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Working as a mental health first aider in games

Inflexion Games' Wyatt Fleming shares why MHFA is important for game studios, the benefits of a specialized course, and what you can do to help your staff

Content warning for talk of suicide, overdose, panic attacks, anxiety, depression, and mental health issues.

First aid is a fairly well-known concept that involves caring for an injured person until professional help can arrive, but this rarely includes instruction on caring for someone suffering from a mental health crisis.

Until mental health is more widely considered part of overall health and included in basic first aid courses universally, a person can take a specialized mental health first aid (MHFA) course.

What is Mental Health First Aid?

MHFA is the care provided to someone who might be developing a mental health problem or experiencing a mental health crisis. You might be wondering – what does that even look like in practice?

Inflexion Games' mental health first aider Wyatt Fleming

This depends on the severity of the situation, but day-to-day this often involves noticing changes in a person’s behavior, having a conversation with them to provide some initial help, then guiding them through the process of getting professional help.

In a work setting this might involve helping that person feel empowered to take time off for their mental health, helping navigate the different public and private benefits and supports available to them, and following up to make sure they’re getting the help they need.

Crisis situations are when a person may need immediate help or intervention – things like substance overdose, panic attacks, suicidal thoughts or ideations, or psychotic episodes.

Similar to physical first aid these scenarios often involve following some basic steps to assess the situation and potentially calling emergency services.

Why MHFA is important for game studios

We spend many of our waking hours at work, so it’s pretty likely we’ll be at work when we need MHFA. In Canada, one in five people will experience some problem with their mental health in the course of a year and I imagine this stat is even worse following the COVID-19 pandemic.

Prolonged stress has also been linked to increased risk of mental health problems and game development tends to be a high stress environment with tight deadlines and long hours with pressure from players, publishers, leadership, and colleagues.

In my experience, game devs also tend to be very passionate about their work and will put in extra time, even when it is not required or expected. This can lead to negative mental health outcomes from increased stress, lack of social connections outside of work, and less time for the things you love.

What leaders can do to help their workers’ mental health

There are many ways an organization or leader can positively impact their employees’ mental health. It starts with creating a safe and welcoming environment that is as stress and anxiety-free as possible. Every studio and group of people are going to have different needs, but these are the factors I’ve witnessed or heard of having the biggest positive impact on employee mental health and wellbeing:

  • Training

Invest in MHFA training for a wide range of people – ideally with someone from each department who will be well situated to notice changes in behaviors and provide MHFA if necessary.

Invest in MHFA training for a wide range of people – ideally with someone from each department

You may already have folks in your organization doing this type of work, but formalizing it with a title and giving them the tools and information they need will help them succeed. It is important to recognize and celebrate the work these folks are doing.

Often, MHFA work is taken on supplementary to someone's usual duties and expectations, so making sure this work is well considered during planning and compensation conversations ensures that it is a fair and worthwhile endeavor.

Invest in training for leaders so they can notice when their reports might be suffering from new mental health problems, are proficient at discussing mental health issues with them, and can guide them to get the help they need when warranted.

Unconscious bias training can also be a useful tool for helping everyone be more cognizant of how their unconscious bias affects their day to day interactions, especially people living with mental illness.

  • Benefits

Ensure all employees have access to mental health-related coverages/insurance. There can be a lot of other barriers aside from cost that might prevent someone from seeking treatment. Sometimes it’s the stigma around seeking and receiving treatment, or feeling like mental health issues aren’t bad enough, or having to wait a long time to access the right provider, so not having to worry about how you’re going to pay for it can go a long way.

Here in Alberta a 50 minute session with a private psychologist will typically cost you $220 or more according to the fee schedule set out by the association, and going through a public provider can take weeks to months.

Ensure all employees have access to mental health-related coverages and/or insurance

Benefits should include prescription drug coverage that covers treatment for mental health disorders like anxiety, depression, and ADHD so that treating a diagnosed mental health problem does not require your employees to consider how much it will cost them or how they will afford their medication.

Including coverage for overall health and wellness can also provide ways for employees to improve their mental health and manage their stress. Services like massage or acupuncture are a good example of these types of services. Coverage for other areas of health like vision, dental, and prescription drugs can also take the stress out of making decisions as they relate to overall health.

For physical office spaces it can be helpful to set aside some private spaces where employees can go if they need to step away for any reason. Bonus points if it’s something more comfortable and cozy than the usual meeting rooms. This can give folks a place to go if they need to be away from others, but can also be a good spot for mental health first aiders to go to chat with someone who needs MHFA.

  • Planning

As leaders, it is up to you to push back on requirements and expectations that would require your team to crunch (work overtime to meet project deadlines). This requires that you know your team's capabilities and capacity well and that you have a strong understanding of what is being asked of you and your team. Vacation, sick time, and other responsibilities also need to be accounted for during planning.

In addition to minimizing the need for crunch, if you will be covering sensitive or potentially traumatic topics in your game, it is important to engage with – and invest in – experts on that topic and to incorporate time for self care during planning for the teams working in and around this content.

  • Policies

Include mental health-related issues in your sick leave policy. If you want to support people and their mental health, then you need to allow them to take time away from work to address their mental health in the same way you allow them to address their physical health.

Enforcing, mandating, or even allowing crunch (extended or prolonged overtime to meet project deadlines) can lead to stress and burnout that can lead to mental health problems. Crunch is a complex topic that warrants a much deeper dive than the scope of this article can tackle on its own, but should generally be avoided for any team’s overall health and wellbeing.

Establish how to talk about mental health in your communication guidelines; it should be very clear what to expect from work communications

Avoid undue uncertainty for employees when it comes to job security, contract renewals, compensation negotiations, and promotions. The more clarity and certainty you can provide around these issues, the easier it is for your people to focus on the important stuff – like making a great game.

Enforce a minimum vacation policy. One of the issues with game devs being so passionate about their work is that it can be difficult to get them to take time away to rest and recharge. Having coordinated studio breaks can really help make sure these super passionate people are getting the time they need to recover from all their hard work.

Establish how to talk about mental health in your communication guidelines; it should be very clear what to expect from work communications. This might include things like how and when to use trigger warnings, or where and when certain topics unrelated to work can be discussed.

If your employees must engage with the community, allow them to do so anonymously and provide clear guidance on how to engage with the community in a safe way. There should also be clear guidance on what to do if an employee is being made to feel unsafe by a community member.

What workers can do

On the staff side, consider taking mental health first aid training. I found the training incredibly useful when I’ve had to have difficult conversations about mental health and have been grateful for my training on multiple occasions when I needed it outside of work.

If your company or manager isn’t doing some of the things I’ve mentioned above and you think they would be beneficial for you or your team's mental health I would encourage you to try to convince them of its value.

If you’re not having any luck with your manager, try chatting with your teammates and see if they feel a similar way or would benefit from some additional support. In my experience having a unified and collective voice is more successful than just one person raising their concerns or asking for something.

If you’re struggling with this or need some advice on how to approach your coworkers or leadership, see if you can ask any leaders in your network for advice. See what it would take for them to change their mind on an issue like this.

Union organizers are also great resources if you have access to them. Ask around and do some research to see if there are some in your area that you could connect with

Union organizers are also great resources if you have access to them. Ask around and do some research to see if there are some in your area that you could connect with. They can give you advice or help you practice having these difficult conversations and tend to be quite familiar with labor laws in your local area and can help you make sure your rights are being respected.

If you do have mental health or overall health and wellbeing coverage, ensure you take full advantage of as much of it as possible. Especially during periods of high stress, I would encourage you to review your coverage and look to use any component that may help you disconnect from work, destress, and recharge or improve your overall health and wellbeing.

When it comes to therapy or seeing a psychologist, I encourage folks to find one before they are in urgent need of them. Having some rapport with a therapist can make it that much easier to talk to them about difficult topics and makes it that much easier for you to reach out if you are struggling.

Finally, something that everyone can do with very little effort is look up your local crisis lines and keep them on you or put them in your phone. These are great resources if you or someone you know is struggling and you’re not too sure what to do next. They can provide advice, help de-escalate situations, or provide emergency services depending on the situation. That said – if you or someone you know is a danger to themselves or others, then you should skip straight to calling your local emergency services.


Studios and their leadership can have a positive impact on their employee’s mental health if they are willing to engage with them to find solutions to issues impacting their mental health and follow up that engagement with investment in solutions and support. I’ve outlined some ideas above, but every studio will have different needs and problems to solve.

For employees – ideally the studio you work for and their leadership teams see the value in providing mental health support, especially if you’ve brought your concerns and suggestions for improvements forward. If they don’t, there is strength in numbers! I think workplaces have a responsibility to support the overall health of their workers and I think workers should feel empowered to band together and demand this support.

If you’re unsuccessful with having changes enacted, then I would encourage you to engage with your local union organizer outside of working hours and see if they can provide any additional support or advice.

Wyatt Fleming is lead game services programmer and mental health first aider at Nightingale developer Inflexion Games.

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