How Be Her Ally became an Ally…

According to the research, 50% to 80% of new moms experience an episode of the “baby blues.” “The average prevalence rate of non-psychotic postpartum depression is 13%.” New moms are having a time of heightened vulnerability to depressive mood changes in the months followed by delivery due to the abrupt and dramatic hormone changes and other life-based causes, and it can be twice as high as during other periods in a woman’s life. In addition, postpartum depression is not only a mom’s issue; new dads can also get it.

The good news is that postpartum depression is totally preventable and treatable if proper interventions are provided.

After navigating through my own postpartum period and helping many friends of mine going through theirs, I found this issue is specifically significant among Asian families in the US.

As we know, Asian families tend to raise babies with help in bigger family sizes, whereas families in the US in smaller ones. Due to this cultural difference, taking care of the baby by just the new mom and dad can be scary and cause more anxiety than they would imagine. Due to the hard traveling situation recently, Asian new parents in the US can’t get help from their families. The doubts and worries of their parents usually make them less confident being a parent. As a result, some expecting parents may exaggerate the difficulty of taking care of their baby on their own and feel more helpless and anxious after the baby is born. Not to mention that postpartum mental health are usually the least priority to prepare compared to topics like how to feed a baby. Without proper preparation, mental-healthily navigating through the postpartum period can be an unexpecting problematic issue later on.

After realizing the significance of mental health during this particular time, I want to do something and help Asian expecting and new parents, who are dealing with this situation alone in a different culture like my husband and me, better prepare for their mental health in their parenthood.

An idea of making a game of family support for postpartum depression targeting Asian expecting and new dads came into my mind. I chose dads as my target audience because new moms usually pay more attention to their babies and easily ignore their wellness in the postpartum period. However, new dads are more likely to notice changes in their wives and offer help at the first minute. After finishing the research, I started to think about the concept and design questions for the game. The first version of the design question is:

“How can I educate players on every information they need to know about postpartum depression and get them well-prepared after playing the game without being overwhelmed?”

To answer the design question, I came up with a very rough game concept of players finding out what happened to their depressive wife in the game as a new dad by messaging people around them. It was inspired by games like Coming Out Simulator and Bury Me, My Love. The text messaging mechanic of these games is so immersive and interesting, and the way they were slowly revealing the truth is so engaging and impressive. However, I found it hard to put the story together when it came to my narration design, and I couldn’t generate enough emotions as I expected.

Then, I created the concept of a text-based adventure game with both texting and face-to-face conversations. I started the narration design and the mechanics later on, but I was totally lost when I finished the scripts. After adding several features, I worried that the complex mechanics might take players away from the narration. The first feature I thought about was time looping, but then I realized that players could quickly lose interest when they experience the storyline more than once. I also thought mini-games in-between chapters might be a good idea, but the risk is players may focus less on the storytelling after constantly playing mini-games. What about tracking stats? Games can be more interactive but less efficient if the monetary is not well-designed. That was an anxious phase of the whole design process, and I was so hesitant to prototype the game. When I was struggling in a dead corner, professor Clay asked me: “Why a game?”

Yeah, why a game? Clearly, a game is not the most efficient way for players to get information compared to other learning formats, like videos and articles. Then, why is the game efficient in this context?

The answer is that it’s all about the experience.

Another design precedent, Depression Quest, is definitely not the best resource to learn, prevent and treat depression. However, it is very immersive and efficient in understanding what depression is with its narration, art, and ambient sounds. Inspiring from it, I was aware that instead of focusing on creating an all-in-one educational resource, an experience for players to resonate with and planting a seed about postpartum depression in their minds would be a better goal. I also changed the game verb from “select” to “balance” and the design question from the previous version to:

How can I prime the awareness of Postpartum Depression in players' minds and get them prepared efficiently without being overwhelmed and offended?

How can I narrate a solid and immersive story from a husband’s view that players can easily resonate with(as a woman and a wife)?

To answer the design questions above, introduce Be Her Ally, a game advocating for family support of postpartum depression. In the gameplay, players will play as the new dad, Jamie, making decisions to balance his life by communicating with different people surrounding him to support his depressive wife, Christie, navigating through the postpartum period. Players must carefully deal with many life dilemmas that have no correct answer while balancing the wellness of family members to get a higher score for a better ending. This game aims to help players be prepared for their mental-healthy parenthood.

After having the concept, I started working on the narrative design. A text-based adventure game relies heavily on storytelling and character design. A good narrative design is also an answer to my design questions. As a result, my main narrative design challenge was to tell an immersive story without players being overwhelmed and offended. Here are several difficulties I encountered:

How can I create one story with which all players could resonate?

An old proverb says: We all have our crosses to bear, and it’s so true in my topic. It is tricky that every family has different dilemmas, and creating a story fitting most families' situations seems complicated. I went back to the interview notes and circled out their common issues:

1. Work-Life-Parenthood Balance

2. Mother-in-law and Daughter-in-law conflicts

3. Different concepts of raising kids between generations

4. Less socialization in the postpartum period

5. Increasing conflicts between new parents

Then, I wrote scripts based on the real stories I collected from people around me to address the issues above in different chapters. I used a flowchart to manage my scripts by creating bubbles in colors to build up the conversations. And another challenge popped up when I was putting the conversations together.

How can I efficiently cover the topics I wanted to discuss naturally in the story?

To better achieve the game’s goal, I embedded the topics I wanted to cover (for example, what is postpartum depression? What are the symptoms? How can family members support at home? Etc. ) into the characters’ lines, players’ choices, and narrations. Now I have the story's structure ready, but I got another problem when I started to write down each line of characters in the story.

How can I create characters with conflicts while not being so dramatic?

Like screen scriptwriting, conflicts are keys to an engaging story and are established in characters' personalities and relationships. I don't want just to document the experience I interviewed or create an over-dramatic story with too many conflicts. So, I carefully designed each character's background story, characteristics, and relationships. Take the example of Christie, the wife and new mom in the story. Christie is an independent and assertive new mother who loves learning and trying new things that benefit her family. However, she is over-worried about her kid and sacrifices her own wellness for the family as many moms do. As a result, although Christie is now suffering from postpartum depression, she doesn’t want to see a psychiatrist because she wants to keep breastfeeding. She is a divergent thinker, so she replies to messages in short lines. Based on her character design, Christie had arguments with her husband and mother-in-law based on her character design about some baby-raising issues. I followed the same character design concept and came up with a story with every character as realistic as possible while the story is engaging. This approach turned out to be a great hit in the following two playtests. All the playtesters think they easily resonate with Jamie, the husband, because the characters and scenarios in the game are so realistic, and many emotions are left after they finish playing the game.

After finishing the scripts, I quickly prototype the game by Twine for the first playtesting. In this version, I tested the efficiency of the fundamental mechanics with six playtesters consisting of new and expecting dads and game designers. All the playtesters liked the story and found the mechanics was immersive and interesting. In order to create a more realistic experience, I came up with the pseudo-real-time concept inspired by Bury Me, My love. To determine whether the idea works, I split playtesters into two groups: the play-at-once group who completed the game without interruptions in-between chapters and the pseudo-real-time group who received messages I sent to remind them to play chapters throughout the day. It turned out that the play-at-once group felt the game longer, whereas the pseudo-real-time group felt the game shorter and more engaging. As a result, I decided to make the game pseudo-real-time and keep the mechanics I had so far.

When I finished the first playtest, I started to dive into development. I switched from Twine to Unity for better performance. I thought it would be more immersive if players could play on phones. It took me two months to develop the beta version, and here are the key features of the latest version.

1. The most important feature is the pseudo-real-time experience. There are five chapters and three endings, and chapters are unlocked based on real-time. Say characters are going to the grocery store at 12 PM. After completing the previous chapters, players will be able to unlock the grocery scenario at 12 PM in real-time and receive a notification when it's available.

2. In order to better explain the idea of balancing life, I added the tracking stats feature in the Beta version. Five stats change during the game based on players' choices. (Baby's Wellness, Christie's Mental Health, Jamie's Mental Health, Jamie's Stamina, and Jamie's Self-Satisfactory Level. ) The final score is calculated by the equations above. As you can see, a positive weight is applied if players balance the stats well, while a negative one is applied if players have imbalanced stats. A higher final score goes to a better ending. The core idea is to tell players that everyone's wellness is equally important. Sacrificing one's happiness for others won't be a good solution.

3. To design and develop scenes consistently, I set up two scene templates for face-to-face conversations by plugin Conversa and texting conversations by a messenger style template from the assets store. Embedding plugins into my unity project is more complicated than I expected. Still, I successfully created two dialogue frameworks that I could use in the following development with my code and design.

4. In addition, I worked with Jackie from the writing center for seven sessions to polish the scripts sentence by sentence to make sure every line in the story is grammatically correct and contextually natural. Besides, I rewrote some scenes to ensure the story was better transit between chapters.

5. I also recreated a more cohesive UI with the campaign's branding and a new stats inspector. Players will easily access their scores and performance by the stats inspector and characters' facial expressions in the beta version.

6. To create an immersive experience, I made the character avatars by hand tracing the stock images. I also added system sound effects like the pop sound when buttons clicked, and ambient sounds in the background.

7. Finally, I built the game for iOS, macOS, and Windows platforms. Due to the resolution issues, only the iOS version was available for the beta playtesting on TestFlight. But, without a doubt, I will continue to solve the problems and build the game for different platforms in the future.

The beta version playtesting had 17 playtesters with a wider variety of demographics than the first one. According to their valuable feedback, the narrative design exceeded my expectations. Most of them liked the mechanics, and they found the arts, sounds, and new UI design enhanced the gameplay experience. However, there are misses. The first one is resolution issues that some testers have overlapping UI and alignment issues for some devices. For this problem, I will revise the UI to fit any devices in the future. The weight is also not working well with the storytelling, and the calculation needs to be adjusted. I will modify monetary by several paper prototypes and playtests for the next step. The stats panel is not bold enough for players to pay attention to, and many players didn't understand how the stats are working after playing the game. I will redesign a new inspector that is more useful in the game for the next version.

After summarizing the problems and putting them together in a Google sheet labeled priority levels, I will solve the issues above by the end of the semester and keep working on the rest of the problems so that the game can be released to help my target audiences soon.

At the end of the documentation, I would love to thank everyone who helped me with this project and all the help during the past few years. During my master's studies, especially when so many people said I am doing something meaningful during the development of this game, I started to understand how passionate I am about being a game designer. Game is not only entertainment but a powerful vehicle to communicate. I will continue to polish Be Her Ally in the future and design more games like this to help more people. I'm certainly not the best game designer now, but being a better game designer is my lifelong goal. And I feel so excited to start the journey.

Vliegen, Nicole PhD*; Casalin, Sara PhD*; Luyten, Patrick PhD The Course of Postpartum Depression, Harvard Review of Psychiatry: January/February 2014 - Volume 22 - Issue 1 - p 1-22doi: 10.1097/HRP.0000000000000013

Victoria Hendrick, Lori L. Altshuler, Rita Suri, Hormonal Changes in the Postpartum and Implications for Postpartum Depression, Psychosomatics, Volume 39, Issue 2, 1998, Pages 93-101, ISSN 0033-3182, https://doi.org/10.1016/S0033-3182(98)71355-6.

Yue-Yun Wang, Hui Li, You-Jie Wang, Hong Wang, Yan- Ru Zhang, Lin Gong, Jian Ma, Yan Wang, Ming-Zhen Wang, Shi-Xian Qiu, Shi-Xin Yuan, Living with parents or with parents-in-law and postpartum depression: A preliminary investigation in China, Journal of Affective Disorders, Volume 218, 2017, Pages 335-338, ISSN 0165-0327, https://doi.org/10.1016/j.jad.2017.04.052. (https://www.sciencedirect.com/science/article/pii/S0165032716314756)

Postpartum Depression: Current Status and Future Directions, Michael W. O'Hara and Jennifer E. McCabe, Annual Review of Clinical Psychology 2013 9:1, 379-407