DeepWell exploring media as medicine

Mike Wilson, one of the founders of Devolver Digital, quietly stepped away from his post last year. His intent was to retire.

Then Wilson met a man named Ryan Douglas. Douglas was not a games guy. Instead, Douglas had built a career out of developing therapeutic medical devices that help people heal, stay calm, and endure.

Like Wilson, Douglas was looking to retire.

"That's how we started talking originally," Wilson recalls. "I was new to the Pacific Northwest at the time, and I was concerned about my light sensitivity."

(Side note: The PNW is known for its legendary gloom. People use sun lamps here, to compensate for the gray skies.)

Wilson and Douglas began talking about light therapies, and how they might be able to replicate those therapeutic benefits in virtual reality.

"Surely there must be something we can do in VR that has the same benefits as light panels -- you know, the happy lights," Wilson recalls.

Douglas, Wilson learned, had manufactured therapeutic sun lamps for a long time. "I had one [of his company's lamps] in my home."

Before they knew it, instead of retiring, the pair had come up with a hybridized idea: to start a publisher/developer company that focuses on approaching games as actual therapies. That company, DeepWell Digital Therapeutics, was officially announced last month.

DeepWell's focus is to study what exactly makes games healthy. For example, why does playing Tetris soothe some PTSD sufferers? DeepWell looks to come up with answers. Then it will use this information to develop and publish its own line of games. And it will share (via consultation) said information with the rest of the medium's publishers/developers. And it's going to do so with the help of an advisory council consisting of dozens of developers and a handful of doctors as well.

Wilson says it's never easy to start a conversation about mental health -- he's been talking about it publicly for a while now -- but he also doesn't particularly care if others are hesitant to discuss the subject.

"People are in real trouble. And video games have the potential to be a powerful tool that we can use for well-being"

Mike Wilson, DeepWell

"The point is, we need to talk about it," Wilson says. "People are in real trouble. And video games have the potential to be a powerful tool that we can use for well-being. Instead of using medicines to get unstuck, or to get out of the stories in their heads, people have been using games to do this exact thing, for a long time now. They've been doing it for years. And they have been using [games] without the benefits of research and science."

DeepWell intends to bring that research and science -- those would be Douglas' departments -- to bear on game development. Indeed, much of what game developers actually do seems to be a crapshoot. They set out simply hoping to make something fun. And, by doing this, by looking for that "fun," they sometimes make games that make people feel better.

"Look, I'm not comparing playing a video game with going to a therapist or anything like that," Wilson says. "We all know that we've leaned on games or films or books or music during times when we needed something to lean on. We needed a story. A distraction. Something that could potentially change our perspective, perhaps forever."

Douglas was the one who sifted through more than two hundred studies, and he had one key takeaway.

"It became clear that what hasn't been defined is that game developers themselves are observational scientists," Douglas says. "They've been looking at the same medium -- human beings and their minds -- from a different angle of engagement."

Douglas says that the persistent question developers ask about their games is identical to the one that observational scientists and doctors ask about therapies: How do I get people more deeply involved?

It doesn't matter if you've found a cure for the common cold or a cancer, Douglas says. If somebody won't take the cure or follow the treatment regimen, the problem doesn't get solved. He points to personal fitness as an example.

"You can buy a treadmill. Put the treadmill in your home. Once it has clothes hanging off of it, it's time to sell it. Because you're not getting on it again," Douglas says.

In short, DeepWell wants to use game to motivate people to be constructive and healthy. The key for Wilson is engagement.

"I'm not comparing playing a game with going to a therapist. We've all leaned on games, films, books or music during times when we needed something to lean on"

Mike Wilson, DeepWell

"It's why games have accelerated past all the other entertainment mediums in history," he says. "Because games force you to engage. And that simple thing, forcing you focus on something, is a huge tenet of cognitive behavioral therapy. Engage!"

Wilson, on the call, uses his fingers to make circles on the sides of his head.

"Stop just sitting there in your story. And actually participate in something, whatever it is."

Douglas says the idea is to use short duration, high-engagement games with a lot of different mechanisms that are intended in combination to somehow address various issues people may face.

"You keep people attracted," he says. "You keep them coming back. Until they can work through all those subsets of why they're depressed or anxious. Which is how cognitive behavioral therapy works. You don't show up and go, 'I'm depressed,' and we go, 'OK here's your depression treatment.' We go deeper. We figure out what is this that's driving this."

Media as medicine?

What makes this especially challenging, Wilson says, are the rules and regulations involved in creating products like this.

Wilson claims he has been "severely allergic to bureaucracy" all his life.

"A lot of people in the creative industries feel the way I feel. It's like, 'Blahhh, I don't even want to do my taxes,'" he says.

Douglas, having worked in the medical devices realms for years, is an expert on these sorts of bureaucratic snafus. Douglas pointed Wilson towards the research that has already been done on games and mental health.

"What we saw in these studies," Douglas says, "was that games were wildly successful therapeutics. There were results, healthy results, that were happening from just playing these games, somewhat without intent."

DeepWell largely aims to flip that script, to tell the world that games are, in fact, good for people.

"Even if [gamers] aren't using [games] for that intention, or [games] aren't designed with that intention," Wilson says. "They are still really good for us. There is no doubt about that."

Mediatonic's Fall Guys (which was published by Devolver) took these notions out of the abstract and grounded them in reality for Wilson.

"What we saw in these studies was that games were wildly successful therapeutics"

Ryan Douglas, DeepWell

"Fall Guys came out at the height of the pandemic. It was Devolver's biggest hit, by far," he recalls. "Overnight, we were inundated with letters from people saying that this game had given them a lifeline during lockdown. It gave them a sense of connection and joy and playfulness that they had been missing. That's when it hit me. I was like, 'Wow, this is such a powerful medium. A medium that has the ability to reach the whole world, overnight, when they need it most.'"

Wilson has been a vocal proponent of new therapies for many years now.

"Gaming itself is sort of an accidental medicine," Wilson says. "And DeepWell is a company that will help that not be an accident. We aim to combine science with entertainment in a way that allows creators to create with more intention -- if they so choose."

Magic makers

DeepWell will develop and publish games (Q1 of 2023 is when their first products are scheduled to come to market). But DeepWell will also facilitate the production of games with other devs. They'll do this, Wilson says, "to guide game-makers through the nebulous process of creating experiences that are intentionally good for people."

Wilson is aware fact that some might potentially dismiss DeepWell as an edutainment company, but he believes that stigma could be overcome.

"The fun is the therapy," Wilson says. "Playing something that you enjoy? It releases dopamine and, hopefully, has a serotonin chaser, too -- if it's designed right. That experience gives you a lasting good feeling. Again, its about getting you unstuck when you're stuck."

Douglas says that one mistake that edutainment and gamification made was that scientists and researchers led the development of products.

"They were always led by the science, and they were led by the MDs," he says. "As a result, they were pushing the game developers to the side. We won't do that at DeepWell. Instead, we'll be limiting their interaction with game devs."

Douglas says that game developers must be game developers -- and nothing more.

"It's already hard enough to be a game maker, to build something that people are going to love and be attracted to," he states. "They don't also need to be told, 'Oh, you can't iterate, and your collaboration needs to look like this,' and 'Oh, I'm sorry, we have to regression-test everything you've done...'

"If you inject that into the world?" he adds. "You are going to get things that look more like edutainment."

Douglas claims that a solid game comes first at DeepWell -- before the therapeutic concerns or potentials.

"Again, you need to have that high level of engagement," he says. "By keeping the gamer thematically attached to the game the whole time, we were able to put people in a much stronger place of treatment potential. Because [the game] is always drawing you deeper into the experience."

Wilson agrees.

"By keeping the gamer thematically attached to the game the whole time, we were able to put people in a much stronger place of treatment potential"

Ryan Douglas, DeepWell

"When science meets games or entertainment, it would be a very bad idea for the scientists to boss the magic makers around," Wilson states. "If the clinicians are designing the games? It's not gonna work out very well."

Wilson says that DeepWell is also consulting with companies to look at games while still in development, pointing out iterative changes that could, potentially, increase the health benefits of their products.

Wilson talks of a theoretical future where DeepWell could dole out the gaming equivalent of "certified organic sticker" for games that are already on the market.

"Imagine you're playing one of your favorite games," Wilson says, "and the next time you install it it has a patch that says 'This game has been cleared for use in the treatment of condition X, Y, Z, or whatever. Do not stop seeing your therapist. Do not stop taking your medication.' And maybe you're not playing [the game] for that particular reason, for treatment of X, Y, Z. But still, you're like, 'Wow.'"

Playing such games, Wilson envisions, would be no different from your doctor recommending diet, exercise, specific foods, and certain activities, i.e. play 15 minutes of Tetris today and try to smile more.

However, Wilson knows that a fine line must be walked here.

"The last thing we want is to say, 'Hey Johnny, time to go play your depression game now,'" Wilson says. "Look. Johnny has to want to play this game because it's fun. He doesn't care if it's gonna be good for him, or not... That's the real magic here. It's to simply let game developers do what they do best. Working around the art, and working around the incredibly compelling nature of what [devs] create. Then having the science be in service of that."

Given the emphasis on fun and the regulatory burdens around marketing actual medical therapies, we ask a DeepWell representative if the idea is to make and release games first and then perform the sort of tests after the fact to determine whether or not they have any beneficial impact as treatment for specific conditions.

"The games will have an overlap between the game mechanics and a treatment mechanism," the representative said. "They will be effective therapies, but being a good game is always the first requirement.

"To be clear, we'll not be making and publishing games that are not of therapeutic value… the fun-game-first philosophy just means that if we break the fun, the therapy won't be delivered."

Coming soon(-ish)

Douglas blanches. "Look," he says. "Mike and I, we were retired, alright? In our respective industries? We were done, my friend. What we saw here was a mental health emergency that was already a problem back in 2019. 12% of the US population had post-traumatic stress disorders and suicidal ideation. When they last 'dipped the stick,' which was pre-Delta variant, that [figure] was up to 44 percent.

"If the clinicians are designing the games? It's not gonna work out very well"

Mike Wilson, DeepWell

"So we grabbed all these people," he adds. "There are 50 of us running around with founders titles. All of whom are working in a volunteer capacity. And I am telling you we are going as fast as we can. The moment we've got a thing to show you of value? You're going to see it. And, no, it's not pretty or fun to run you through the quality system or, you know, here's a 300-page patent of why this does what it does, and so forth. Often, when you've got a simple and elegant explanation, which is what I'm trying to give you, on the back end you have a lot of machinery."

The first DeepWell game is, Douglas assures us, looking promising so far. "Like any Mike Wilson joint you'd expect," he says, laughing. "It's going to be a great game... But it's really important for you to understand this is not about one game. One game is not going to solve the world's problems."

Wilson has created a number of gaming companies of varying success in his past, and he sees potential in DeepWell to be as significant as any of them, in its own way.

"I'm embarrassed to hope for anything as successful as Devolver [was]," Wilson says. "But we're certainly going to try. To make a run at this. To break ground here. I don't expect this to be the zany, wild ride that Devolver was for me.

"This is not going to be the easiest thing I've ever been involved in, But it could be hugely important -- for all of us, right? And it also could be that we completely fuck it up. If we do? Hopefully we'll make enough noise that somebody else does it perfectly [next time]. All we can do is try to present an example.

"My agenda has always been this: Let's just enjoy ourselves and empower artists and be nice to everybody and see what happens. And you know what? Sometimes it works out."