In an Australian-first, WA’s health system is offering inpatient and outpatient services for people suffering from gaming disorders or excessive digital use.
By Cathy O’Leary
It is an issue that doctors might inadvertently be dealing with on a regular basis with younger patients – teens who are anxious, depressed, not sleeping well and missing school.
Drill down to how they are spending their time, and the answer might be that they are sitting at home playing games or scrolling social media – morning, noon and night.
Gaming disorder and excessive internet use might not have been on the medical school curriculum for many doctors, but it is a fast-growing social phenomenon being fuelled by the omnipresent digital world.
While there are some global estimates of 3-4% of people suffering from gaming disorders, and rates of one in 10 people with excessive screen use, the figures are thought to be higher, with the problem sometimes camouflaged by other symptoms and co-morbidities.
But a team of clinicians in Perth is spearheading a new intervention and treatment approach – thought to be an Australian first, if not the world – by offering both an outpatient clinic as well as inpatient treatment.
Funded under the South Metropolitan Health Service, Fiona Stanley Hospital is the first public hospital to have a gaming disorder clinic, and from this month, GPs can also refer female patients aged 18 and over to five designated inpatient beds at Cockburn Health.
Cockburn will provide in-patient admissions for patients from both metropolitan and rural areas who need digital detox and other in-patient treatments. For males and female aged 16-18, in-patient admissions will be provided by the youth in-patient unit at FSH.
Origins in COVID

The gaming disorder clinic has been operating since 2022 as part of the FSH’s Addiction Prevention and Treatment Service.
Clinicians recognised the need for a specialist gaming disorder clinic during the COVID-19 pandemic when they saw a steep rise in gaming disorder and related problems in adolescents and young adults presenting to the emergency department and the youth and adult mental health and medical wards.
When the clinic was piloted in 2021, it was believed to be the first in the world, as other international centres tended to have clinics as outpatient or detox camps rather than one within an acute hospital setting.
Few patients were initially referred to the clinic by GPs because most doctors were unaware of the service, but since then, it has treated more than 200 patients, almost three-quarters of them male, with the majority aged 15 to 19, while some patients have been as young as seven while others are aged in their 50s.
Many have co-morbidities such as ADHD, autism, depression, anxiety and substance use issues.
The clinic has been spearheaded by consultant psychiatrist and head of service Dr Daniela Vecchio, who is working to raise public awareness about gaming disorders, promote prevention and early intervention, and develop solutions.
She told Medical Forum it was not about being ‘anti-gaming’ but for some people this form of entertainment could turn into a harmful addiction.
“In Australia, the data shows that in school-aged children there is a prevalence of 2.8%, and in terms of problematic screen use it’s over 10%, particularly in teenagers, and we also think it’s the tip of iceberg and likely to be higher,” she said.
“The phenomenon is very much under recognised, and people present to the emergency department due to schizophrenia, depression or attempted suicide.
Dr Vecchio said many people could play games without it causing any problems but in others it was a persistent pattern of gaming despite negative consequences and involved loss of control and making it a priority over other activities.
Aggressive and anxious
“It’s where it’s causing impairment in their functions. In the clinic, we see very severe cases where patients become very reclusive, they don’t go to work or attend school, and they might act in an aggressive way when limits are placed on their gaming use.
“They’re often anxious, depressed and irritable, and their lifestyle is compromised, and they might have obesity and musculoskeletal problems.
“We had one patient who developed severe pressure ulcers, the bone could be seen, because of prolonged sitting while playing games.”
Dr Vecchio said that before the clinic opened, there were few resources to treat these disorders.
While progress had been made, the next step was to educate professionals in the health and school sectors, and to develop screening and prevention, but both required funding.
“We are the only outpatient clinic of its kind in Australia, so it is important that we have community-based services who can do screening in schools or do interventions in home because we have the phenomenon of school refusal,” she said.
Data showed that among a school-aged cohort, only 45% attended school, and of those of working age, the majority did not work.
“This is very concerning, and shows we need to act early, but we also need to promote healthy gaming because we also don’t want to demonise gaming because it can be fun, and people can connect with each other,” Dr Vecchio said.
“The problem is that some individuals are vulnerable to develop gaming disorder addiction, and the games are designed to keep the user engaged, and others encourage online gambling so people can end up spending thousands of dollars which then makes them depressed.
“We’ve had patients who have attempted suicide in the context of this depression and loss of control, and like other addictions, there can be physical damage, such as to the prefrontal cortex, so their ability to plan and to regulate their emotions is affected.”
She said often gaming disorders did not happen in isolation, with the majority of FSH’s patients having ADHD, depression or social anxiety, so it was important in terms of interventions to treat the co-morbidities and work with families.
Patients were encouraged to have a digital detox, which could be done at home or in more severe cases carried out on the youth ward.
“We usually start by encouraging them not to have devices in their room at night, to give it to their families, and perhaps switch off the wifi,” Dr Vecchio said.
“We encourage them to have other activities, because the worst enemy for them is the boredom, so they need to replace gaming with social activities – or social prescribing – so family activities like cooking a meal together without devices around, and not just for the individual but for the whole family.
“There isn’t medication for this disorder, so you need to make changes to the system.”
Back to school
Dr Vecchio said the clinic staff were particularly concerned about school refusal in these children, because if they did not get an education that could affect their whole life, their work and relationships.
“We try to facilitate a return to school, and we work with the school – such as the principal and school psychologist,” she said. A learning centre at FSH could give students tutoring one-on-one before they started the return to school.
The hospital also offered a self-help group, facilitated by a doctor and a peer support worker, where they could come once a week to talk about their week and engage in fun activities such as playing board games using fantasy and strategies similar to those used in online gaming.
Dr Vecchio told Medical Forum the clinic was funded solely through the hospital but to be sustainable it needed to secure long-term funding.
“The demand is now very high, and the patient cases referred to us are often very complex, and while the trial has been successful, to treat the disorder you have to address many things like education, and that can be complicated,” she said.
“Children with conditions like ADHD are more vulnerable to the harms from gaming disorders and have to be assessed on a case-by-case basis.
“But we need to be doing more for prevention and early intervention such as screening before children become severely affected.
“For some, gaming is an escape from reality, and of course we’re in a digital world and nobody wants people to stop engaging in healthy activity, but not when it gets to the stage where they don’t sleep at night because they’re playing video games, or they stop looking after themselves – they don’t eat or shower – and they might become obese.
“There have been cases of children assaulting family members, and there is also a risk of radicalisation online – Australia has seen a few cases of this.”
Some people with gaming disorders also gambled, and this compounded their financial woes.
“In some cases, detox has to be done in a safer, more supported environment than home, and that’s where we’re looking to use our five inpatient beds for gaming disorder at Cockburn Health – there has never been anything like this before,” she said.
“We believe this could be the first unit of its kind in the world – and it’s not just for gaming disorders, it might be excessive social media use. These cases will be a detox, but in a very supported way, treating any co-morbidities.”
The service also liaises with clinics in other countries such as Korea and Japan, where gaming disorder is very prevalent, and this was helping to further global research into gaming disorder.
Dr Vecchio said that as well as the need for funding and policies, other options that could be considered to combat the adverse effects from gaming included advertisements – supported by the multimillion-dollar gaming industry – warning on the harms or having taxes on games.
GP referrals welcome
In the meantime, she encouraged GPs to refer patients for outpatient treatment as well as inpatient care if needed.
The clinic is accepting referrals for patients with gaming disorder, hazardous gaming, problematic internet use, social media use disorder and allied conditions for assessment.
The criteria included patients who game excessively and experience functional impairments; are aged over 16 (although lower ages can be considered on a case-by-case basis); are not currently suicidal; and are being case-managed by a service or have already been referred and accepted.
Since October 14, the service has accepted referrals for females aged 18 and over for admission to Cockburn Health, with the beds due to open on December 2.
Referrals can be emailed to fsh.gamingdisorderclinic@health.wa.gov.au
Who is gaming?
Demographics of 200-plus patients at FSH
Gender:
- Three-quarters male – 153 males, 50 females.
Age:
- Almost half aged 15-19 years
- A quarter aged 10-14 years
- Two children aged 5-9 years
- Eldest patient aged 59
Primary diagnosis in order of prevalence:
- Hazardous gaming
- Gaming disorder
- Hazardous internet use
- Hazardous social media use
Employment/education status:
- Half students
- 33% unemployed
- 18% employed
Co-morbidities in order of prevalence:
- ADHD
- Depression
- Anxiety disorder
- Autism spectrum disorder
- PTSD
- Others – bipolar, substance abuse, personality disorder, gender dysphoria, eating disorder.
School attendance among school-aged:
- 45% good attendance
- 29% non-attendance
- 26% limited attendance.