VR therapy for severe mental health conditions to be trialled in NHS patients

VR is a potentially powerful tool for mental health care, given that many conditions are inseparable from certain environments, said Professor Daniel Freeman, the Oxford University psychologist leading the project.

“If we have a fear of heights, that’s really connected to being at a height; if we’re socially anxious, that’s about our social situations,” he told E&T.

“The way to overcome these problems is to go back into these situations and relearn how best to think and feel and behave in them. You constantly know that it’s not real and that allows you to do things that you couldn’t in the real world, but your mind and body behave as if it’s real despite the constant awareness. That’s the fantastic thing about it.”

This NHS trial will focus on patients with schizophrenia diagnoses who struggle with fear and withdrawal in real world scenarios, seriously affecting their physical and mental health.

“What we find is that many of these patients [with schizophrenia diagnoses], despite treatments, are still left with residual problems - anxiety, depression, paranoia, voices - that makes them fearful and they retreat from everyday life,” said Freeman. “A journey to the shops is difficult, for example.”

In the sessions, the patients will explore different sections of a virtual shopping centre alongside their VR ‘coach’, which provides assessment and guidance using cognitive therapy. The six 20-30 minute scenarios are graded for difficulty, with the more challenging scenarios featuring larger crowds. Eventually, the patient will be asked to enter situations without the virtual coach.

Some interaction with the coach is possible using voice recognition technology, although there is potential in the future to develop smarter coaches which allow for more interaction.

Pilot studies suggest that the benefits gleaned in VR simulations tend to be transferred to real life.

The first phase of the project will look into ensuring that the equipment is easy to use. This will be followed by a large clinical trial in NHS trusts. Finally, researchers will demonstrate how it could be deployed across the NHS. Although smaller studies have been conducted with NHS patients before, this is the first time VR has been deployed in a routine health service setting.

The project is led by Freeman and his colleagues, but also involves NHS trusts, a mental health charity, the Royal College of Art and a spinout company from the University of Oxford. It has been made possible with a £4m grant from the National Institutes for Health Research.

Researchers hope that this VR therapy could become accessible on the NHS within just three years.

Freeman hopes that this trial could pave the way for patients with common mental health disorders such as depression and anxiety to be supported with VR therapy. This could be useful as a treatment for almost all mental health conditions, as well as for general psychological wellbeing, he said.

In April 2017, a Leicester hospice announced that it would be rolling out an original VR app for its terminally ill residents, which allows them to enjoy experiencing a familiar location from the comfort of their chair.

Despite the potential use of VR therapy in treating common mental health conditions, Freeman clarifies that VR therapy should supplement existing therapies, not replace them. Human therapists are often more reassuring than a computer and can respond to complications that their virtual counterparts cannot.

“We rely on having highly skilled therapists there and they’re in short supply. To train up the amount of people who are needed would be very, very expensive, particularly in the current climate […] whereas in VR you’ve got the potential to deliver it at very low cost,” he said. “That’s not to say we’d want therapists replaced, it’s just a way of greatly increasing access.”

Freeman is optimistic and confident about the NHS trial, given the “extraordinarily good” pilot data collected from smaller scale studies.