Do you find you are spending more and more time on your phone, scrolling through your social media feeds? 

Will the new Instagram Threads age well and continue to grow in popularity and usefulness, or will it go the way of many social media platforms and programs that have a use-by date and sink quietly into oblivion?

The World Economic Forum included using the metaverse to improve mental health outcomes for people. In other words, this is using screen time to build connections in shared virtual spaces to assist in combating the growing mental health crisis instead of contributing to it.

It is well known that excessive screen time and social media use can lower psychological well-being, particularly in adolescents and children^[1].

Yet in the 2023 Flagship Report on the Top Ten Emerging Technologies for 2023, the World Economic Forum included using the metaverse to improve mental health outcomes for people. In other words, this is using screen time to build connections in shared virtual spaces to assist in combating the growing mental health crisis instead of contributing to it.

The impact of mental health issues has increased both in Australia and in Singapore since COVID-19.

The mental health impact in Singapore

COVID-19 added to the stressors facing many young people in Singapore, with home-based learning creating a sense of isolation and the ongoing pressure to perform academically. The recession caused by the pandemic also increased the anxiety of youths as they faced an uncertain future. Hence, for many Singaporean young people, the pressure to achieve academically, social isolation and increasing anxiety about the future has contributed to rising mental health issues. In 2021, the youth suicide rate in Singapore reached a five-year high.

Graduating from the education system does not mean that Singaporeans are leaving the pressure cooker lifestyle of the education system behind. The already stressed-out youths enter an even more demanding workplace. Employees in Singapore tend to work long hours. This only worsened with COVID-19 when personal and professional boundaries became blurred with working from home. It is thus unsurprising that Singaporean workers report high levels of burnout and the associated mental health conditions of depression and burnout.

The cost of treatment, especially in the private healthcare sector, is a significant deterrent for many Singaporeans. While public mental healthcare is subsidised, where people are experiencing acute symptoms and cannot wait, many must pay hundreds of dollars out of pocket for a session with a mental health professional in private practice. This puts effective mental health treatment out of reach for many. When surveyed, Singaporeans rated the effectiveness of treatment for mental health issues such as suicide in the country as average.

The mental health impact in Australia

From the 2021 NSMHWB (ABS 2022a), it is estimated that:

●    1 in 5 (21%) people who had experienced a mental disorder in their lifetime had symptoms in the 12 months before the survey interview. For these people, anxiety disorders were the most prevalent type of disorder (17%), followed by affective disorders (8%) and substance use disorders (3%).

●    A higher proportion of females than males (45% compared with 43%) had experienced a mental disorder in their lifetime, with a higher proportion of females than males (25% compared with 18%) also experiencing symptoms in the 12 months before the survey.

●    16–24-year-olds (40%) were most likely to have experienced symptoms of a mental disorder in the previous 12 months, while those aged 75–85 years were the least likely (4%).

Hence, both Singapore and Australia share similar experiences in the mental health area that include:

a)     Increasing number of people within the community experiencing mental health issues.

b)     Rising cost of mental health care. 

c)     Mental health services unable to keep up with demand. Within the United States, it is estimated that the psychiatrist workforce will contract through 2024 to a projected low of 38,821. This equates to a shortage of between 14,280 and 31,091 psychiatrists. Although these are US figures, they are not unique because Australia and Singapore also face a shortage of trained professional staff to deal with the rising incidence of mental ill-health within the community.

Given these factors, the inclusion by the World Economic Forum of the metaverse as a virtual reality space where people can interact with a computer-generated environment and other users in real time for mental health support and well-being makes sense.

How the metaverse can assist with the delivery of mental health services

The metaverse can be utilised to provide mental health services in several ways.

1. Virtual Therapy and Counselling

The metaverse can provide a platform for virtual therapy sessions, allowing individuals to connect with mental health professionals remotely. This can improve accessibility and convenience, particularly for those with limited access to in-person therapy or who live in remote areas.

2. Immersive Relaxation and Mindfulness

Virtual reality experiences within the metaverse can offer immersive and calming environments that promote relaxation and mindfulness. These experiences can help individuals reduce stress, anxiety and improve their mental well-being.

3. Social Support and Community

The metaverse can serve as a space for people to connect with others who share similar experiences or struggles. Virtual support groups, communities, and social networks can provide a sense of belonging, reduce feelings of isolation, and allow individuals to share their stories and support each other.

4. SKILLS TRAINING AND EXPOSURE THERAPY 
Virtual reality simulations within the metaverse can be utilised for skills training and exposure therapy for various mental health conditions, such as phobias or anxiety disorders. By creating controlled virtual environments, individuals can gradually face their fears or practice new coping strategies in a safe and controlled manner.

5. Education and Psychoeducation
The metaverse can offer a platform for mental health education and psychoeducation programs. Interactive virtual environments can provide engaging and informative experiences to teach individuals about mental health, promote self-care practices, and raise awareness about different conditions.

6. Avatar-based Self-Expression

In the metaverse, individuals can create avatars that represent themselves. This can allow people to express themselves freely, explore aspects of their identity, and engage in self-discovery. Avatar-based self-expression can be empowering and supportive for those who may feel restricted or judged in their physical lives.

Gaming platforms are already being used for mental health treatment. Such platforms increase patient engagement and help destigmatise mental health issues. For example, DeepWell Therapeutics has created video games to treat depression and anxiety; UK-based Xbox studio Ninja Theory has incorporated mental health awareness into mass-market games and plans to expand into treatment with their Insight Project.

However, it is essential to note that while the metaverse can benefit mental health, there are potential issues and drawbacks that must be considered. Some of the potential risks associated with the metaverse include:

1. Lack of Human Connection

While virtual interactions, even in immersive environments, are better than nothing, they cannot fully replicate the depth and nuances of in-person human connections. This could lead to isolation or detachment, especially for individuals who rely on genuine social interactions for their mental well-being.

2. Unrealistic expectations

The metaverse might create unrealistic expectations for what mental health support can provide. Virtual reality experiences can be powerful but should not be seen as a substitute for professional therapy or medical interventions. People might expect quick fixes or immediate solutions to complex mental health issues, which can lead to disappointment or even exacerbate their conditions.

3. Accessibility and inclusivity

While the metaverse has the potential to provide support to a wide range of individuals, it also introduces new challenges related to accessibility and inclusivity. Only some people can access the necessary technology or skills to navigate virtual reality environments. This could create a digital divide, further marginalising those who already face barriers to mental health support.

4. Data privacy and security

The metaverse relies heavily on collecting and analysing user data to create personalised experiences. This raises concerns about data privacy and security, as personal information could be exposed or misused. Moreover, collecting sensitive mental health data could have long-term implications, including potential discrimination or stigmatisation.

5. Ethical concerns

The use of virtual reality for mental health support raises ethical questions. For example, there is a risk of potential exploitation or manipulation of vulnerable individuals within the metaverse. Additionally, issues related to informed consent, data ownership, and the boundaries of therapeutic relationships need careful consideration.

6. Addiction and overreliance

Immersive virtual environments have the potential to be highly engaging and addictive. If individuals start relying excessively on the metaverse for mental health support, it could lead to a neglect of real-world relationships and responsibilities, ultimately worsening their mental well-being.

Adopting a cautious and evidence-based approach is crucial when integrating the metaverse into mental health support to address these risks.

Thorough research, ethical guidelines, and the involvement of mental health professionals are necessary to ensure the responsible and safe use of these technologies. Providing these risks are recognised and managed effectively and ethically, there is the possibility that the metaverse may be a tool to assist in improving some people’s mental health.

[1] https://www.sciencedirect.com/science/article/pii/S2211335518301827