Previously submitted to: JMIR Serious Games (no longer under consideration since Sep 15, 2026)
Date Submitted: Apr 21, 2026
Open Peer Review Period: Apr 23, 2026 - Jun 18, 2026
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Promoting mental health literacy through Minecraft streaming on Twitch: participatory action research with adolescents and young adults.
ABSTRACT
Background:
Depression and anxiety among youth have increased significantly, highlighting the urgent need to improve their mental health literacy. Gaming platforms, such as Twitch with nearly 100,000 weekly Minecraft streamers, offer significant potential as innovative venues for mental health promotion.
Objective:
To co-design, implement, and evaluate a Minecraft streaming-based intervention promoting mental health literacy among adolescents and young adults aged 15-25 years.
Methods:
Through participatory action research, we conducted ten virtual workshops (October 2023-June 2024) with four streamers and a clinical psychologist to co-develop "Walk Your Therapist"—live streams combining Minecraft gameplay with mental health education. We evaluated the intervention using a quasi-experimental design with the Mental Health Literacy Questionnaire (MHLq), observations, chat analysis, and interviews.
Results:
Three sessions reached 613 unique viewers. Of these, 97 participants completed baseline assessments (mean age 19±4 years, 86.6% male, 9.3% NEET) and 43 completed follow-up. Participants showed significant improvements in MHLq scores (94±19 to 104±7, p<.001, d=0.70), with gains in knowledge of mental health problems (38.2±9.3 to 44.2±4.9, p<.001), first aid skills (20.9±6.2 to 23.0±4.1, p=.04), and self-help strategies (16.1±3.2 to 17.2±2.2, p=.03). Participants spontaneously discussed gaming addiction and stigma. Streamers reported increased personal mental health awareness and sustained positive community engagement.
Conclusions:
This co-designed gaming intervention demonstrates promising potential for youth mental health promotion through existing streaming communities. Clinical Trial: ClinicalTrials.gov NCT06473857
Citation
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