You’re standing on a beach. At your feet, waves gently lap against the sand. In the distance, the sun slowly sets into the sea. Your mind, once a frenetic jumble of stresses and worries, clears – you’re now focussed solely on the water in front of you. Slowly, the beach and its waves recede into the distance as you slip the headset off – a physical reminder that the idyllic scene wasn’t real, but a digitally rendered environment created by the Dream Machine, a virtual-reality (VR) system designed to improve mental wellbeing.
Invented by Dr Jamil El-Imad, a research fellow at London’s Imperial College, the Dream Machine is one of a new wave of VR systems in healthcare. Users put on a VR headset and engage in a virtual meditation while the system monitors concentration level and relaxation.
“When a user puts the headset on, they’re presented with various location options, like a beach or a mountainside monastery,” says El-Imad. “After looking at the setting they like most, it automatically loads, immersing them in the virtual, but realistic-feeling, environment.”
As they begin to meditate, electrodes embedded in the headset measure brainwaves to determine how concentrated they are on the scene in front of them. If they’re focussed, they will see the scene clearly. But if they’re not, a misty fog will fill the space. The more they concentrate, the clearer it is. At the end of the experience, users are given a score reflecting how well they’ve concentrated – a gamified feedback system that encourages users to improve their mindfulness with each session.
“Mindfulness is about focussing on the moment, creating a sense of awareness and training your brain to let your thoughts flow,” says El-Imad. Recent studies have shown it to be as effective as psychiatriatric medications in alleviating mental health issues such as anxiety, depression and post-traumatic stress disorder (PTSD) and, as a result, innovation and research into its use as a treatment for mental health issues has boomed.
“We don’t truly understand how the brain works, but until now the focus has been on pharmaceutical treatments. Going forward, I think it’s important to look seriously into science-based, non-pharmaceutical alternatives,” says El-Imad. “The Dream Machine was built around the idea of neuroplasticity – the fact that we aren’t hard-wired, and experiences can change the way our brains process and deal with experiences.”
As research has proven successful, healthcare systems have moved to incorporate the treatment into their offering. In February 2018, the National Health System (NHS) in the UK awarded £4 million ($5.2 million) to enable state-of-the-art psychological VR therapy. The project, led by Professor Daniel Freeman of the University of Oxford’s Department of Psychiatry, brings together a team of NHS trusts, universities, a mental health charity, the Royal College of Art and a University of Oxford spin-out company.
Unlike the Dream Machine, the NHS project uses exposure therapy where a virtual coach takes participants into computer-generated simulations of situations they find troubling. For example, role-play scenarios may take patients through a VR bar or drug den, helping recovering alcoholics or drug addicts develop coping strategies for real-world situations where they will be most at risk of slipping back into drink or drugs.
Sitting at a virtual bar, a VR bartender will offer an alcoholic a drink. Glasses are clinking all around and jovial chatter fills the air. A coach then helps them through the process, encouraging them to practise techniques to overcome their difficulties. Encountering the situation may be overwhelming in the real world, but “patients often find it easier to do this work in the virtual world”, says Freeman. “The beauty is that the benefits transfer to the real world.”
VR systems could also be modified to help addicts’ loved ones empathise with their experiences and, critically, provide an opportunity to dramatically increase the number of people who can access the most effective psychological therapies.
In the UK, mental health conditions affect approximately one in four people each year but, as recently as 2016, government-supported mental health programmes received just 13 percent of the total NHS budget. Meanwhile, the budget for adult social care, which provides ongoing mental health support, has been cut in real terms by 13.5 percent in England over the eight years to 2018.
“Our new treatment is automated – the virtual coach leads the therapy – and it uses inexpensive VR kit, so it has the potential for widespread use in the NHS,” says Freeman.“Over the next three years this major investment should lead to real and positive change in services for patients.”
While the hardware for these systems is expensive today, exponential advances in technology mean VR systems could get to a place where they’re affordable enough to be in any home, office or school in the near future.
“Just look at computing – in the last 20 years, we’ve democratised information to the point that anybody can find the information they want instantly. As VR devices become cheaper and better, we’ll continue to move towards democratising experiences in the same way – more and more people will be able to experience what it’s like to stand on the edge of the Grand Canyon, fly or use a tool like the Dream Machine to help build mental resilience,” says El-Imad.
While VR isn’t a panacea for a mental health crisis, behaviour is affected by experiences. “If we’re able to provide a virtual experience that’s so lifelike it is a reality substitution machine, the possibilities for mental health care are fantastic.”
Wednesday 10 October is World Mental Health Day. To highlight this, Culture Trip is looking at how different societies are shining a light on this important issue in innovative and alternative ways.
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If you are experiencing mental health issues, in the UK, Samaritans can be contacted on 116 123 or email firstname.lastname@example.org. You can contact the mental health charity Mind by calling 0300 123 3393 or visiting mind.org.uk. Please note there are no affiliations of any kind between the aforementioned organisations and Culture Trip.