How can we improve outcomes for people with severe mental health difficulties?
The issue is an urgent one: all too often, individuals with psychosis find day-to-day life so anxiety-provoking that they simply withdraw. Everyday tasks — getting on a bus, doing the shopping, speaking to other people — become very challenging. Work and home life suffer. And mental and physical health deteriorate.
Psychological therapy can be very beneficial here. But it needs to be the right kind of therapy. What works best is active coaching in the situations that trouble people, helping patients move beyond their fears. However, this is difficult without a skilled therapist who has the time to get out and about with patients. And patients often find the idea frightening. The result is that a potentially powerful treatment is seldom actually delivered.
This is why we’re so delighted to be the first winners of the NIHR i4i Mental Health Challenge Award. We believe it will enable us to help transform the lives of many NHS patients with severe mental health problems, dramatically increasing access to the most effective types of psychological intervention. How will we do this? By delivering high quality automated psychological therapy using state-of-the-art immersive virtual reality technology.
In our VR we take people into sophisticated simulations of the real-life scenarios they find troubling. We do it in a graded way, so patients aren’t presented with situations they really can’t cope with at first. And we make it fun. Patients find it easier to do this work in the virtual world – and they enjoy using our VR applications. As one of our pilot study patients commented: “It’s an incredible experience.” But the beauty is that the benefits transfer to the real world.
One of the most innovative features of our VR is our virtual therapist. A friendly computer-generated avatar, voiced by a real person, carefully guides the patient through the therapeutic work, helping them practise techniques to overcome their difficulties. In effect, the treatment is automated, making it a low-cost yet effective complement to existing care.
gameChange comprises three main stages. First is the design and development of the VR treatment, building on the work we’ve done over many years. Completely re-programming our treatment we will produce a six session automated treatment that’s easy to use, engaging, and right for patient needs. Stage two is a large multi-centre clinical trial in NHS trusts across the country to demonstrate the benefits of the VR treatment. The third part of the project will see us develop an implementation package and roadmap to roll out the treatment across the NHS.