WEBVTT 00:00:03.790 --> 00:00:10.280 Dr. Samantha Hack: Welcome everyone. This is the Mental Health Recovery and Wellness 00:00:10.280 --> 00:00:16.279 Webinar Series. This series is made possible by the VA Office of Mental Health and Suicide 00:00:16.279 --> 00:00:22.430 Prevention, Psychosocial Rehabilitation and Recovery Section, and the VISN 5 Mental Illness 00:00:22.430 --> 00:00:27.900 Research, Education and Clinical Center, or MIRECC, in partnership with the Employee Education 00:00:27.900 --> 00:00:34.750 System. The planning committee’s members for this Webinar series include Daniel Bradford, 00:00:34.750 --> 00:00:41.500 Valerie Fox, Spencer Glipa, Catherine Lewis, Marty Oexner, Kathryn Peacock-Dutt, Donna 00:00:41.500 --> 00:00:49.110 Russo, Tim Smith, my co-host Ralf Schneider, and myself, Samantha Hack. Today’s Webinar 00:00:49.110 --> 00:00:54.730 is entitled, “Video Games and Gaming Communities in Mental Health Recovery”. Our presenters 00:00:54.730 --> 00:01:02.740 for today’s Webinar are Dr. Michelle Colder Carras, and Mr. Mathew Bergendahl. Dr. Colder 00:01:02.740 --> 00:01:09.570 Carras is a public mental health researcher specializing in video games and gaming communities. 00:01:09.570 --> 00:01:15.500 She works closely with gaming community stakeholders to understand the role that gaming plays in 00:01:15.500 --> 00:01:20.960 mental health. Her recent work focuses on the potential role of peer support within 00:01:20.960 --> 00:01:26.590 online gaming communities for mental health support and suicide prevention. Mr. Bergendahl 00:01:26.590 --> 00:01:33.350 is the program manager for the Stack Up Overwatch program, or StOP, which provides Veteran gamers 00:01:33.350 --> 00:01:38.979 around the clock access to a team of trained and certified crisis management volunteers. 00:01:38.979 --> 00:01:45.500 He is a licensed professional counselor and served from 1999 to 2005 in the United States 00:01:45.500 --> 00:01:50.979 Air Force. If you have any questions throughout today’s presentation, please feel free to 00:01:50.979 --> 00:01:56.030 post them in the chat box, and the presenters will get to them as they pop up, or address 00:01:56.030 --> 00:02:01.950 them at the end of the presentation. At this time I am happy to turn the Webinar over to 00:02:01.950 --> 00:02:07.070 our presenters. Marty Oexner: Michelle, are you still having 00:02:07.070 --> 00:02:09.450 problems getting in? Well, I just ask you one more time. 00:02:09.450 --> 00:02:13.409 Dr. Michelle Colder Carras: Oh, I am, but that’s okay. I have my slides ready. 00:02:13.409 --> 00:02:18.299 Marty Oexner: Well, I’ll tell you what we’ll do while we’re doing that, we’ll bring 00:02:18.299 --> 00:02:24.450 the polling questions back up for a minute and I’ll reopen these for folks who haven’t 00:02:24.450 --> 00:02:26.829 answered them yet. Dr. Michelle Colder Carras: That would be 00:02:26.829 --> 00:02:31.580 great. Marty Oexner: And we can go ahead and do that. 00:02:31.580 --> 00:02:36.980 There are six questions up there and they’re all based on video games, whether you play 00:02:36.980 --> 00:02:42.750 the games regularly, whether you have experienced problems from gaming. If you’ve ever used 00:02:42.750 --> 00:02:54.099 a chat, if you’ve ever heard of the discord program, what do you think of online communication, 00:02:54.099 --> 00:02:59.859 and the connections you can get, and then the bad question… what’s your age? So… 00:02:59.859 --> 00:03:05.659 Dr. Michelle Colder Carras: Yeah, the one everybody is frightened of. Okay, so you have 00:03:05.659 --> 00:03:10.989 the first slide up I assume? Marty Oexner: I’m getting back over there 00:03:10.989 --> 00:03:17.269 right now, I’m going to go ahead and end the polls and if you want us to display those 00:03:17.269 --> 00:03:20.749 later we can, of if you want us to tell you what’s going on with them we can do that 00:03:20.749 --> 00:03:24.419 too. Dr. Michelle Colder Carras: That will be perfect. 00:03:24.419 --> 00:03:25.419 I think the… Marty Oexner: Are you still not in? 00:03:25.419 --> 00:03:27.419 Dr. Michelle Colder Carras: No, I’m still working on it. But I think the, the first 00:03:27.419 --> 00:03:36.169 thing that would be interesting is to show how many people regularly play video games. 00:03:36.169 --> 00:03:39.609 And I guess I’m gonna have to ask you or Mat to describe those results. 00:03:39.609 --> 00:03:46.480 Marty Oexner: Sure, so that would be question 1, and Mat, I’ve got those up for you. 00:03:46.480 --> 00:03:51.230 Mat Bergendahl: I appreciate it. So the question that was posed was: Do you play video games 00:03:51.230 --> 00:03:58.579 regularly? Video games on a computer, console or mobile phone? So at the top of the list 00:03:58.579 --> 00:04:06.819 at 43%, 26 folks weighing in, “I’ve never really played”. The next one at 20% is “I 00:04:06.819 --> 00:04:13.599 used to play regularly, but I don’t play now”. We’ve got 9 folks at 15% saying 00:04:13.599 --> 00:04:21.950 “I play regularly”, and at 13%, 8 people, “I love video games and I play it a lot”, 00:04:21.950 --> 00:04:30.620 and then at 8% with 5 folks, “I’m a hardcore gamer.” So, we do have a wide range of experiences 00:04:30.620 --> 00:04:39.100 with them, kind of like we see in the log when we’re doing these polls, so that was good. 00:04:39.100 --> 00:04:43.960 Dr. Michelle Colder Carras: That is good. That’s exciting. We usually don’t find 00:04:43.960 --> 00:04:48.400 that we have people who are actually hardcore gamers, who are willing to admit that in our 00:04:48.400 --> 00:04:53.000 presentation, so that’s really cool, and we expect that those folks would have a pretty 00:04:53.000 --> 00:04:56.680 good understanding of all the things that we’re talking about, but for some of you, 00:04:56.680 --> 00:05:01.400 it’s definitely gonna to be an introduction, so, I’m glad that we are going to have the 00:05:01.400 --> 00:05:08.740 opportunity to give you some context and background. Can you advance the slide to disclosures please? 00:05:08.740 --> 00:05:16.560 Thanks. So, for me, Michelle Colder-Carras, just to let you know, that my funding sources 00:05:16.560 --> 00:05:22.790 include these different organization, including the VA. I don’t currently have any conflicts, 00:05:22.790 --> 00:05:30.160 but, both Mat and I are video game players. So, if you could advance to the next slide, 00:05:30.160 --> 00:05:37.640 we’re going to give you an intro to video games. And one more slide. And now, ideally, 00:05:37.640 --> 00:05:40.420 you should see a picture of broccoli, is that correct? 00:05:40.420 --> 00:05:46.950 Mat Bergendahl: That’s correct Doc. Dr. Michelle Colder Carras: Okay, great. So, 00:05:46.950 --> 00:05:52.190 when many of you think about what we mean by video games and health, probably you think 00:05:52.190 --> 00:05:57.930 of this idea of serious games, because especially within the Veteran treatment, for example, 00:05:57.930 --> 00:06:06.650 for PTSD, we do tend to think of how we can use simulated environments to forward health. 00:06:06.650 --> 00:06:12.900 And, you know, this is not just limited to Veterans, because of obviously people are 00:06:12.900 --> 00:06:18.170 designing all kinds of games for health or social media applications that connect people 00:06:18.170 --> 00:06:23.440 to be used for health but the problem with these types of applications that are made 00:06:23.440 --> 00:06:29.840 for health purposes, is that they are not able to sustain engagement. They usually will 00:06:29.840 --> 00:06:38.490 have, if they have any kind of scientific assessment for study, then what we find is 00:06:38.490 --> 00:06:44.440 that the pilot studies often show that they work and, you know, maybe they’ll even work 00:06:44.440 --> 00:06:51.930 in a small naturalistic setting, but usually people recognize that they are not as engaging. 00:06:51.930 --> 00:06:57.120 So, they essentially are like chocolate covered broccoli – you know it’s good for you, 00:06:57.120 --> 00:07:01.680 its got this layer of like deliciousness, but ultimately it’s not really what you 00:07:01.680 --> 00:07:08.580 want. Okay, can you advance one more time? And I believe you should be seeing a picture 00:07:08.580 --> 00:07:12.340 of a crowd – is that true? Mat Bergendahl: It is. 00:07:12.340 --> 00:07:18.330 Dr. Michelle Colder Carras: Great. So what my research is focused on is instead of thinking 00:07:18.330 --> 00:07:24.450 about how we can design games that could be used for health purposes, how can we take 00:07:24.450 --> 00:07:30.160 advantage of the incredible popularity of games that are made for entertainment? This 00:07:30.160 --> 00:07:36.840 picture shows actually an E-Sports tournament – they have filled this arena to watch a 00:07:36.840 --> 00:07:45.010 world championship League of Legends game. Games have become the highest grossing industry, 00:07:45.010 --> 00:07:50.120 entertainment industry in the world. They gross more than Hollywood. So, that gives 00:07:50.120 --> 00:07:57.389 you some sense of the context that we’re operating in when we talk about games being 00:07:57.389 --> 00:08:05.150 engaging and what we’ll discuss is the communities that involve around games, also being engaging. 00:08:05.150 --> 00:08:12.590 So, next slide please. And just to confirm we’re talking about evolution of video games, 00:08:12.590 --> 00:08:14.900 right? Mat Bergendahl: Correct. 00:08:14.900 --> 00:08:20.750 Dr. Michelle Colder Carras: Okay, great. So, we haven’t answered the age question yet. 00:08:20.750 --> 00:08:25.430 So I don’t know our range of ages. Why don’t we go ahead and bring that up now just for 00:08:25.430 --> 00:08:36.030 fun… If you’re able to do that, Marty? Marty Oexner: It should be up now. 00:08:37.040 --> 00:08:39.735 Dr. Michelle Colder Carras: Somebody will have to describe to me then. 00:08:40.016 --> 00:08:46.585 Mat Bergendahl: I will do that for you. So we have nobody between the ages of 18 and 00:08:46.697 --> 00:08:59.870 24. Between the ages of 25 to 39 we have a total of 21 people for 44%; 40 to 54,15 people, 00:08:59.870 --> 00:09:07.060 which is 31%; 55 to 64, 11 folks at 23%; 65 and older 1 person at 2%. 00:09:07.060 --> 00:09:18.790 Dr. Michelle Colder Carras: Okay, that’s really cool. Um, so the majority age group 00:09:18.790 --> 00:09:27.559 has grown up with Nintendo, and the Internet, and video games being basically a daily part 00:09:27.559 --> 00:09:32.420 of life. And then, many more folks, you know, they may not have played video games growing 00:09:32.420 --> 00:09:37.809 up, but certainly should be aware of these basic ones that we see here – Super Mario 00:09:37.809 --> 00:09:43.279 Brothers, you know, those early platformers. Those came out in the 80’s and the 90’s 00:09:43.279 --> 00:09:48.149 even, and then in the early 2000’s we have what are called massively lead multiplayer 00:09:48.149 --> 00:09:55.009 online games that bring together people throughout the world to play in the same game environment 00:09:55.009 --> 00:10:01.459 at the same time. These kinds of games emphasize group play, they emphasize teamwork, and sometimes 00:10:01.459 --> 00:10:07.949 they emphasize combat and competition. And then finally, in the last 2010’s and more 00:10:07.949 --> 00:10:13.890 recently we have, we’re combining games with real environments. So, in the lower right 00:10:13.890 --> 00:10:18.699 corner you see Pokemon GO, and if you haven’t played that you should try it – it’s very 00:10:18.699 --> 00:10:24.120 interesting. And then, on the bottom left corner, we have actual virtual reality, and 00:10:24.120 --> 00:10:29.040 this is an exercise game that I really love because it can put you in a virtual environment 00:10:29.040 --> 00:10:39.399 and it gives you a really good incentive to keep moving. So, let me see…, yeah, let’s 00:10:39.399 --> 00:10:42.930 move on, and we should have games differ and sandbox. 00:10:42.930 --> 00:10:48.110 Mat Bergendahl: Yes, it is. Dr. Michelle Colder Carras: Great. So, Mat 00:10:48.110 --> 00:10:52.850 has probably played both of these games more than I have, so, I’ll just describe them 00:10:52.850 --> 00:10:59.439 real quickly. On the left you see Minecraft, which probably everyone has heard of. It’s 00:10:59.439 --> 00:11:04.889 a game where you can build things with blocks, so you can see some users took the time to 00:11:04.889 --> 00:11:10.920 build the United Nations. It gives the opportunity to be really creative. It’s the kind of 00:11:10.920 --> 00:11:15.779 game where there are no rules, there’s no specific things that you have to do to progress 00:11:15.779 --> 00:11:24.079 in the game. And, in comparison, the game on the right is also a sandbox game. You can 00:11:24.079 --> 00:11:29.619 explore with it, you decide how you want to progress. But the difference with this game 00:11:29.619 --> 00:11:36.339 is that it is a survival game. So you start out naked in the woods and I believe you can 00:11:36.339 --> 00:11:41.990 get a rock and your goal is basically to survive, and if that involves killing other people, 00:11:41.990 --> 00:11:48.040 then that’s what you do. Mat, anything to add from those, from that idea of sandbox 00:11:48.040 --> 00:11:52.560 and Rust versus Minecraft? Mat Bergendahl: Certainly, both games definitely 00:11:52.560 --> 00:12:00.740 have a very elevated sense of freedom as far as what you do, what you build. Games like 00:12:00.740 --> 00:12:06.959 Minecraft is also been considered to be kind of a great way to just relax in the environment 00:12:06.959 --> 00:12:14.410 and just build things. You’re right Doc, I’m definitely a big fan of survival games. 00:12:14.410 --> 00:12:23.480 I enjoy that balance between maintaining your own wellness versus, you know, continually, 00:12:23.480 --> 00:12:30.269 continuing your own goals within the game. To me it’s a very relaxing environment to 00:12:30.269 --> 00:12:33.689 be in. People will say, “Well why would you want to do that? You’re constantly worrying 00:12:33.689 --> 00:12:39.680 about your health and your stats and stuff like that”, but it’s just kinda like, 00:12:39.680 --> 00:12:44.790 you know, well, once you get into it, get used to it, it’s very fun, very freeing. 00:12:44.790 --> 00:12:53.350 Dr. Michelle Colder Carras: Yeah, exactly. So like we’ve talked about, games can be 00:12:53.350 --> 00:12:58.480 very engaging, and we have many different genres of games. There’s many more other 00:12:58.480 --> 00:13:04.379 than sandbox games, but we won’t really go into them in depth here. The Strong Children’s 00:13:04.379 --> 00:13:11.860 Museum in Rochester has a good online exhibition of video game timeline, if you ever want to 00:13:11.860 --> 00:13:16.720 take a look at that. So, that’s something that I could recommend. But let’s move on 00:13:16.720 --> 00:13:24.089 to what we can see when people become too engaged with games. So, we’ll talk about 00:13:24.089 --> 00:13:32.379 the negative before we talk about the positive. If you could move on to the next slide? And 00:13:32.379 --> 00:13:36.379 hopefully you see Tokemon there. Mat Bergendahl: Yes, you do. 00:13:36.379 --> 00:13:44.920 Dr. Michelle Colder Carras: Okay, great. So, from a health perspective, for a decade, the 00:13:44.920 --> 00:13:51.089 main perception of video games has focused on a couple of negative areas, focused on 00:13:51.089 --> 00:13:57.720 whether video games contribute to violence and whether playing games excessively can 00:13:57.720 --> 00:14:08.069 be a form of addition, and we now have some kind of codified disorders. The first disorder 00:14:08.069 --> 00:14:13.980 is called Internet Gaming Disorder, which appeared as a condition for further study 00:14:13.980 --> 00:14:22.689 in the DSM in 2013. And you can see here that the symptoms of this disorder really closely 00:14:22.689 --> 00:14:30.179 resemble those of pathological gambling, which really closely resemble substance addiction. 00:14:30.179 --> 00:14:39.009 And the motivation for creating a disorder is that for some people gaming takes over 00:14:39.009 --> 00:14:44.689 their lives, to the point where they’re unable to function, and there is evidence 00:14:44.689 --> 00:14:52.959 that playing games excessively, people can develop similar brain responses to what is 00:14:52.959 --> 00:15:04.480 seen in addiction. So, for that reason, the working group, when this first became discussed 00:15:04.480 --> 00:15:11.660 in like 2011 or 2012, there was a question of whether playing too much or using the Internet 00:15:11.660 --> 00:15:18.319 too much could be considered a compulsion or an addiction, and after a lot of discussion 00:15:18.319 --> 00:15:26.529 it was decided to put it into the addiction category because of the neuroscience behind 00:15:26.529 --> 00:15:33.319 looking at people who played a lot and people who actually experienced this impairment that 00:15:33.319 --> 00:15:42.139 seemed more addiction like. So, that, however, that wasn’t the first official disorder. 00:15:42.139 --> 00:15:48.800 The first official disorder was designated in 2018 in the ICD-11 by the World Health 00:15:48.800 --> 00:15:54.879 Organization. And the definition that you see on the right side for that is I think 00:15:54.879 --> 00:16:02.869 more straightforward and it gives you a sense of real impairment being a necessity. So, 00:16:02.869 --> 00:16:09.450 in this case you have impaired control over gaming. Priority given to gaming over other 00:16:09.450 --> 00:16:14.730 activities, to the extent that gaming becomes the most important thing, and that this behavior 00:16:14.730 --> 00:16:22.449 pattern continues or gets worse, despite consequences, and that it causes significant impairment, 00:16:22.449 --> 00:16:28.759 and is evident for 12 months, unless the impairment is really threatening many, many areas of 00:16:28.759 --> 00:16:37.619 life in a very severe way. So, I’d like to say that this is really finalized, and 00:16:37.619 --> 00:16:44.089 that experts around the world all agree that this is a serious problem, but there is still 00:16:44.089 --> 00:16:49.160 some disagreement, and the disagreement is not that some people don’t experience serious 00:16:49.160 --> 00:16:58.470 addiction like problems, but that it is sometimes difficult to distinguish between transitory 00:16:58.470 --> 00:17:05.069 engagement in games, such as that that might happen when a person is undergoing a difficult 00:17:05.069 --> 00:17:11.040 period in their life, or they have some other thing going on that they’re using games 00:17:11.040 --> 00:17:23.970 to deal with, and that this may temporarily be a problem, but it might resolve, or, (17:17 00:17:23.970 --> 00:17:37.660 dog barking - Sorry, my dog watcher had not removed the dog from the room, I apologize. 00:17:37.660 --> 00:17:55.550 One more second, we’re gonna make sure she gets out of the room). Okay, my apologies. 00:17:55.550 --> 00:18:02.680 The difficulties of conducting these things from home. So, right and the other way we 00:18:02.680 --> 00:18:09.810 can think of engagement. Let’s move on to the next slide. You can also have engagement 00:18:09.810 --> 00:18:20.010 as a way to connect to others and find yourself in an enjoyable setting where you’re playing 00:18:20.010 --> 00:18:24.930 a lot, but you’re not interfering with life. And that’s when one of the concerns comes 00:18:24.930 --> 00:18:32.640 in, because many people who are working on the working groups to try to figure out how 00:18:32.640 --> 00:18:41.140 to identify and distinguish between addiction like problems and engagement. They don’t 00:18:41.140 --> 00:18:46.850 seem to understand very well, this idea of extreme engagement. So, I don’t know, many 00:18:46.850 --> 00:18:52.870 of you are probably clinicians, many, if not most, and you may have had patients who prefer 00:18:52.870 --> 00:18:58.410 to play games several hours a day. For many people, this may seem like a lot, but it may 00:18:58.410 --> 00:19:04.620 just be a preferred past time for them. Just the way you might play soccer for hours a 00:19:04.620 --> 00:19:12.860 day as preferred pastime. But, because it’s not well understood outside of gaming circles 00:19:12.860 --> 00:19:21.680 quite yet, it seems like there’s not a good way to really cover how to distinguish between 00:19:21.680 --> 00:19:28.080 that and addiction. So, hopefully though, one thing that has happened as a result of 00:19:28.080 --> 00:19:40.230 the pandemic, is that we understand better that games can offer 00:19:40.230 --> 00:19:54.821 a huge advantage for allowing people a space to enjoy their lives in settings where they 00:19:54.821 --> 00:19:59.690 are otherwise not able to enjoy them. And I’ll talk about that a little bit more when 00:19:59.690 --> 00:20:07.160 I describe my early research with Veterans. So, what I have been trying to discuss in 00:20:07.160 --> 00:20:14.050 my research is the ideal that we need a paradigm shift – previously from public health and 00:20:14.050 --> 00:20:19.570 health research, we’ve thought of games as negative. There are more and more studies 00:20:19.570 --> 00:20:29.270 coming out that show that traditional games for entertainment have possible uses for mental 00:20:29.270 --> 00:20:35.750 health. So, one of my papers that I have in the bibliography provides more information 00:20:35.750 --> 00:20:42.390 about these, and I do cite these papers specifically as well in the bibliography for this presentation, 00:20:42.390 --> 00:20:48.670 but just to quickly summarize, there have been RCTs, randomized controlled studies, 00:20:48.670 --> 00:20:57.150 that show that playing Tetris after a traumatic experience reduces the number of intrusive 00:20:57.150 --> 00:21:02.850 thoughts in the following weeks, and that of course may be protective against PTSD. 00:21:02.850 --> 00:21:10.510 The one in the middle here, I’m sorry, do we, we moved to paradigm shift right? I may 00:21:10.510 --> 00:21:13.780 have forgotten to say next slide. Mat Bergendahl: We’re there. 00:21:13.780 --> 00:21:21.370 Dr. Michelle Colder Carras: Okay. Sorry about that. So, Second Life, the middle picture 00:21:21.370 --> 00:21:29.260 there, Second Life, is a, is a, not really a video game, but a virtual world where anyone 00:21:29.260 --> 00:21:36.860 can gather and socialize. And in this specific picture you see my avatar on the end presenting 00:21:36.860 --> 00:21:42.980 with two of my colleagues from around the world and we’re talking about the uses of 00:21:42.980 --> 00:21:48.910 video games for mental health, specifically in the disability setting. I think that presentation 00:21:48.910 --> 00:21:54.660 might even be recorded, so I’ll try to find it if anyone is interested. The game Solitaire 00:21:54.660 --> 00:22:02.620 has been used to monitor cognitive decline in people at risk. The game Bejeweled has 00:22:02.620 --> 00:22:11.590 been shown to reduce clinical depression, to the point where people are out of the range 00:22:11.590 --> 00:22:23.520 of depression. Things like Game Boy, games, consoles, platforms – what am I trying to say… consoles 00:22:23.520 --> 00:22:31.740 I guess, they have been used by people with autism, for example, to empower them to interact 00:22:31.740 --> 00:22:38.150 with other folks and games like Pokemon GO can be used to promote physical activity. 00:22:38.150 --> 00:22:44.850 Next slide please. And just really quickly, another of the papers that is in the bibliography, 00:22:44.850 --> 00:22:50.960 we discussed how video games can be used for therapeutic purposes by thinking about the 00:22:50.960 --> 00:22:55.780 fact that individuals chose games based on their life experiences, what’s going on 00:22:55.780 --> 00:23:04.150 in their lives, and then within the game they have some way to engage purposely and meaningfully. 00:23:04.150 --> 00:23:09.901 It can be immersive, and they have the opportunity for social interactions and teamwork. Now 00:23:09.901 --> 00:23:16.430 how we can use those, from a clinical perspective, the games generate data, where we can capture 00:23:16.430 --> 00:23:24.420 that data, analyze it on the fly and then use that to deliver intervention. So, sorry 00:23:24.420 --> 00:23:30.340 for glossing over that, but I have, we have much more good stuff to give to you. So, next 00:23:30.340 --> 00:23:34.660 slide. And Mat, I think that you can take over for a couple of minutes. 00:23:34.660 --> 00:23:39.030 Mat Bergendahl: Yep, I’m here, and thank you Doc. So, we’re gonna talk a little bit 00:23:39.030 --> 00:23:44.770 more about Veterans and video games. That’s kinda where I come in when talking about Stack 00:23:44.770 --> 00:23:54.520 Up Overwatch program as well. Let’s go to the next slide. Thank you. So let’s talk 00:23:54.520 --> 00:23:58.450 a little bit about Twitch. We have a couple of pictures here that I’d kinda like to 00:23:58.450 --> 00:24:03.410 talk to you about. In that first one, the picture in the top left-hand corner, you got 00:24:03.410 --> 00:24:08.240 Doc there and I’m sitting there with my glasses on, the gentleman at the bottom, 00:24:08.240 --> 00:24:15.570 he’s our communications director at Stack Up. We’re using the Twitch platform as a 00:24:15.570 --> 00:24:21.650 way to engage our Veteran population, as well as active duty and civilians, to talk a little 00:24:21.650 --> 00:24:27.590 bit about what’s going on with COVID. When COVID first hit, you know, the biggest, there 00:24:27.590 --> 00:24:31.560 were a lot of questions out there, and there were a lot of concerns. A lot of worries as 00:24:31.560 --> 00:24:38.870 far as what can we do protect ourselves. We were also, you know, trying to do our part 00:24:38.870 --> 00:24:44.770 as far as combating this misinformation, which, you know, at that time there was quite a bit 00:24:44.770 --> 00:24:49.860 of it, a lot of speculation as far as how to prevent, you know, spreading it or how 00:24:49.860 --> 00:24:56.310 to prevent getting it in the first place. So we would Twitch. Twitch is a streaming 00:24:56.310 --> 00:25:01.820 platform, for whose of you who don’t know more often than not is being used to stream, 00:25:01.820 --> 00:25:07.790 live stream video games where the streamer can engage directly with their audience and 00:25:07.790 --> 00:25:13.830 that’s one very essential tool about this platform, is that there is that high level 00:25:13.830 --> 00:25:19.020 of engagement that is going on. So going back to the streams, the COVID streams that Doc 00:25:19.020 --> 00:25:25.740 and I were doing you will see in that top right-hand corner, you can see a screen shot 00:25:25.740 --> 00:25:30.980 of what it looks like, you know, when we were talking about various, the mental health impacts 00:25:30.980 --> 00:25:38.520 and the impacts to your health about COVID, the viewers will sit there and watch and then 00:25:38.520 --> 00:25:45.110 ask questions directly, very much like you’re doing right now. And that’s what made Twitch 00:25:45.110 --> 00:25:51.430 such a powerful tool. It’s not just for gaming – you can use it for mental health, 00:25:51.430 --> 00:25:59.240 you can use it for artwork or music, there’s several different ways to use it. So, Twitch 00:25:59.240 --> 00:26:05.320 in itself is definitely a powerhouse when it comes to the gaming community so as such, 00:26:05.320 --> 00:26:13.140 for Veterans and active duty people it is a tool for them as well when it comes to engagement. 00:26:13.140 --> 00:26:22.070 Nest slide please. So here’s the other part about Stack Up, is the discord platform. As 00:26:22.070 --> 00:26:27.650 you had seen on the polls, if you had a chance to weigh in on them, it’s, it’s a very 00:26:27.650 --> 00:26:36.140 intuitive program. It has different ways of reaching out and engaging with the community. 00:26:36.140 --> 00:26:41.450 The Stack Up program organization, which we will go into a little bit more in depth later, 00:26:41.450 --> 00:26:46.710 it does most of its engagement online. And that’s what makes it have that’s what 00:26:46.710 --> 00:26:53.050 gives it the capability of having such a larger reach, as opposed to more localized organization. 00:26:53.050 --> 00:26:59.440 We can be reached throughout the entire world. In fact, we’ve got members from New Zealand, 00:26:59.440 --> 00:27:05.620 Australia, United Kingdom, all over the world. This is the platform that we use to engage 00:27:05.620 --> 00:27:11.741 the rest of the community, meetings, as well as the StOP program, the Stack Up Overwatch 00:27:11.741 --> 00:27:19.400 program. So we kind of talk a little bit about here. You can see here with a chat, you know, 00:27:19.400 --> 00:27:25.340 it’s just, it’s very, it’s about as close and personal as you can get. You also 00:27:25.340 --> 00:27:32.120 have the capability of doing voice chats or video chats, sharing your screen, or even 00:27:32.120 --> 00:27:41.620 if we want to streaming your own desktops. For example, for our community nights they 00:27:41.620 --> 00:27:46.760 will have movie night, so would all sit there and watch a movie together and chat about 00:27:46.760 --> 00:27:53.570 it in the discord channel and here with the StOP program it’s within the Stack Up community. 00:27:53.570 --> 00:28:01.280 It gives immediate access for those who are looking for mental health assistance or if 00:28:01.280 --> 00:28:05.550 they’re in like some kind of a crisis we can help them get set up with resources as 00:28:05.550 --> 00:28:14.750 well. Next slide please. So, we definitely want to talk a little bit about the Veteran 00:28:14.750 --> 00:28:23.230 gamer when it comes to just, like what I would call like, you know, the influences. I don’t 00:28:23.230 --> 00:28:29.100 want to read this slide off to you completely, but it’s important to take note and take 00:28:29.100 --> 00:28:37.130 a look to see just how these online communities, like Stack Up, can have an influence on an 00:28:37.130 --> 00:28:44.630 individual person. And here we’ll see on the micro-system peer support, the VA itself 00:28:44.630 --> 00:28:51.200 uses peer support specialists throughout the country and, at least from my feedback that 00:28:51.200 --> 00:28:57.630 I’ve been given, both as a Veteran and as a mental health professional, it has a tremendous 00:28:57.630 --> 00:29:08.140 success. And that’s exactly one of the reasons why it’s the, the program within Stack Up 00:29:08.140 --> 00:29:14.380 is so, a very successful one because of the way the peer support specialist have that 00:29:14.380 --> 00:29:20.600 capability to reach out to the member when they are in need of help. And then the actual 00:29:20.600 --> 00:29:25.920 system, we had the Stack Up community as a whole. It’s very similar to, you know, the 00:29:25.920 --> 00:29:31.560 VA system, and of course other mental health resources when we are trying to help out that 00:29:31.560 --> 00:29:38.480 Veteran, or that active duty personnel who are experiencing some issues. And then of 00:29:38.480 --> 00:29:45.170 course we have, you know, the macro-system as a whole. The military culture and the gaming 00:29:45.170 --> 00:29:51.760 culture, there is definitely some overlap there. And we see that influenced throughout 00:29:51.760 --> 00:30:01.250 the entire system, you know, straight down to the individual user when it comes to overseeing 00:30:01.250 --> 00:30:06.130 in the Stack Up community. We have Veterans who served and have done several deployments, 00:30:06.130 --> 00:30:13.670 and then we have Veterans who were serving during times and they were never deployed. 00:30:13.670 --> 00:30:21.590 But they all have gaming culture in relation. So, it makes the common ground, that common 00:30:21.590 --> 00:30:28.700 knowledge, you know, it makes it a little bit easier for the peer support folks to reach 00:30:28.700 --> 00:30:33.710 out to them. And then of course you see, on the very last here, is COVID-19. And that 00:30:33.710 --> 00:30:38.850 impacts all of them. And that’s exactly what gets seen inside Stack Up when it first 00:30:38.850 --> 00:30:45.910 started to hit, folks coming in that are talking about family members who ended up getting 00:30:45.910 --> 00:30:51.700 COVID, some of them who had passed away. We have a lot of first responders here too who 00:30:51.700 --> 00:30:58.700 are also Veterans talking about their experiences of dealing with COVID-19 as a first responder. 00:30:58.700 --> 00:31:05.400 So, it certainly has had a huge impact on every single one of these systems and how 00:31:05.400 --> 00:31:14.730 the Stack Up community was doing business. Next slide please. Well let’s talk a little 00:31:14.730 --> 00:31:20.891 bit more about Stack Up. At Stack Up, we have four pillars of our program. The first one 00:31:20.891 --> 00:31:25.860 is the Stack Up Overwatch program, which we talked about it is definitely the most direct 00:31:25.860 --> 00:31:31.870 mental health benefit that we have within the online community. Then we have stacks, 00:31:31.870 --> 00:31:39.730 which is more of the boots on the ground group, where each stack is localized between, in 00:31:39.730 --> 00:31:45.890 a city, or a couple of cities, depending on where they’re at. It gives the opportunity 00:31:45.890 --> 00:31:53.930 to come together and do community services, sometimes doing just fun events, interacting, 00:31:53.930 --> 00:32:00.170 social gathering, which is, you know, the basics of Stack Up is all about community 00:32:00.170 --> 00:32:06.551 and social connectivity. Then we have Air Assaults. If you take a look at the picture 00:32:06.551 --> 00:32:10.630 on the top right-hand corner, you see a lot of folks wearing the red shirts, the Stack 00:32:10.630 --> 00:32:17.110 Up red shirts the famous brand of what we wear when we’re going out to groups. The 00:32:17.110 --> 00:32:25.220 Air Assaults we, we have a group of what we consider Veterans who are, you know, a lot 00:32:25.220 --> 00:32:31.900 of them are disabled, some of them have wounds from their deployment, and we get them all 00:32:31.900 --> 00:32:38.860 together, and we take them out to places like Comic Con, or PAX for those who know about 00:32:38.860 --> 00:32:45.350 it. Just kind of a way to get Veterans who are often isolated and disconnected, into 00:32:45.350 --> 00:32:51.250 a group of other Veterans where they can sit there and engage in a platform that they enjoy, 00:32:51.250 --> 00:32:57.170 be in an area that they, you know, again, most gamers know of PAX and they definitely 00:32:57.170 --> 00:33:04.120 just want to just check it out. And then we kind of give them the VIP treatment. And then 00:33:04.120 --> 00:33:09.900 again, the idea is to get them all together, and very organically you will see them sitting 00:33:09.900 --> 00:33:16.960 there talking and swapping stories about their time of being in the military. Very, very 00:33:16.960 --> 00:33:24.970 interesting ways of engagement, and again, we spend them, an all expense paid trip, including 00:33:24.970 --> 00:33:29.940 the lodging and of course getting them there to the PAX, food as well. The only thing 00:33:29.940 --> 00:33:34.720 that we do is just try to be there for them and talk to them about what they’re experiences 00:33:34.720 --> 00:33:41.170 are like. The very last thing that we have is a Supply Crate. The Supply Crates are seen 00:33:41.170 --> 00:33:47.070 at the bottom left-hand corner there. We send them out to Veterans from active duty members 00:33:47.070 --> 00:33:53.080 – a lot of the active duty members who are deployed, you know, um, video games once again 00:33:53.080 --> 00:34:00.300 serves as a way to unwind and de-stress when it comes to being out there in a war zone. 00:34:00.300 --> 00:34:06.230 Talking a little bit about myself I was in Iraq during the start of the war back in, 00:34:06.230 --> 00:34:13.679 well, 2003, and you know, and being in security forces it was a very demanding job it was 00:34:13.679 --> 00:34:19.590 very sketchy at times, to say the least, and so after a long day of work I would go back 00:34:19.590 --> 00:34:25.570 to our tent and fire up the TV on my day off and play a game on my PlayStation 2. It was 00:34:25.570 --> 00:34:31.360 just my way to take a break from everything that was going on. So, this is basically the 00:34:31.360 --> 00:34:36.090 same thing. Deployed members can send out requests for Supply Crates, we’ll fill up 00:34:36.090 --> 00:34:42.919 a tote full of X-Boxes, Video games, t-shirts, a bunch of other swag that will help them, 00:34:42.919 --> 00:34:48.330 hopefully help them during their time out there in the desert or in the Middle East, 00:34:48.330 --> 00:34:53.650 or wherever they are. We’ve sent these out to the entire world as far as our reach goes. 00:34:53.650 --> 00:34:58.260 It just really depending if the service members are there, we can definitely try to get them 00:34:58.260 --> 00:35:07.480 a Supply Crate. Next slide please. Dr. Michelle Colder Carras: Back to me… 00:35:07.480 --> 00:35:14.800 I’m gonna try to skip ahead a little bit. Hi everyone, I’m officially in here now 00:35:14.800 --> 00:35:20.930 and my dog is actually behind the door somewhere. So, hopefully we’ll have a more smooth presentation 00:35:20.930 --> 00:35:26.320 now. Um, I’m actually going to skip ahead, because we’ll talk about Veteran’s use 00:35:26.320 --> 00:35:33.750 of video games. This was a project that ran from 2016 to 2017 and in cooperation with 00:35:33.750 --> 00:35:42.030 the VA. We asked Veteran gamers who gamed regularly for like 7 hours a week. We asked 00:35:42.030 --> 00:35:47.230 them about the role that games played in their lives, and in their mental health recovery, 00:35:47.230 --> 00:35:53.000 and we found that for these gamers, the few gamers that we interviewed in this qualitative 00:35:53.000 --> 00:35:59.600 research study, that games helped relieve some symptoms that were otherwise very difficult 00:35:59.600 --> 00:36:08.090 to relieve. It gave them a way to cope when the tools that they were learning did not 00:36:08.090 --> 00:36:16.320 really make it. And let me just show you a few of the quotes, and again, again you’ll 00:36:16.320 --> 00:36:22.540 be able to see these in the downloadable slides. For example, in terms of connecting with other 00:36:22.540 --> 00:36:28.540 people, they were happy to be able to connect with other Veterans out there. Again, it goes 00:36:28.540 --> 00:36:33.190 back to the culture that Mat was talking about. We all know the lingo that, that part of the 00:36:33.190 --> 00:36:39.680 culture helps maintain good relationships with family. Again, I apologize for skipping 00:36:39.680 --> 00:36:44.800 through, but you will have access to these slides. The thing that really struck me as 00:36:44.800 --> 00:36:50.210 a mental health researcher, and a person with lived experience, is that games could be used 00:36:50.210 --> 00:36:56.790 for distraction when nothing else worked. If you need to be sober and you’re playing 00:36:56.790 --> 00:37:02.200 a video game for 8 hours a day, then you’re not using heroin for 8 hours a day. To me, 00:37:02.200 --> 00:37:11.590 that was a very powerful finding. Now, lets move on to the project that we are working 00:37:11.590 --> 00:37:16.050 on now. This is the evaluating the Stack Up Overwatch program. And Mat, I’m trying to 00:37:16.050 --> 00:37:20.540 remember is this one of the slides that you were doing or I was doing? 00:37:20.540 --> 00:37:27.099 Mat Bergendahl: Um, I think this is the one that I’m going to go ahead and do. So let’s 00:37:27.099 --> 00:37:32.780 talk a little bit about the general chat. Again folks, this is in reference to the discord 00:37:32.780 --> 00:37:38.230 channel, you know with this evaluation, there is a couple of things that we need to take 00:37:38.230 --> 00:37:43.330 at look at as far as the depth of what you can do within discord. So as you see here, 00:37:43.330 --> 00:37:51.500 we have the general chat. We talked about, you know, around 2000 users online, but it’s, 00:37:51.500 --> 00:37:56.090 realistically, as far as active users, it’s a little bit, well, it’s a lot smaller than 00:37:56.090 --> 00:38:01.320 that, like around 200 folks. The general chat itself is used just for casual discussion. 00:38:01.320 --> 00:38:07.440 Often people are talking about current events, a lot of gifts are being shared back and forth. 00:38:07.440 --> 00:38:12.180 We use that for our meetings. The Wednesday night meetings that we have where we engage 00:38:12.180 --> 00:38:18.320 directly with the community and getting feedback and discussing things that are coming up. 00:38:18.320 --> 00:38:25.180 Again, it’s just for overall general use. Now, within that program, or within that sever, 00:38:25.180 --> 00:38:30.860 we have the Overwatch program. That is much more specific in scope as far as what it’s 00:38:30.860 --> 00:38:41.990 being used for. The Overwatch program is where users will come when they are in need of assistance. 00:38:41.990 --> 00:38:46.500 You know, folks will come and some of them will be a little bit more guarded and say, 00:38:46.500 --> 00:38:53.270 ‘Hey, I need some help’, and one of the, the support folks will come and reach out 00:38:53.270 --> 00:38:58.920 to them. Sometimes people will be very blunt and open and they’ll completely discuss 00:38:58.920 --> 00:39:06.770 what’s going on. We wanna offer them, we do offer them private chats. We, within the 00:39:06.770 --> 00:39:12.290 Overwatch program, we can do one-on-one voice chats with them to give them a little bit 00:39:12.290 --> 00:39:22.090 more sense of protection as far as having everybody seeing what’s going on. And so, 00:39:22.090 --> 00:39:27.230 while some folks are very open about it, some folks want to have an opportunity to go into 00:39:27.230 --> 00:39:33.240 one-on-ones and so that’s why we have the private voice or the text chat channel. Within that 00:39:33.240 --> 00:39:41.720 is where we are starting to do the assessment of that person. Each person that comes into 00:39:41.720 --> 00:39:49.410 our chat channel, are assessed for their suicidal or homicidal ideations, we try to find some sort of support 00:39:49.410 --> 00:39:55.000 system for them. It’s very, it’s very solution focused, orientated as far as getting 00:39:55.000 --> 00:40:01.370 them services that they need as well, of course, as doing the follow-up with them. We want to 00:40:01.370 --> 00:40:05.520 make sure that when they come in there, even if they are there just to vent, and believe 00:40:05.520 --> 00:40:09.570 me, we definitely get them quite often, we want to make sure that they walk away with 00:40:09.570 --> 00:40:19.369 some sort of solution oriented goals for them, and that’s kind of two-fold – one, it 00:40:19.369 --> 00:40:25.820 puts the responsibility back on the user as far as, you know, working through their own 00:40:25.820 --> 00:40:32.620 challenges, as we always say “You are your own best advocate”, and at the same time, 00:40:32.620 --> 00:40:38.510 it gives them that empowerment that they are taking advances towards changing their issue 00:40:38.510 --> 00:40:47.130 that’s going on. Okay, so next slide please. Dr. Michelle Colder Carras: Okay, I think 00:40:47.130 --> 00:40:51.740 we’re back to me, and what I’m going to do since we only have a couple of minutes, 00:40:51.740 --> 00:40:56.390 is I’m going to skip through some of this very quickly and make sure we get to some 00:40:56.390 --> 00:41:02.760 of the questions from chat, and I think it was not Steven Bundy, but Steven Richardson, 00:41:02.760 --> 00:41:08.940 “Please make sure that…” there it is…, “the age limitations to prevent addiction 00:41:08.940 --> 00:41:14.690 in young and cognitively developing children.” I’m afraid, you can, if you’d like, you 00:41:14.690 --> 00:41:19.080 can E-mail me and I’m happy to have that discussion with you, but it’s not something 00:41:19.080 --> 00:41:24.230 that’s really relevant for our presentation right now, so I do have those other questions 00:41:24.230 --> 00:41:29.440 about discord and Twitch and we will answer those for sure. So, I’m gonna skip forward 00:41:29.440 --> 00:41:35.720 a bit, just really quickly. This is how we combine the data sources for our current evaluation 00:41:35.720 --> 00:41:40.760 study. These are the questions for our study. “Basically, what is StOP, is it being delivered 00:41:40.760 --> 00:41:46.460 the way we expect it, and is it fulfilling its mission?” So, just to, quickly, we conducted 00:41:46.460 --> 00:41:52.950 a mixed method study with four data sources including chat analysis, a survey and analysis 00:41:52.950 --> 00:42:02.740 of intake forms and interviews with the providers. So, these are our mixed methods integration 00:42:02.740 --> 00:42:08.730 findings. StOP is designed to be an online chat room based crisis intervention program. 00:42:08.730 --> 00:42:14.130 Users have tried other approaches to address their mental health issues and we understand 00:42:14.130 --> 00:42:20.010 this in the Veteran world that there are many reasons why Veterans want to seek help and 00:42:20.010 --> 00:42:23.540 don’t, or they have tried to seek help and haven’t been satisfied or haven’t been 00:42:23.540 --> 00:42:29.440 able to get the help that they need. And, users appreciate the different formats that 00:42:29.440 --> 00:42:36.810 they can use to get help. Is it being delivered as expected? Staff team members follow the 00:42:36.810 --> 00:42:44.660 rubric for working with people who seek help. There are a few technical problems, but every 00:42:44.660 --> 00:42:47.850 once in a while something will come up that the team will have to develop a work around 00:42:47.850 --> 00:42:54.170 for. At the point that we collect the data, screening for suicide risk was inconsistent, 00:42:54.170 --> 00:43:00.070 but because this is a grass roots program, it evolves very quickly, and even since that 00:43:00.070 --> 00:43:05.630 time there have been additional policies to improve the screening for suicide risk. So, 00:43:05.630 --> 00:43:14.000 we know from, even from suicide hotlines, that screening is not always 100%, so the 00:43:14.000 --> 00:43:20.750 goal is to bring it up to the standards for suicide hotline. And, is it fulfilling its 00:43:20.750 --> 00:43:27.760 mission? It is providing connection. The peer support format is a big contributor to that. 00:43:27.760 --> 00:43:32.550 It provides users with suggestions for getting professional counseling, for hooking up to 00:43:32.550 --> 00:43:38.270 the VA program and other types of resources that they might struggle to find otherwise. 00:43:38.270 --> 00:43:45.680 And the military and Veterans who use StOP, they really appreciate the fact that the StOP 00:43:45.680 --> 00:43:54.670 peer supporters understand military and Veterans. Now we also have a section of the grant on 00:43:54.670 --> 00:44:01.200 the COVID-19 pandemic, and like Mat said, many, many people have been severely impacted, 00:44:01.200 --> 00:44:06.500 but there is some tension in our funding because we also found that some people were, they 00:44:06.500 --> 00:44:11.460 felt like, the meme was, “I’ve been training for this my whole life”, you know, having 00:44:11.460 --> 00:44:16.740 to stay home and connect with people through the Internet. For those people who hadn’t 00:44:16.740 --> 00:44:23.170 yet been effected seriously, that was one thing that came out of our findings as well. 00:44:23.170 --> 00:44:30.010 So, there are many challenges and lessons learned from this study. And, I think the 00:44:30.010 --> 00:44:36.240 best place to learn more about them is going to be our paper, because even just to begin 00:44:36.240 --> 00:44:41.350 with, let me address those questions real quick. Unsavory discord servers. So going 00:44:41.350 --> 00:44:46.300 back to the idea of a gaming culture, some things about the gaming culture can be unsavory 00:44:46.300 --> 00:44:53.480 for sure. Toxicity can be a problem in the gaming culture, and even just people being 00:44:53.480 --> 00:44:59.109 kind of lighthearted and using locker room talk and insults, you know, those are gaming 00:44:59.109 --> 00:45:06.610 and military things. So, it is easy to see where things can go on that aren’t supportive 00:45:06.610 --> 00:45:15.080 of mental health. So, that’s at, that’s a cultural thing that has to be attended to. 00:45:15.080 --> 00:45:21.320 In Internet spaces, including discord and Twitch and other places that gamers hang out, 00:45:21.320 --> 00:45:27.240 they seem to be anonymous, but at the same time it’s not difficult to identify people. 00:45:27.240 --> 00:45:31.640 So when you’re doing research you have to be very, very careful in how you proceed, 00:45:31.640 --> 00:45:39.950 and we did this by having me, as the lead researcher, be a part of the Stack Up community 00:45:39.950 --> 00:45:46.280 for a couple of years, and then work with them very carefully to describe and decide 00:45:46.280 --> 00:45:51.850 how we were going to deal with the need for privacy and anonymity. And I think the only 00:45:51.850 --> 00:45:56.960 other thing that I want to mention right now, two other things, when we think about the 00:45:56.960 --> 00:46:03.869 target population for an online study, it’s really important to consider what it means 00:46:03.869 --> 00:46:09.000 to be a member of a server or a community, and what it means to be an active member, 00:46:09.000 --> 00:46:16.400 because that will really effect how we interpret our results. Also, how we define peer support, 00:46:16.400 --> 00:46:23.380 it’s defined very specifically within the VA context and within Stack Up. One of the 00:46:23.380 --> 00:46:28.710 things that it was originally designed to be was not peer support the way that we think 00:46:28.710 --> 00:46:37.070 of it, but more like citizen support or community member support, but through out interviews 00:46:37.070 --> 00:46:42.670 and our other qualitative data, and even some of our quantitative data, we found that the 00:46:42.670 --> 00:46:51.790 lived experience of being a Veteran and / or struggling with a mental heath challenge, 00:46:51.790 --> 00:46:58.750 that was a very important part of the delivery of the support, as well as the meaning and 00:46:58.750 --> 00:47:03.530 the growth of the peer support, we don’t want to say providers, but the people who 00:47:03.530 --> 00:47:12.260 are providing the peer support. So, that wraps it up. My apologies for dog barking and other 00:47:12.260 --> 00:47:17.870 tech problems and running a bit long. Um, I can look at the chat now, or if somebody 00:47:17.870 --> 00:47:22.010 wants to tell me what the unanswered questions are, Mat and I can definitely answer those 00:47:22.010 --> 00:47:29.670 questions now. Ralf Schneider: Okay, there was a general 00:47:29.670 --> 00:47:37.220 question earlier, this is Ralf, from Sarah Fisher, about wondering if there was any evidence 00:47:37.220 --> 00:47:45.050 she can look into about or regarding the benefits of gaming across age ranges and she was thinking 00:47:45.050 --> 00:47:52.580 about those who start gaming early may be developing some skills at an early age that 00:47:52.580 --> 00:47:57.070 would benefit. Any thoughts on that? Dr. Michelle Colder Carras: Okay, that’s 00:47:57.070 --> 00:48:02.700 a really good question. It actually ties in a little bit to the question from Steven Richardson, 00:48:02.700 --> 00:48:07.260 that I said that I didn’t want to answer. So now I can answer it in the context There 00:48:07.260 --> 00:48:14.400 are definitely advantages to playing when you’re young. These advantages in learning 00:48:14.400 --> 00:48:20.770 skills like turn taking, communicating, and when we think of communicating, okay, I’m 00:48:20.770 --> 00:48:27.020 55, when I think of the importance of learning how to communicate as a child, my mind inherently 00:48:27.020 --> 00:48:32.640 goes to face-to-face communication because I think, well, that’s the human thing, that’s 00:48:32.640 --> 00:48:38.930 what humans need. But, in reality, children are growing up in a global society, where 00:48:38.930 --> 00:48:44.130 learning how to communicate online is going to be equally important to learning how to 00:48:44.130 --> 00:48:51.070 communicate face-to-face. So, that’s one of the skills that children can learn as they 00:48:51.070 --> 00:48:58.490 are growing. But, like Steven was implying, there’s also, because children lack the 00:48:58.490 --> 00:49:04.820 self-regulatory skills, there is the chance that their interest in gaming can be, it can 00:49:04.820 --> 00:49:12.270 more easily get out of hand. So I’m, I think that setting limits, you know, the research 00:49:12.270 --> 00:49:18.310 shows that putting age limits on games is not as effective as we would hope, but 00:49:18.310 --> 00:49:25.270 making people more aware of the content and how this specific content can lead to different 00:49:25.270 --> 00:49:31.109 kinds of problems, like some things might be more addictive, or might make people more 00:49:31.109 --> 00:49:36.090 likely to rampantly spend money or likely gambling, like those kinds of things are good 00:49:36.090 --> 00:49:45.869 to be, to include in labels for games. So, I don’t think I answered the HIPAA issue 00:49:45.869 --> 00:49:53.660 questions very well. My understanding of HIPAA is that it has to do with healthcare institutions, 00:49:53.660 --> 00:50:00.970 so I’m not sure. There are one or two actual, actually there are one or two Twitch streamers 00:50:00.970 --> 00:50:05.790 who are providing, they say they’re not really providing healthcare services, but 00:50:05.790 --> 00:50:09.660 they’re talking with people about their addictions and about their mental health problems. 00:50:09.660 --> 00:50:18.050 So in that sense, possibly, you know, there could be this idea that healthcare services 00:50:18.050 --> 00:50:22.590 are being provided in these communities, and then HIPAA would become a problem. But otherwise, 00:50:22.590 --> 00:50:28.720 it’s more of a, more of a general privacy issue. So, for example, my gamer handle is 00:50:28.720 --> 00:50:35.640 MichelleDocColderCarras and so I’m open because I want people to be able to contact 00:50:35.640 --> 00:50:42.030 me and learn about my research, but most people have gamer handles like Frag-O…, Mat, that, 00:50:42.030 --> 00:50:47.360 you know, aren’t easily linked with their real identity. Nonetheless it’s not difficult 00:50:47.360 --> 00:50:54.750 to track someone down. So I’m scrolling up really quickly through the chat. I’m 00:50:54.750 --> 00:50:58.369 so glad that we have people involved in the chat. That’s really great 00:50:58.369 --> 00:51:06.830 Ralf Schneider: There was another one near the end um, about how to get, for peers, how 00:51:06.830 --> 00:51:15.970 to get their Veterans involved in Stack Up or StOP or even a local gaming group. And 00:51:15.970 --> 00:51:18.940 I know we… Dr. Michelle Colder Carras: Those are all 00:51:18.940 --> 00:51:23.410 great. Yeah, Mat, take it away. Mat Bergendahl: Sure, so there’s a couple 00:51:23.410 --> 00:51:30.190 of ways that this can be done. I think one way would be, it really depends on if that 00:51:30.190 --> 00:51:35.760 Veteran is interested in utilizing the services or maybe providing services, if they want 00:51:35.760 --> 00:51:43.560 to join the community. It’s really, I would say that, you know, we can always just, you 00:51:43.560 --> 00:51:50.971 know send that peer support specialist information about Stack Up, maybe talk with them. Our 00:51:50.971 --> 00:51:57.310 managers that we have for the stack program could certainly help facilitate that as well. 00:51:57.310 --> 00:52:04.560 One of the, Chris, he’s an Army Veteran, just about ready to retire, he’s always 00:52:04.560 --> 00:52:11.750 been interested in bringing more folks into the program. And again, they can obviously 00:52:11.750 --> 00:52:15.820 pick and choose as far as their engagement goes they can, you know, we are always looking 00:52:15.820 --> 00:52:22.780 for more community members and if somebody feels interested they are inclined to actually 00:52:22.780 --> 00:52:29.210 maybe work one of the programs, like the stacks program or the StOP program, we will help 00:52:29.210 --> 00:52:36.740 them out with that as well of course. So, let me, I’ll put my E-mail address in the 00:52:36.740 --> 00:52:44.770 chat if you wish to reach out and I can help facilitate that. 00:52:44.770 --> 00:52:55.230 Ralf Schneider: Great. This is Ralf, I see we’re running out of time, but I thank everybody 00:52:55.230 --> 00:53:01.869 for all the comments, and Dr. Colder Carras and Mr. Bergendahl, really appreciate this. 00:53:01.869 --> 00:53:08.930 This is exciting stuff (cuts out 53:00) and again thanks so much to everybody. 00:53:08.930 --> 00:53:14.370 Dr. Michelle Colder Carras: Thank you everyone. Mat Bergendahl: Thank you everybody.