You’re standing on the ninety-ninth floor of the Empire State Building. Far below you the cars stream down Fifth Avenue like ants. Two months ago you had vertigo so severe that you experimented with VR treatment to alleviate your anxiety. By your seventh session you were cured, on top of the world, literally. 

Doctors first used virtual reality as a mental health treatment back in 1995. Researchers assessed its effect on ‘anxiety, avoidance, attitudes, and distress associated with exposure to heights.’ Buoyed by the results, a slew of similar studies explored the promise of VR for treating aviophobia (fear of flying), claustrophobia, and PTSD.

Fast forward to 2024, and VR has evolved from the research labs of universities to the living room of millions, and even the world’s largest healthcare employer, Britain’s NHS. As prices fall and the tech improves, mental health innovations will soon be available to all. With the number of mental health issues increasing year-on-year, it can’t come soon enough.

“One of the most limited resources in mental health treatment is having access to a therapist,” notes Professor Daniel Freeman, Chair of Psychology at the University of Oxford, an NHS psychologist, and founder of mental health startup, Oxford VR. “We have a huge amount of mental health problems and lack the capacity to treat them all.”

Automation is one solution: remove the physical therapist from the treatment. Created by Daniel, the Phoenix programme is an automated VR therapy designed to improve the self-confidence of individuals diagnosed with psychosis. Instead of a therapist, a virtual ‘coach’ (with a recorded human voice – no AI for now) accompanies patients, typically aged 16-30, through a series of virtual confidence-building environments.

“We have a huge amount of mental health problems and lack capacity to treat them all.”

— Prof. Daniel Freeman, Chair of Psychology at the University of Oxford and founder of mental health platform Oxford VR

Tasks include farming activities that help patients master new skills, public speaking scenarios that challenge them to face their fears, and relaxation exercises that teach them how to care for themselves. “VR provides a safe environment that is flexible and thought-provoking enough for a person to acquire new learnings,” Daniel explains, noting that all these skills and behaviours can be transferred to the real world. 

Powered by Meta Quest headsets and rooted in cognitive behavioural therapy, Phoenix is currently going through trials. Preliminary results have been encouraging, with patients demonstrating growth in self-confidence and overall psychological well-being.

One of the team’s projects is gameChange, VR therapy programme that helps patients with social anxiety and the psychiatric symptoms that often accompany it: depression, delusions, and hallucinations. Symptoms that can make it difficult or impossible for patients to leave their home.

“VR is our most popular intervention.”

— Prof. Daniel Freeman, Chair of Psychology at the University of Oxford and founder of mental health platform Oxford VR

Developed alongside the NHS, gameChange immerses patients in simulations of everyday situations, from cafés, shops, and busy streets to doctors, buses, and pubs. In the largest ever randomised controlled trial of a VR treatment for mental health, gameChange “significantly reduced anxiety and distress in everyday situations.”

Perhaps best of all, these benefits were still effective six months after the treatment. GameChange is now the first VR treatment recommended by the NHS, and is being received with open arms by those who need it most. “Reception from people with mental health problems has been extraordinarily positive,” says Daniel. “It’s our most popular intervention.”

While it’s being explored in the UK to treat anxiety, American researchers are trialling VR to treat the trauma of war. Almost 300 million people globally experience some form of PTSD in a given year, military or otherwise, and projects like Bravemind and STRIVE are pioneering ways to treat PTSD for US veterans that could be applied well beyond combat.

As well as anxiety and PTSD, sufferers of depression, burnout, loneliness, and addiction could all soon be treated with virtual reality. And why stop there? Virtual worlds could be used as a broader educational tool, letting people confront phobias in a safe and accessible environment. Daniel suggests that one day we could see “a full suite of VR products that help you maximise your psychological state.” The headset really will see you now.