Mental health is defined as a condition of a person’s well-being in coping with the stress of life. Mobile apps that used gamification has been proven effective as a mental health intervention in the form of therapeutic tool for counseling and mental therapy. Entertainment content of video games has been shown to improve mood, enhances motivation, and reduce stress/emotional relief. Though the benefits of gamification as an intervention tool for assisting people during life difficulties were widely researched, yet less research focused on what are the significant gamification elements in a game design that can influence one mental health state. In fact, research on mental health and gamification in Malaysia is relatively new and limited. This research aims to identify the significant gamification design elements which influence the user in overcoming their mental health problems through game playing and game interaction. The scope of this research involved a focus group consists of five (5) users with anxiety issues and with more than two years’ experience in playing entertainment games to elevate their anxiety problems. The research methodology was conducted using qualitative approaches via narrative inquiry (in-depth interview) to understand the user’s experiences and interaction with the entertainment game app. The results were consolidated using a thematic analysis approach. From the research findings, four (4) design themes emerged, there are 1) storytelling 2) challenge 3) engagement, and 4) point and reward. Based on the participant’s feedback the design element of engagement was discovered as the most significant to enhance passion and emotional involvement in participation and completion of levels/challenge in game interaction. In conclusion, the research has identified four (4) gamification design elements that drive possible emotional changes of the participants during their interaction with the game app. As the research was exploratory in nature with a limited number of respondents; for future work, we proposed a mixed-method approach to understand each design element and its relationship through prototype building and theoretical model validation.