330 Chapter 8 This distinction was not observed when the trailer designs contained the entertainment message. Consequently, participants were more than five times more likely to select the mental health game promoted in one trailer design over the other. These findings compellingly show that explicit mental health messaging does not deter young adults exhibiting mental health symptoms, but, in fact, enhances appeal of such games, making them more attractive to these individuals. Moreover, the emergence of the unexpected difference in the attractiveness of the two trailer designs underscore the importance of aesthetic appeal in the choice for mental health games. Indeed, previous research has shown that youth consider engaging and visually appealing game designs crucial for mental health games to succeed (R. Pine, Sutcliffe, et al., 2020). Surprisingly, (the generally low levels of) motivation to change, and emotion and stress mindsets did not significantly influence the choice to engage with a mental health game. We did find that individuals with heightened anxiety levels anticipated less fun from the games compared to those without such symptoms, however symptom type and severity did not predict actual game choice. These findings are inconsistent with previous research in conventional intervention contexts. That research showed that motivation to change, mindsets and symptom severity are important predictors of help-seeking and presumably openness to mental health interventions (Burnette et al., 2020; Lawrence et al., 2017; M. I. Oliver et al., 2005; Sawyer et al., 2012). A couple of studies, however, have also shown that severity of (depressive) symptoms does not influence help-seeking (Chin et al., 2015; Merikangas et al., 2011). Our findings are in line with these latter studies, indicating that nonspecific factors do not influence the likelihood of selecting a mental health game. Although youth with anxiety symptoms may initially expect less fun from a mental health game, the results demonstrated that mental health messaging can reach youth experiencing a broad spectrum of internalising issues. In Chapters 6 and 7 we also examined the impact of game choice and nonspecific factors on engagement and experiences of gameplay. Participants’ game choice for the mental health or entertainment promoted game did not influence gameplay duration or overall game experiences. Nor were motivation to change, and emotion and stress mindsets associated with gameplay duration. These results show that those choosing the mental health game exhibited comparable gameplay duration, intrinsic motivation, autonomy, and competence levels, as well as similar increases in affect compared to those selecting the entertainment game. Exploratory analyses, however, did reveal that participants with severe symptoms reported feeling more autonomous
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