Part 1 of this post talked about the politics behind funding video game research in the US and the implications of those politics for population health.

Now let’s start tying this back to mental disorders and ICD-11 Gaming disorder from a public health  perspective.

Mental health problems like depression have high costs to society

Whether you believe they originate from chemical imbalances in the brain, other factors, or a combination; mental health problems cause suffering. Families and friends may also be affected, and society feels the economic costs in terms of lost wages (e.g., from disability due to depression or other problems) or lost years of life (e.g., due to suicide). It’s a good return on investment (ROI) to prevent or reduce the individual and collective burden of mental health problems.

Some mental health problems cause a greater burden than others. Depression, for example, leads to more overall suffering /burden worldwide partially because it’s so common. It’s also costly. In 2010, the combination of direct costs of treating depression (and conditions that go along with it), workplace costs like absenteeism or presenteeism, and suicide-related costs costs were estimated to be more than $210 billion. Suicide leads to greater burden not only because of the tragic loss, but also because economically, a potentially productive member of society can no longer contribute—these are the mortality costs of suicide. Although interventions to prevent and treat depression aren’t guaranteed to work, investing money into depression and suicide prevention research is like to have a high ROI.

No data for costs of video game “addiction” to society

These costs are harder to calculate for video game related addiction-like problems. The worldwide prevalence of addiction-like problems related to video game play (i.e., Internet gaming disorder) seems to be much lower than that of depression, and there have been no studies of the economic burden[1]. There have been no reported suicides attributable to video game play. Although there have been no cases of murder in the scientific literature, five cases of carbon monoxide poisoning  have been reported (from use of improperly-vented generators during power outages, which the researchers attribute to children wanting to play video games). The popular media has reported deaths due to excessive video game play, but these are likely related to other problems, like the fentanyl overdose of a Twitch streamer. We do know that (potentially unconstitutional) laws have been enacted to prevent game “addiction” in some countries and that treatment facilities are devoted to Internet/game “addiction” exist. So, although we have no data for the economic costs to people and society of video game “addiction”, it’s clear that they are calculable (I’ll wait for my next manic episode to do this, unless someone gets to it sooner).

Recap: Which public health issues are a greater burden to society?

The economic costs of gun violence are at least $229 billion per year in the US. This includes the cost of things like emergency services, long-term medical and mental-health care, court and prison costs, lost wages and quality of life.

Yet there is $0 funding to study gun violence in the US and significant barriers to increasing funding. Instead, billions of dollars are spent on the study of violent video games.

The economic cost of depression is very high. There are many ways to treat it, and some ways to prevent it seem to work. The NIH has spent at least $13 billion on depression research since 2005. [2]

We don’t know the economic cost of video game “addiction”, yet the NIH recently awarded almost $200,000 to a researcher to study it. (Disclaimer: The training grant that funded my postdoctoral research was from the NIMH, and I used part of my postdoc to study game “addiction”, so there could be other ways in which it has been publicly funded in the US.)

So, in order of estimated cost to society/public health:

Cost and funding of publicly-funded health problems/risk factors

Condition	Economic cost	Funding  (since 2005)	Funding vs. costc
Gun violence	$229 billion /year	$ 663,000a	0.00002%
Depression	$210 billion (2010)	$13 billionb	0.52%
Game “addiction”	Unknown	$ 189,000b	unknown
Video game violence	cost neutral or savings	$ 2.7 millionb	unknown

(a) CDC-funded studies from the figure here (b) NIH-funded studies from NIH RePORTER data (c) Calculated as proportion of economic cost since 2005 for which publicly-funded research has been conducted

Now that the WHO has also decided that Gaming disorder warrants its own diagnosis, I am really hoping we can put things in perspective.  It would be reasonable to establish a benchmark now—to estimate economic costs associated with game addiction specifically—to determine the potential ROI for time, research effort and taxpayer money.

[1] ((“video games”[All Fields] OR “computer games”[All Fields] OR “digital games”[All Fields] OR videogames[All Fields] OR videogame[All Fields] OR “video game”[All Fields]) AND ((“economics”[MeSH Terms] OR “economics”[All Fields] OR “economic”[All Fields]) OR (“economics”[Subheading] OR “economics”[All Fields] OR “cost”[All Fields] OR “costs and cost analysis”[MeSH Terms] OR (“costs”[All Fields] AND “cost”[All Fields] AND “analysis”[All Fields]) OR “costs and cost analysis”[All Fields]))) AND ((“behavior, addictive”[MeSH Terms] OR (“behavior”[All Fields] AND “addictive”[All Fields]) OR “addictive behavior”[All Fields] OR “addiction”[All Fields]) OR (“disease”[MeSH Terms] OR “disease”[All Fields] OR “disorder”[All Fields]) OR (“pathology”[MeSH Terms] OR “pathology”[All Fields] OR “pathological”[All Fields]) OR problematic[All Fields] OR excessive[All Fields])

[2] NIH RePORTER search: Text Search: depression (and), Search in: Projects Limit to: Project Terms, Admin IC: All, Fiscal Year: 2018, 2017, 2016, 2015, 2014, 2013, 2012, 2011, 2010, 2009, 2008, 2007, 2006, 2005