2 31 REVIEW OF APPLIED & CASUAL GAMES FOR MENTAL HEALTH Many children, adolescents and young adults (herein ‘youths’) experience mental health problems such as anxiety, depression, self-injury, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), conduct disorder and schizophrenia (Costello et al., 2003; Global Burden of Disease Collaborative Network, 2020; D. Knopf et al., 2008; Merikangas et al., 2010; Polanczyk et al., 2015). In recent decades, the prevalence rates of mental health problems have been on the rise (Collishaw, 2015; Olfson et al., 2015), making them a significant contributor to the overall burden of disease among young people (GBD Mental Disorders Collaborators, 2022; Gore et al., 2011; World Health Organization, 2021). Despite extensive research into psychological therapies for mental health, multiple meta-analyses show modest effect sizes at best, indicating that only 63% of youth experience improvements following treatment (Mychailyszyn et al., 2012; Stockings et al., 2016; Weisz et al., 2017). This suggests that the effectiveness of current mental health interventions has reached its limit (P. J. Jones et al., 2019; Weisz et al., 2019). At the same time, considerable unmet needs remain, with the vast majority of youth in need of care not receiving or accessing treatment due to barriers related to high costs of interventions, shortage of mental health specialists, and stigma associated with mental health (Bijl et al., 2003; Collins et al., 2004; Granic et al., 2014; Kataoka et al., 2002; D. Knopf et al., 2008; Mukolo et al., 2010; Park-Lee et al., 2016; Salloum et al., 2016; Wells et al., 2002). Moreover, a substantial proportion of youth receiving treatment discontinue prematurely because current therapies (those based on cognitive-behavioural principles) are not engaging and motivating for youth (De Haan et al., 2013; Granic et al., 2014; Kazdin, 1996). These findings underscore the urgent need for a new approach in designing, delivering and implementing mental health interventions (P. J. Jones et al., 2019; Kazdin, 2019; Liverpool et al., 2020; Weisz et al., 2019). As indicated by systematic reviews and meta-analyses, digital health interventions hold enormous potential to improve effectiveness, reach, uptake and accessibility, and appeal (Fairburn & Patel, 2017; Hollis et al., 2017; Li et al., 2014; Torous et al., 2021). More specifically, applied games have been proposed as a viable alternative for delivering interventions, owing to their natural appeal, intrinsic motivational characteristics, cost-effectiveness, and scalability (Fleming et al., 2017; Fleming et al., 2023; Granic et al., 2014; Kazdin, 2015; Lau et al., 2017). Applied Games Applied games are digital interventions that employ game design elements in an effort to make interventions more enjoyable, motivating and engaging (Schmidt
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