Using Magic to 'fight' mental illness: therapeutically applied tabletop roleplaying

Abstract

Background: Mental illness accounts for 15% of the global burden of disease for 10-19-year-olds. Low Mental Health Literacy (MHL), impaired intrinsic motivation, and intimidating standard treatments limit care-seeking and perpetuates mental illness into adulthood. Local Problem: A psychiatric inpatient unit in Montana serving adolescents ages 12-18 wanted to increase group attendance. Methods: A 6-week education and implementation quality improvement (QI) initiative was developed using therapeutically applied tabletop role-playing games (TA-TTRPG) as part of unit programming to increase extrinsic motivation and increase group attendance. Intervention: Training to educate staff on administration of TA-TTRPGs. Development of pre-implementation training, group tracking documentation, and satisfaction surveys. Results: Of the 102 possible attendance occurrences, 74 attendances (73%) occurred across 12 TA-TTRPG groups, falling short of both the attendance goal of 80% and group administration goal of 18. Two of the four (50%) staff members felt adequately prepared to administer TA-TTRPG groups. Conclusion: TA-TTRPGs showed an attendance increase of 28% over talk-based groups, 11.7% over non-TA-TTRPG game groups, 27.3% over art groups, and 41.2% over media groups. This QI project demonstrates the feasibility of utilizing TA-TTRPGs as a motivating tool in an inpatient psychiatric setting.