The mental health landscape has welcomed discoveries, launches and experiences that showcase immersive technologies. Research, innovations and campaigns that explore the relationship between advancing technologies and mental health have come to the fore in 2022.

As a result, we have seen sophisticated and ever-evolving technologies such as artificial intelligence (AI), virtual reality (VR) and gaming positioned as an effective tool to support holistic healthcare. Consumers want to access mental health interventions that are scalable, stigma-free, accessible and affordable. However, clinicians need more time to adopt new technologies.

Enter the era of advanced solutions to support mental health.

AI-led therapy: Removing barriers

AI-driven chatbots that centre on therapeutics and self-care are gaining prominence. AI-led tools like voice recognition software Ellipsis listens and looks out for signs of emotional distress, while relational agent Woebot aims to help people talk through challenging situations and practise cognitive behavioural therapy (CBT) techniques.

Woebot has raised $123.5 million since its 2017 launch, with almost $100 million generated since 2021. “The precise role of this tech in our current health system is still emerging; however, there is little doubt that digital, self-directed tools will be part of a more comprehensive, inclusive, and preventative mental health care system,” says Alison Darcy, founder and president of Woebot Health.

The appetite for digital mental health support using AI-led techniques is rising. Increasingly, the tech is forging a complementary role in mental health management and treatment.

“Traditional therapy fundamentally cannot be scaled because it really is based on a human-to-human relationship,” says Darcy. Using AI-led technology that listens, learns and delivers empathetic mental health support via smart devices can offer clinicians, patients and broader society an opportunity to make care more accessible and available.

“While we, as a society, are more open than ever about mental health, stigma is still a significant barrier to care,” Darcy adds. Therefore, innovations are removing the human element from communication to eliminate fear and enable therapeutics to reach people who may not seek help otherwise.

Balancing convenience with human connectivity

However, concerns around the legitimacy and safety of therapeutic chatbots permeate the medical industry, as tools remain unregulated and largely without approval.

Merging face-to-face and digital support can help with these concerns. The technology can, for example, offer potential in a simulated training setting.

“We believe AI offers great opportunities to support people working in mental health,” says Dr Mark Ungless, director of Data Insights, Mental Health Innovations. “We are using AI to develop a conversation simulator to help train volunteers to take text-based conversations at Shout.” Launched in 2019, Shout is the UK’s first free, 24/7, confidential text messaging support service.

Social VR can transform new-world experiences

VR is a rapidly advancing tech capable of transporting people to virtual places, enabling interaction in ‘hyper-real’ ways and tracking users’ behaviour. The technology appears in treating and managing various conditions, including stress, anxiety and pain management, as it aims to change pain perceptions.

“Virtual reality technology has been used as part of psychological therapy in specialist mental health clinics for more than 25 years,” says Dr Elizabeth Murphy, gameChange Trial Coordinator and Research Clinical Psychologist at Greater Manchester Mental Health NHS Foundation Trust. However, VR in psychological therapy, “until recently, was always on a small scale as the technology was supported by in-person therapy”, Murphy says.

Mental health access for all

Access and scalability have driven innovation.“While some companies are pursuing digital therapeutics, which require individuals to seek a prescription for a digital VR app from a physician, the biggest potential lies in scalable mental wellness apps that can be accessed by anyone, anytime,” says Noah Robinson, Founder and CEO of Innerworld.

In April 2022, a UK national study developed gameChange, which automates psychological therapy for psychosis in a VR setting with a virtual therapist built in. “Psychological VR therapy that can be delivered in the patient’s home offers huge promises for treatment,” says Murphy. Results found that gameChange automated VR therapy significantly reduced participants’ anxiety and distress about everyday social situations.

“We’re still some way off technology like gameChange being available in mental health services as standard, but we hope this is going to change soon,” says Murphy. A current implementation study is underway to investigate how it can be part of routine clinical services.

“Currently, most mental health VR interventions focus on exposure therapy,” says Noah Robinson, Founder and CEO, Innerworld. However, the founder believes the “most potential lies in social VR, or the metaverse, because it is the most interpersonal and anonymous technology that exists”.

Designed for VR to leverage immersive social presence and anonymity, Innerworld is currently proposing a randomised control trial to determine whether more expensive VR headsets are needed or if it can deliver a metaverse experience via flat screens that are equally effective. If so, the researchers can scale these interventions to reach people on their own devices. “My suspicion is that the immersive nature of VR technology will confer additional benefits,” says Robinson. 

Advancements in VR can automate mental health conditions’ diagnosis through a core set of biometric data that can be collected, such as movement, reaction time, eye tracking and voice analysis, Robinson shares. The data can be used for diagnosis and the personalisation of mental health interventions.

“As we develop evidence on the efficacy of mental health VR interventions, we can present this data to payers and employers to help them subsidise the cost of immersive technologies and interventions,” says Robinson.

Collaboration and information

Understanding mental health remains a priority. VR capabilities provide the potential to create experiences and interventions co-designed with mental health practitioners to be tailored to treatment and management. In October 2022, York University created a VR choir to understand the health and wellbeing benefits of virtual singing. “VR is [a] fabulous tool”, says Dr Helena Daffern, Professor at AudioLab, University of York.

Through its virtual choir, researchers can observe users and better understand how people interact, practically and emotionally, which has informed the technology’s subsequent development and design stages. Future opportunities exist to “research ways to develop the technology to understand more about the user within a broader diagnostic framework”, Daffern shares.

Gaming offers edutainment opportunities

Education and entertainment, or edutainment, merge in gaming applications for mental health. “Gaming is the largest sector in the entertainment industry and gamers are increasingly raising money for charity while playing,” says Jen Bott, Senior Event Fundraising Manager for Help For Heroes. One gaming and mental health company DeepWell Digital Therapeutics emerged in March 2022 to launch gameplay that combines entertainment with accelerating treatments.

“Unfortunately, video gaming is not very prevalent in the mental health landscape,” highlights lead developer and researcher Dr Darren Edwards, Senior Lecturer in Public Health, Swansea University. After learning that approximately 50% of Europeans engage in video gaming, Swansea University researchers developed ACTing Minds in 2022 to respond to this gap.

The innovation draws upon the gamification of mental health interventions and embedded learning to present education in a fun and interesting way via acceptance and commitment therapy (ACT). It aims to teach users about positive ACT-consistent behaviours such as building values, orientation and acceptance over avoidance.

“Video games have the potential to play a huge role in supporting mental health education,” Edwards adds. Qualitative interview data indicated opportunities are present in psychoeducation and supplementing existing therapeutic work. 

Recent insights reveal the importance of digital tools in providing short-term support for Generation Z males. Organisations are turning to gaming to help increase their presence among younger gaming audiences.

In November 2022, veteran Paul Colling completed Help for Heroes’ Hero Up 11.11 gaming challenge. The fundraiser, which saw Paul raise almost £10,000, combines gaming with mental health awareness and support. “Gaming has a positive effect all round for me, it takes my mind off the pain a little,” says Colling. “Many of the veterans we support at Help for Heroes have spoken about how gaming has been a valuable part of their life when used appropriately,” Bott adds.

What’s next?

With burdened healthcare systems stretched further post-Covid, studies and companies are exploring how advancing tech can respond in today’s mental health landscape.

However, amid the growing need for accurate understanding, informed treatment and support, questions remain around the balance between at-home technology and clinician-focused healthcare.