Picking up on one of the themes for A&SM#4 Notifications from the Technological Unconscious here’s an article from the Guardian yesterday on the first NHS internet addiction clinic. Henrietta Bowden-Jones was one the speakers at the AWAAN symposium at Central St Martins last year and co-editor of the AWAAN book.

NHS to launch first internet addiction clinic

A London hospital is preparing to launch the first ever NHS-funded internet addiction centre for young people and adults, the Guardian can reveal.

The move comes at a time of growing concern about internet and gaming dependency, with the World Health Organization (WHO) classifying gaming disorder as a mental health condition this week.

The centre, run by the Central and North West London NHS foundation trust, will initially focus on gaming disorders, with a plan to expand its services to cover other internet-based addictions. It will be a place of treatment and research, offering advice to families.

“Gaming disorder is finally getting the attention it deserves. The distress and harm it can cause is extreme and I feel a moral duty on behalf of the NHS to provide the evidence based treatment these young people and their families need,” said psychiatrist Henrietta Bowden-Jones, the clinic’s founder.

“We are unlikely to witness an epidemic of young players with an addiction to gaming but for the ones who do struggle, the Centre for Internet Disorders will be a life-changer.”

The WHO’s decision has been praised by some while others argue that the move is premature. At present there are some private hospitals in the UK where gaming disorder is being treated but none offer free treatment.

Funding has so far been secured for a weekly therapy group for gaming addicts, according to Bowden-Jones. Subject to clearing some final hurdles, the centre will be financed by the NHS, research grants and philanthropic sources.

“This is the first step, but the Centre for Internet Disorders will deal with other internet compulsions, if and when needed, when funding is available. If we end up with 20 people or 30 wanting to be treated for porn addiction, for example … if we have got the funding for that then we could provide help,” she said.

Bowden-Jones said that they were initially focusing on gaming because they were keen to protect young people from dropping out of school. Gaming disorder is defined by the WHO as a pattern of persistent or recurrent gaming behaviour so severe that it takes “precedence over other life interests”.

Symptoms include impaired control over gaming and continuation or escalation of gaming despite negative consequences. Some countries had already identified it as a major public health issue, and addiction experts, charities and parents are becoming increasingly concerned about the amount of time children are spending playing online games.

“Other countries have free services, for example there are some in Asia. We are really behind. I am not sure how it took us so long. Maybe it’s because we had no champion and I will identify as that champion. You just need one person in the right place at the right time,” Bowden-Jones said.

She said there was no consistency in the use of screening tools to determine the scale of internet or gaming addiction. The WHO will work on producing a global tool that everyone can use. Bowden-Jones called for prevalence surveys every one or two years.

Bowden-Jones said that while she was aiming to get NHS funding for the centre, she also recognised the limitations and restricted budgets, saying she also hoped for philanthropic donations, research collaborations and to work alongside charities. “I am also realistic and as someone who is trained in psychiatry and has dealt with frontline psychosis cases I know other things need to be addressed as well,” she said.

Jeff van Reenen, addiction treatment programme manager at the Priory’s hospital in Chelmsford, said an internet addiction clinic would be incredible and was long overdue.

“Internet, social media and gaming addictive or dysfunctional behaviour has been rife for a long time and completely unaddressed other than by people like us,” he said.

But other experts were more sceptical. Anthony Bean, a licensed psychologist and executive director of a nonprofit mental health clinic in Fort Worth, Texas, is among those who oppose the WHO’s decision to include gaming disorder in its International Classification of Diseases.

“I don’t think a centre for gaming or internet addiction is a good idea … the worry is that it means you are only paying attention to what is going on in front of you rather than around you, which in this case would be the concept of a gaming disorder possibly suggesting that there could be no other reason why a person is seeking mental health treatment. A pigeonhole tactic could lead to misdiagnosis,” he said.

Eytan Alexander, a recovering addict and founder of UK Addiction Treatment Centres (Ukat), which runs seven facilities in England, welcomed the news of a treatment centre but noted a difference between people playing as hobby and being addicted.

“The fact the NHS is preparing to open a treatment facility is welcoming news. It’s a step in the right direction, but I do believe the NHS should not pigeonhole its limited budget on one particular addiction following lots of media hype,” he said.

He said the budget would be better spent on treating addiction generally rather than gaming dependency specifically and that there should be attempts to raise awareness about gaming responsibly.

Data from Ukat centres show the number of people asking for help with gaming addiction has increased from four in 2014 to 16 in 2017. But Alexander said this data was limited because people could be referred for other addiction problems, with gaming later turning out to be the problem.

Adam Cox, a clinical hypnotherapist specialising in addiction, said internet addiction was a growing problem. “People who work for social media companies, porn sites, or gaming developers, their goal is to monetise the content they are creating. They are using every trick in the book to get people to spend more time online,” he said.

People now spend money in games on things such as better guns or additional lives, said Cox. Loot boxes, an in-game purchase consisting of a virtual container that awards players with items and modifications based on chance, have attracted controversy and comparisons to gambling in recent months.

“The freemium model where the game is free but then you pay for extras, is putting the emphasis on game developers to make them incredibly addictive and meet psychological needs such as significance and connection, to incentivise players to spend money and time on these games,” said Cox.

He added that people can invest hours competing against other players. “If they need to leave the screen for even a few moments it could undo all the effort they have invested up to that point. This is why we’re seeing people urinate into bottles or even their beds: they simply can’t leave the game once it’s started.”

Experts said parents should not become alarmed, however, saying only a minority of children would become affected in this way. “It’s those who naturally have an addictive personality or are vulnerable [who will be most affected],” Cox said.

He added: “There are benefits to using these games in moderation, for example in helping children to learn hand-eye coordination. But if playing them is the first thing kids do when they wake up and they do that doing instead of other things then it’s a problem.”

The original piece is here: https://www.theguardian.com/society/2018/jun/22/nhs-internet-addiction-clinic-london-gaming-mental-health