In 2013, Nature told the world that NeuroRacer, the first health game from the research lab that would spin out to become Akili Labs, was a game changer. While Akili Labs cofounder and Chief Science Advisor Adam Gazzaley might quibble with the details, he definitely thinks mental healthcare is a game in need of a change.

“Every researcher wants the pun of ‘game change’ used as a headline in Nature for their paper,” Gazzaley said in a keynote at the Partners Connected Health Symposium last month. “But I really bring that up because it’s tortured me for years. It forces me to message that this particular game – as excited as we are about what we accomplished – we don’t know if it’s a game changer. Maybe it will, maybe it won’t, but what I hope is a game changer is the methodology. That a group of scientists worked carefully with a group of professionals from another industry, in this case the world of video games, to create something neither group can do on their own. And then to do a very carefully-designed study, placebo, randomized, to understand how a game could impact someone in a meaningful, sustainable way.”

While there are a lot of companies developing brain-improving games, Akili’s scientific approach sets it apart. The company has been developing and testing Project: Evo, the spiritual successor to NeuroRacer, for several years and is now seeking FDA clearance to make the game a prescribable therapy for ADHD.

Gazzaley also sees mental healthcare in general as a game badly in need of change. 

“There’s nothing inherently wrong with using small molecules to boost cognition,” he said. “But for over 50 years we’ve been trying to accomplish this, and we do not have very well targeted therapeutics in this domain. We have general neurotransmitter systems but not on the underlying foundational level of the brain which is the neural network. Therefore we are forced to push our doses to very high levels, getting just as many side effects as we do effects…Probably the biggest problem is that it’s an open loop system. There are long, sloppy non-quantitative cycles between how we intervene and how we update that intervention. You take a pill home from the doctor’s office. Months pass while you objectively monitor side effects, and then a non-empirical decision is made to go up or down a little bit...I would say that this is really not good enough. This is too many major fundamental problems that stand in the way of boosting cognition in 2016.”

He hopes that the video games his lab is developing, which are designed to create reinforcing feedback loops, will be the beginning of a new therapeutic area for mental health. In addition to project Evo, the company has four other games: Meditrain, designed to help improve focus; Rhythmicity, designed to improve rhythm and timing; Virtual Attention, a VR game focused on improving focus; and Body Brain Trainer, which uses a wearable to monitor the users cognition and physiology at the same time and develop them in tandem.

“I’m really excited by what we’re reading out from some of these games,” he said. “We don’t really think the real advances are going to happen in the next two to five years. But when we start putting all these games together, something we think of as neural CrossFit training, we think this is where we’re going to have real impact is this synergistic effect across a whole package of games.”