journal.‍