Dr Nigel Whittle, head of medical and healthcare at design and engineering consultancy Plextek, looks at the devastating effects of lockdown on mental health and considers the varying uses of VR technology in combatting the rise in anxiety, depression and feelings of hopelessness.
According to the Mental Health Foundation, Coronavirus: Mental Health in the Pandemic Study, there has been a divergence in people’s experience of its effect on mental health; depending on their socioeconomic context, age group and pre-existing issues. These persistent differences are likely set to increase.
Those affected by socioeconomic inequalities, are aged 18-24 and who had mental health problems prior to lockdown have been more likely to experience anxiety, panic, hopelessness and loneliness. Most worryingly, as of the end of June, one in 10 of those people reported having had suicidal thoughts.
Additionally, many of the supports for people with mental health problems, such as one-to-one therapy, psychiatric appointments, training courses, volunteering and supported employment opportunities, came to a halt overnight.
Particularly, peer support, community resources and everyday enjoyable leisure activities had to pause, resulting in the loss of overall help for many.
As a result of this perfect storm, their mental health conditions have become exacerbated. Very worryingly, these very people have reported suicidal thoughts at triple the rate of those in the general population.
The study consistently found that young adults were more likely to report stress arising from the pandemic. Findings from the third week in June showed they were more likely than any other age group to be negatively affected, owing to the triple whammy of curtailed education, diminished job prospects and reduced social contact with peers.
This age group is already statistically a time of high risk for experiencing a mental health problem: three quarters of mental health problems arise before the mid-twenties.
Looking at those who are slightly younger, findings from the charity, Young Minds, based on a survey of 2,036 teenagers with a history of mental health needs, revealed 80% of respondents agreed the crisis had made their mental health worse in June and July – up from 32% last March.
Cited were feelings of increased anxiety, isolation, loss of being able to cope and loss of motivation. Among more than 1,000 who had been accessing support prior to March, from the NHS, school counsellors, private providers, charities and helplines, 31% said they still needed the support but were unable to access it.
So, what can we do now in terms of new and emerging VR technologies to help with planning public services and support?
VR usage has come on leaps and bounds since the days of its association with gaming and via public attention in the 1980s and 90s through blockbusters such as The Lawnmower Man. Devices like Oculus Rift, with its entertainment heritage and a $2 billion investment from organisations such as Facebook, have elevated VR to a serious technology hot topic.
A recent study published in the Journal of Medical Signals and Sensors showed VR can be helpful in treating claustrophobia. This adds to the emerging and promising research using it in addressing anxiety disorders, including social anxiety.
It can also be applied to exposure therapy, a type of behavioural therapy which puts the person in real-world situations that triggers the anxiety and, over time, can face the threatening condition with less anxiety.
Other studies have found VR can help shorten the length of treatment, saving on time and cost and helping the actual therapists become more accessible either in person or remotely, and in settings like hospitals and emergency rooms.
VR offers the opportunity to develop more personalised therapeutics, especially in mental healthcare. It is already being used to treat PTSD, phobias and psychiatric conditions such as conversion disorder and showing excellent results.
VR systems are now both affordable and easy to install and set up, enabling the technology to be pushed forward for widespread adoption in the very near future.
Commonplace commercial applications of the technology can enable all kinds of amazing virtual experiences to those suffering mentally. It also allows for safer, controlled environments provided inside a headset.
We will also be able to use mobile devices and smartphone apps which will be available in the home, schools and community spaces, opening up access to its use in treatment for people who otherwise may not have been able to afford the time and money needed to be sat on the traditional, proverbial psychiatrist’s couch.
VR can also aid diagnosis because it can immerse each patient in the same scenario. For this reason, some researchers believe that VR-based diagnostic testing for conditions like schizophrenia, ADHD and autism could offer more objective results than traditional interview-based methods. It’s also possible that it could be used to augment or replace traditional mental health therapy for some.
Smartphones like Joyable walk users through five-minute activities based on the principles of cognitive behavioural therapy, so why not employ a VR version? This in turn could again make mental health treatment more accessible, as just mentioned.
Many people with mental health issues still go untreated due to a shortage of qualified clinicians, long waiting lists and, as ever, the associated stigma.
As VR-enabled therapy is automated and the ‘therapist’ is embedded within the programme as an avatar, it enables evidence-based treatment to be delivered faster than traditional therapies and could result in a large increase in the number of patients who can be treated.
It has previously been said that parents feel as though they have ‘lost’ their child to mental illness. VR solutions could have the potential to turn this perception on its head and help both the family and the patient understand and cope with mental, as well as, physical conditions.
By 2030 patients will be utilising VR as an effective distraction technique. Excessive trauma can be subdued by creating an immersive environment that ‘distracts’ the patient transporting them to a calming environment that enables ‘normality’ to resume and the associated anxiety to be reduced.
Escapism is a great part of VR and changes the way patients psychologically view the world and their (and others’) health issues. It offers a much more personalised rehabilitation approach that can be tailored to the specific needs, wants and levels of degree required by each individual patient. When it comes to mental health, one size never fits all.
The pandemic and resulting lockdown measures, along with their effect on the economy, are bringing about massive societal changes. We might all be sailing on the same rough sea, but as said, not in the same boats and do not have the same equipment to navigate these choppy waters. As a developed society we have a duty not to leave anyone behind.
In many ways we were already experiencing a mental health crisis before this time. The bandied-about phrase from politicians ‘building back better’ for mental health should start right now, by adopting a public health and prevention approach – as prevention is way better than cure. VR could well be the way in which this goal is achieved.