Book review: Checkpoint by Joe Donnelly

We’ve seen growing interest in the interface between video games and mental health.

Checkpoint, published in 2020, approaches this topic from various angles, intertwining pop science and personal narrative to make a strong case that video games have a growing importance in people’s mental wellbeing.

Author Joe Donnelly, a journalist, writer, and mental health advocate, takes an investigative approach to the subject, interviewing clinicians, gamers, and other stakeholders to understand the place video games have in the mental health field.

A lot to cover

Among the wide range of topics he explores is how video games portray mental health issues. He covers how stigmatisation of mental illness is a common pitfall of horror games, and speaks to Lucy Morris, who founded a game development challenge called Asylum Jam, in which participants must create a horror game that doesn’t evoke harmful mental health tropes.

He avoids making firm statements where the research isn’t supportive: one chapter speculates that video games may help gamers understand the finality of death, and describes a number of games that show the consequences of death, but Donnelly stops short of saying that such games actually reduce suicidality. Throughout the book, relevant games are signposted, which can be helpful for clinicians who may be less acquainted with the medium.

The book also looks at potential clinical applications of video games, such as how virtual reality is used to treat conditions like PTSD. Donnelly speaks to a psychologist who champions the technology’s use in exposure therapy. While there’s not enough here to justify use of video game therapy in mainstream practice, the book does work well as a primer regarding this developing area.

Much of the book concerns individual experiences, with anecdotes from gamers about how video games have helped them in areas such as exploration of gender identity, finding connection and solidarity, gaining respite through escapism, or feeling a sense of accomplishment. Donnelly also threads through his own story of depression, and the games that were the soundtrack to his recovery, lending his explorations a personal motive.

Tell me something I do know

Of course, a text description of a video game can never fully convey the emotional and engaging aspects of the original. Part of the enjoyment I had with this book was reading about games I had previously played, giving me a clear frame of reference to reflect upon the topics brought up. For example, Donnelly discusses the game GTA Online, an over-the-top multiplayer game where players commit virtual crimes within a vast city playground. The book details how such a space could also be used to facilitate serious conversations and engagement amongst its players, using the example of a group who use the game to roleplay as characters. Donnelly reveals how he spoke to such a group about dealing with the impact of his uncle’s suicide, and explains how the experience was “in may ways cathartic.” I thought about how my friends and I would spend hours playing and talking about our individual lives on the same kinds of servers. All of us were over 3000 miles away from each other and this was a means for us to communicate and socialise.

Other games explored in the book which I’ve had experience of include Actual Sunlight and Depression Quest, which both address mental health topics such as depression and suicide. Will O’Neill, creator of Actual Sunlight, explains in the book that he wanted to “depict depression in a way which resonated a lot more personally.” Having played the games before, I had greater appreciation for the stories about their development. While it was interesting to read about games I haven’t yet played, without a solid frame of reference, it was hard to be as emotionally engaged.

Fair criticism

The book itself is written by somebody who, as a video games journalist and enthusiast, is very much part of video game culture both professionally and personally. It does skew more towards a positive viewpoint of video games and the author recognises his personal investment in defending something which he and many others value. This is especially understandable in the context of demonisation of video games by the media and wider society.

However, the book does not shy away from discussing potential unhealthy associations between video games and mental health. Certain gamers might be apprehensive about such a diagnosis coming from out-of-touch clinicians, and so Donnelly finds a more relatable source, gaming journalist Wesley Yin-Poole, who appreciates the value of video games, but has his own experience of unhealthy gaming, and writes “...it seems reasonable that something along the lines of a gaming disorder might actually be a useful thing to think about.” The chapter on gaming disorder walks a careful line, acknowledging that there are people with legitimate issues with unhealthy gaming behaviour who are in need of help, and showing appropriate caution regarding the effects of pathologisation.

Overall, this book serves well for those who wish to have a better insight into the various overlaps between video games and mental health. Clinicians may gain some initial understanding of the areas in which interests are developing, and be signposted towards key video games to explore. Among all the personal anecdotes in the book, clinicians may also gain some appreciation for the human experience of playing video games and how people feel about it, which can help lay a foundation for more meaningful discussions about gaming behaviour with their own patients.

By Dr Chun Chiang Sin Fai Lam