Virtual Reality Technology to Treat Mental Illness

Yufei Li

BA(Hons)Computer Animation and Visual Effects, Bournemouth University, St Peter’s Rd, Bournemouth, U.K.

Keywords: Virtual Reality Technology, Immersive Interaction Technology, Mental Illness, Personalized Treatment

Experience.

Abstract: Virtual reality is a new technology of immersive interaction. A 3D model created by a modeler, animators,

etc. are used to interact with users and bring a sense of realism to users. Therefore, it has contributed to

blanching achievements in different fields. It has shown great application potential in the field of medical

health. For example, VR treats mental illness (depression, anxiety, PTSD, etc.). Because of the limitations of

traditional mental illness treatment, such as the treatment environment is difficult to simulate real-world

scenarios, and patient engagements is insufficient. Virtual technology of traditional psychotherapy by building

a highly simulated virtual environment to provide patients with a safe, controllable and personalized treatment

experience. Therefore, virtual reality technology has a significant role in the treatment of mental illness. This

paper aims to review the application status, research achievements, theoretical basis, research gaps and

innovations of VR technology in the treatment of mental illness.

1 INTRODUCTION

Virtual reality technology, as a new immersive

interactive technology, has shown great application

potential in the medical and health field in recent

years, especially in the treatment of mental illness.

This research was proposed in the 1960s, and today,

it has moved from the laboratory to the clinical and

applied. Traditional psychological disorders, such as

cognitive behavioral therapy (CBT), psychoanalytic

therapy, and humanistic therapy. Traditional

treatments for mental illness rely on the patient's

imagination and recollection. The effect of traditional

mental illness treatment is often limited by subjective

factors, such as the treatment environment is difficult

to simulate the real scene, and the patient's

participation is insufficient

(Koronka, 2025). Virtual

reality creates a simulated 3D environment, enabling

patients to confront fears in a secure, controlled

setting, alleviate stress, and transform cognition

(Emmelkamp et al., 2021). This way breaks through

the limitations of traditional treatment, so it opens up

new possibilities for psychological treatment. From

post-traumatic stress disorder to anxiety disorders,

phobias to depression, virtual reality technology is

changing the approach to psychotherapy. This

https://orcid.org/0009-0004-6561-8175

technology not only improves the treatment effect,

but also promotes the development of psychological

treatment to the direction of precision and

individuation.

In the treatment of mental illness, the widely used

technology is VR technology. Because of the

effectiveness of VR technology, it covers a variety of

mental illnesses. Such as anxiety disorders, post-

traumatic stress disorder (PTSD), phobias,

depression, and many other mental illnesses. In the

study, patients released their stress through realistic

scenes of VR technology, no longer overthinking and

depression and other emotions, so it is very effective

in treating mental health problems.

However, despite the significant advantages of

VR technology in the treatment of mental illness, its

application still faces many challenges. First, the high

cost of the technology limits its popularity in the

clinic, and not all patients have the opportunity to

choose VR to treat mental health problems; Secondly,

the realism and interactivity of virtual reality

environment still need to be further improved to

enhance the patient's sense of immersion and

treatment effect. Creating a realistic virtual

environment requires the help of animators, modelers

and illustrators. During this period, numerous

168

Li, Y.

Virtual Reality Technology to Treat Mental Illness.

DOI: 10.5220/0013680500004670

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 2nd International Conference on Data Science and Engineering (ICDSE 2025), pages 168-174

ISBN: 978-989-758-765-8

technical problems and limitations arose. Therefore,

the reality and interactivity of virtual reality

environment are still the key points of whether mental

illness can be treated by VR technology; Finally, the

long-term effects and safety of VR therapy still need

to be further validated through large-scale clinical

studies (Saeed, et al. 2024).

This paper discusses the application status of VR

technology in the treatment of mental illness,

advantages and challenges, and looks forward to its

future development direction. Through the review

and analysis of the existing research, this paper will

provide theoretical basis and practical guidance for

promoting the in-depth application of VR technology

in the field of psychotherapy.

2 MANUSCRIPT PREPARATION

Virtual Reality (VR) technology, as a new immersive

interactive technology, has been widely concerned in

the field of mental illness treatment in recent years.

By building a highly simulated virtual environment,

it provides patients with a safe, controllable and

personalized treatment experience, making up for the

shortcomings of traditional psychotherapy. The

purpose of this paper is to review the application

status, research achievements, theoretical basis,

research gaps and innovations of VR technology in

the treatment of mental illness.

3 STUDY THE MAIN MENTAL

ILLNESS

3.1 Anxiety

Anxiety. Research has shown that anxiety is often

thought of as an adaptive response to a potential threat

and occurs when individuals exhibit extreme

behavioral tendencies. On the one hand, excessive

caution causes individuals to disengage from the

environment and prevents people from correcting

inaccurate perceptions. Excessive carelessness, on

the other hand, enables individuals to be in constant

contact with their surroundings, enabling them to

quickly identify and correct mistakes. As a result,

high sensitivity to perceived threats becomes

common, while insensitivity to actual risks becomes

rare. The researchers believe that this imbalance may

lead to pathological anxiety in humans (Frazer & Carl

T，2016).

3.2 PTSD

Post-traumatic stress disorder (PTSD) is an important

psychiatric illness occurring following trauma. This

condition is characterized by symptoms in the form

of intrusional recollections, repeated dreams related

to trauma, and flashbacks; avoidance of trauma-

related stimuli; negative views regarding oneself, the

world, and future; increased arousal; and alterations

in sleep patterns. Treatment is established by clinical

evaluation of these traits. Psychotherapy is employed

in most patients in preference to pharmacological

treatments for certain symptoms in certain patients

(Barnhill & New York-Presbyterian Hospital, 2023).

The World Health Organization has carried out

investigations regarding post-traumatic stress

disorder (PTSD). In its conclusion, the World Health

Organization defines the characteristics of PTSD. As

opposed to widespread myths, post-traumatic stress

disorder is not just caused by suffering distress or

experiencing other psychological problems in

response to a traumatic experience since scientific

proof suggests otherwise. Symptoms of post-

traumatic stress disorder include reviving the

traumatic experience, avoidance of individuals or

contexts related to the experience, increased arousal

with notable distress, and interference in regular

routines and family, social, academic, or work-related

pursuits. Post-traumatic stress disorder victims

commonly experience intrusive recollections about

distressing experiences, making them experience

things as though the experience is recurring. Other

factors including family background problems related

to psychiatric diseases, an earlier age, and fewer

school years achieved in school work significantly

increase vulnerability to developing post-traumatic

stress disorder in response to a potentially traumatic

experience. Such recollections are commonly

preceded by intense fear or fearfulness. Sensory cues

including visible images, audible sounds (for

example, sounds produced by gun-shooting), smells

(for example, smell by an aggressor) or touch can

trigger such recollections. The recollection can take

the form of intruding thought, nightmare or in

extreme forms, flashbacks. When in a flashback

episode, an individual responds and reacts just like he

is transported to the period in life during which this

traumatized situation happened, repeatedly

experiencing in vivo the dangerous situation. Post-

traumatic stress victims can also experience

depression, fear, substance dependency diseases, in

addition to suicidal thoughts and conduct. Physical

stress and harmful drinking have been known to be

factors causing various diseases including

Virtual Reality Technology to Treat Mental Illness

169

cardiovascular diseases. Post-traumatic stress

disorder can be treated by psychological

interventions, including trauma-focused cognitive

behavioral therapy and eye movement desensitization

and reprocessing therapy. Many treatment methods

incorporate exposure methods, where the victim

narrates, explains, or imagines the trauma in order to

trigger recollections in distress in an organized and

safe manner. Actual or virtual presentation to

provokes that can induce trauma-related recollections

can be an essential part of psychological treatments in

post-traumatic stress disorder (WHO，2024).

3.3 Depression

Depression represents a widespread psychiatric

condition in human society. Characteristically, its

symptoms present in the form of continuous low

spirits or decreased enjoyment or pleasure in various

undertakings. During an episode of depression,

patients experience feelings of sadness, irritability, or

empty feelings. At the same time, various symptoms

present in combinations. Further symptoms can be in

the form of difficulty in concentration, over-guilt or

feelings of worthlessness, feelings of hopelessness

about the future, suicidal or death-related thought

patterns, changes in sleep patterns, changes in eating

patterns or body weight, and presence of extreme

fatigue or decreased energy. One should note that

depression can present in various patterns. Patients

can have three types of episodes: single episode

depression, which refers to the patient's first and only

episode; recurrent depression, where patients have

had at least two previous episodes; and bipolar

disease, where manic symptoms alternate with

depressive symptoms. During manic phases, patients

can present with increased agitation or irritability,

increased activity or increased energy. Other features

can be increased talkativeness, increased flow of

thought processes, increased confidence in himself,

decreased amount of needed sleep, distractibility, and

acting in an impulsive manner or in an uninhibited

manner. The etiology of depression is

multidimensional in etiology, including both social

factors, psychological factors, and genetic factors.

Patients can have an increased risk of developing

depression in response to an unfortunate experience

in life, e.g., job loss, grief, or various distressing

occurrences. Additionally, extended bouts of down

spirits or intense stress can lead to additional

psychiatric conditions in patients. Management of

depression is inextricably related to physical

condition because various factors causing

development, remittance, or effecting depression

have in-depth interconnection to patients’

physiological status. Patients frequently have below-

average rates of physical exercise in addition to

patterns of binge drinking, both factors that have been

correlated with an assortment of diseases including

cardiovascular disease, cancer, diabetes, and

pulmonary diseases. Physical inactivity interacting

with these factors can lead to the resultant

development of depression. On the other hand, it is

imperative to realize that patients suffering from these

diseases can suffer from depression because of the

difficulty in coping with both physical illness and

emotional well-being. Current programs by the World

Health Organization (WHO) towards prevention have

been proven to reduce symptoms in patients suffering

from depression. As an illustration, the WHO Mental

Health Gap Action Plan (mhGAP) emphasizes

identifying depression and attempted suicide/self-

harm as essential factors in screening for depression

in priority areas in mental illness. This system

provides patients with easier accessibility to

treatment through non-psychiatric providers who get

support in treating individuals suffering from

neurological diseases, substance dependency, and

psychiatric illness by the WHO. Additionally, the

World Health Organization has developed an

abridged guide to providing psychological therapy to

patients suffering from depression by trained lay

counselors (WHO，2023).

4 RESEARCH ACHIEVEMENT

4.1 Anxiety treatment

Anxiety intervention. Evidence suggests that virtual

reality (VR) technology has a significant impact upon

the treatment of anxiety disorders. One example is

virtual reality exposure therapy (VRET) used to treat

certain phobias, including acrophobia (height fear)

and aviophobia (fear of flying) and social anxiety.

This entails the imitation of settings like a virtual

altitude scene or virtual queue situation. Furthermore,

building an intense social get-together atmosphere is

part of the process. Evidence suggests that VRET can

reduce symptoms in patients significantly. The

therapy outcomes achieved by this method equal or in

certain cases exceed those gained by conventional

exposure therapy (Powers & Emmelkamp, 2008).

4.2 PTSD treatment

Post-traumatic stress disorder (PTSD). VR

technology has also made important advances in the

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treatment of PTSD. By recreating traumatic scenes,

VRET helps patients gradually face and overcome

psychological trauma in a safe environment. Six

virtual reality treatments were associated with

reduced PTSD judgments and symptoms in Iraq and

Afghanistan veterans, although there was no control

condition for virtual reality exposure. Studies have

shown that VRET can significantly reduce symptoms

in PTSD patients and improve their quality of life

(Rothbaum et al., 2014).

4.3 Depression treatment

Depression. The use of VR technology in depression

treatment is also increasing. For example, VR

cognitive behavioral therapy (VR-CBT) helps

patients improve mood and cognitive function by

simulating positive situations and activities.

Preliminary studies have shown that VR-CBT can

effectively reduce depressive symptoms and improve

patients' feelings of self-efficacy (Falconer et al.,

2016).

5 THEORY OF THERAPEUTIC

METHODS

5.1 Exposure therapy

The theory of exposure therapy. Exposure therapy is

the main theoretical basis of VR technology in the

treatment of mental illness. Through repeated

exposure to fear or trauma-related virtual

environments, patients are able to gradually adapt and

overcome their psychological disorders (Rothbaum &

Hodges, 1999).

A separate study was carried out examining

virtual reality (VR) exposure therapy. This study

demonstrates the efficacy of technologically aided

single virtual reality exposure therapy (VRET) in

treating arachnophobia, using accessible consumer-

grade equipment and novel automated programs,

compared to established conventional practice, in

vivo single therapy (OST), in a parallel group

randomized non-inferior design. The results revealed

through linear hybrid modeling evidenced decreased

avoidance behavior and reported fear in both cohorts

upon completion of the treatment, with VRET

trending toward approaching the notable therapeutic

benefits of OST over time. No notable drift was

evidenced during the follow-ups conducted during

months 3 and 12, although notable deterioration was

not evidenced until month 12. Tests to detect negative

effects evidenced no notable differences between

both experimental treatments. This work confirmed

automatic VRET to reduce symptoms related to

arachnophobia in the short term while determining

that in the longer term, this was equal to in vivo

exposure therapy. Additionally, the efficacy trial in

VRET is designed to determine both true

effectiveness and non-specific therapy factors

developing during therapy that are influenced by

dosing technician intervention (Lindner, et al. 2019).

5.2 Cognitive behavioral therapy

Cognitive Behavioral Theory (CBT) is used to form

the theoretical background in this research. This study

aims to analyze the tenets of CBT to inform improved

patient care through alterations in their thought

process and conduct. Research has established that

virtual reality (VR) has immense potential in treating

psychiatric illness. Evidence is in support by proving

that virtual reality is rich in potential in psychiatric

condition management. However, effectiveness is

dependent upon seamless cooperation between

design professionals and researchers in virtual reality

to design true virtual environments since patients

respond in various ways; thus, developing

personalized and true environments is imperative in

each case. Economic and technical requirements are

thus anticipated to keep rising (Freeman et al., 2017).

The utilization of virtual reality therapy in

combination with Cognitive Behavioral Therapy

(CBT) has been investigated through an equivalent-

sized, single-blind, randomised controlled trial across

nine trusts in the United Kingdom's National Health

Service (NHS). Study participants included patients

who were over the age of 16 and who had been

diagnosed with spectrum schizophrenia or who were

exhibiting emotional symptoms related to psychosis,

in addition to difficulty leaving their residences

because of problems related to anxiety. Study

participants were randomised (1:1) to receive

gameChange VR in addition to usual treatment or to

continue to have only usual treatment. Randomisation

used block algorithms with block sizes varying by

both study site and by type of service delivered.

The gameChange VR app has been specially

created to target individuals suffering from

agoraphobia and related fears in usual contexts. It is

meant to aid individuals in reducing fear during social

interactions and in public contexts. The subjects

received six sessions over a period of six weeks

through the gameChange VR therapy. Clinical testing

revealed that with assistance by an expert in mental

health, noticeable improvement in avoidance

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171

symptoms and distress related to anxiety was

registered upon completion of these sessions.

Participation in therapy through virtual reality was

extremely engaging to the subjects. However, overall

effectiveness in treating was constrained by the

reality that most individuals in the treatment cohort

had low pre-baseline avoidance scores regarding fear,

leaving little prospect for noticeable change. Though

patients indicated partial remission to an extent, most

notable was in symptom relief regarding agoraphobia.

This is among the largest trials carried out to test

virtual reality treatments in treating psychiatric

conditions. The gameChange VR simulation gave

patients a chance to practice coping in true life

contexts, including leaving their residence, attending

cafés, shopping, attending doctor visits, and taking

transit. Sessions have been created in collaboration

with individuals who have suffered psychiatric

problems to guarantee that the treatment is responsive

to problems in true life.

Compared to standard treatment alone, game

change VR treatment significantly reduced fear

avoidance and distress in everyday life. Patients with

severe difficulties experienced moderate to

substantial improvements lasting up to 6 months,

particularly in controlling agoraphobia. The therapy

works by reducing exaggerated threat perception and

defensive behaviors, which are central to the

cognitive processes underlying anxiety (Freeman, et

al., 2022).

Explore self-compassion in VR. Another study

investigated whether immersive virtual reality

enhanced self-compassion in people with depression.

The researchers designed an eight-minute virtual

reality scenario in which 15 patients practiced

expressing compassion from one virtual body and

then receiving their own compassion in another

virtual body. In open trials, repeating this exercise

three times over four weeks significantly reduced the

severity of depression and self-criticism, while

significantly increasing self-compassion. Four

participants showed significant clinical improvement.

These findings suggest that immersive virtual reality

interventions have considerable clinical potential,

although further development and controlled trials are

needed to verify their effectiveness (Falconer, et al.

2016).

5.3 Biofeedback mechanism

Biofeedback mechanisms. Studies have shown that

combining virtual reality (VR) technology with

biofeedback systems enables patients to visualize in

real time physiological responses to therapy

interventions, including skin conductance and heart

rate. When used in virtual reality exposure therapy

(VRET), this combination provides an unprecedented

degree of control; therapists can adjust exactly the

degree of intensity, duration, and speed of exposure

to each individual's requirements. Additionally, in the

event of undue stress in a patient, therapy can be

stopped in an instant. Therapy effectiveness can be

increasingly improved by applying biofeedback to

achieve increased specificity and effectiveness

(Repetto et al., 2013).

A follow-up study emphasized problems related

to integrating systems of biofeedback, especially

tracking heartbeat variation in virtual reality (VR)

environments to support in situ adaptation in these

contexts. As an example, an automatic adjustment in

scene complexity in accordance with increased

patients' anxiety can induce feelings of calmness.

Military professionals including army troops, flyers,

and crew members work assiduously towards

integrating increasingly advanced and efficient stress

training programs. This systematic review discusses

an overview of experimental work carried out in

previous years examining virtual reality-grounded

stress management training programs among military

professionals. This novel and advanced technique has

immense potential to act as an efficient methodology

to support military officers in coping with stress

(Pallavicini, et al. 2016).

6 CHALLENGES AND

EXPECTATIONS

6.1 Cost and popularity

Technology cost and popularity. The research shows

that although VR technology has the possibility of

future development, it has not become a hot topic in

the world. The biggest limiting factor for the use of

VR in clinical practice is cost. The researchers did not

have the research funds to develop the clinical

application of VR technology and the corresponding

high application software. New software comes from

many laboratories around the world, and these

researchers test and develop VR for clinical use, so

the cost of developers is too high, and the price will

naturally increase, and the high cost of development

and VR technology needs to have safety and

effectiveness, so they continue to not be

commercialized. Because the development of VR

technology is too fast, the new technology will

replace the old technology, researchers need new

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equipment to continue research, and even overturn

the previous research data, so these problems hinder

the clinical development of VR technology (Bell, et

al, 2020).

6.2 Reality and interactivity of virtual

environment

The authenticity and interactivity in virtual contexts

have an essential role to play in ensuring greater

ecological validity, an essential goal in virtual reality

(VR) design. However, the degree of required

immersion to induce presence is an area in which

researchers continue to conduct extensive work.

Influencing this immersion is the display quality in

VR equipment (such as frame rates and resolutions)

as well as design factors (such as representing entities

in virtual contexts in life-like ways in an engaging

manner) and multi-modal interactivity. One notable

effect commonly referred to in VR is referred to as

the "valley of terror." This refers to the point where

humanoid entities in an otherwise believable virtual

context with minimal faults (such as unrealistic

breathing patterns) can elicit revulsion or unease in an

otherwise plausible situation. Curiously, avatars with

greater exaggeratedness avoid this effect better since

these elicit better responses in users compared to

humanoid presentations with increased reality (Mori

et al., 2012).

6.3 Personalized treatment

Personalized therapy is an essential pathway to

developing virtual reality (VR) technologies.

Research has shown that VR has the potential to act

as an efficient diagnostic tool in analyzing psychiatric

diseases, including depression, in addition to

providing personalized motivational factors tailored

to therapy, thus facilitating immense engagement

leading to beneficial therapy outcomes. Additionally,

incorporation of wearable sensors significantly

enables user interaction in the virtual reality domain,

thus further optimizing therapy processes (Waqas et

al. 2024).

7 CONCLUSIONS

This paper reviews the application status, research

achievements, theoretical basis and gaps of virtual

reality technology VR in the treatment of mental

illness. Studies have shown that VR technology is

effective in the treatment of anxiety disorders, PTSD

and depression, especially in exposure therapy and

cognitive behavioral therapy. Its theoretical basis

includes exposure therapy, cognitive behavioral

theory and biofeedback mechanisms, which provide

a scientific basis for VR therapy. However, the

application of VR technology still faces challenges

such as high technical cost, insufficient sense of

virtual environment, and long-term effect and safety

to be verified.

Future research should focus on reducing the cost

of technology, improving the realism and interactivity

of virtual environments, and verifying long-term

effects and safety through large-scale clinical studies.

In addition, combining artificial intelligence and big

data technology, the development of personalized

treatment plans is an important direction. Despite the

challenges, VR technology has great potential in the

treatment of mental illness and is expected to become

a mainstream treatment in the future.

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