Effectiveness of Augmented and Virtual Reality-Based Interventions in Improving Knowledge, Attitudes, Empathy and Stigma Regarding People with Mental Illnesses—A Scoping Review

Interventions adopting augmented and virtual reality (AR/VR) modalities allow participants to explore and experience realistic scenarios, making them useful psycho-educational tools for mental illnesses. This scoping review aims to evaluate the effectiveness of AR/VR interventions in improving (1) knowledge, (2) attitudes, (3) empathy and (4) stigma regarding people with mental illnesses. Literature on published studies in English up till April 2022 was searched within several databases. Sixteen articles were included. The majority of studies were conducted in the West (93.8%), within undergraduates (68.8%) but also amongst high school students, patients, caregivers, public including online community, and covered conditions including psychotic illnesses, dementia, anxiety and depression. A preponderance of these included studies which employed AR/VR based interventions observed improvements in knowledge (66.7%), attitudes (62.5%), empathy (100%) and reduction of stigma (71.4%) pertaining to people with mental illnesses. In the context of relatively limited studies, extant AR/VR based interventions could potentially improve knowledge, attitudes, empathy and decrease stigma regarding people with mental illness. Further research needs to be conducted in larger and more diverse samples to investigate the relatively beneficial effects of different AR/VR modalities and the durability of observed improvements of relevant outcomes of interests over time for different mental conditions.

[1]  M. Subramaniam,et al.  The perspectives of healthcare professionals in mental health settings on stigma and recovery - A qualitative inquiry , 2022, BMC Health Services Research.

[2]  Paweł W. Woźniak,et al.  There Is No First- or Third-Person View in Virtual Reality: Understanding the Perspective Continuum , 2022, CHI.

[3]  Faisal Saeed,et al.  Phobia Exposure Therapy Using Virtual and Augmented Reality: A Systematic Review , 2022, Applied Sciences.

[4]  Mohammed Al-Sarem,et al.  Augmented Reality, Serious Games and Picture Exchange Communication System for People with ASD: Systematic Literature Review and Future Directions , 2022, Sensors.

[5]  Mehdi Sayyah,et al.  The Effect of Virtual Reality on Emotional Response and Symptoms Provocation in Patients With OCD: A Systematic Review and Meta-Analysis , 2022, Frontiers in Psychiatry.

[6]  K. Bahaadinbeigy,et al.  The usefulness of virtual, augmented, and mixed reality technologies in the diagnosis and treatment of attention deficit hyperactivity disorder in children: an overview of relevant studies , 2022, BMC Psychiatry.

[7]  Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 , 2022, The lancet. Psychiatry.

[8]  P. Caponnetto,et al.  The Simulation Game—Virtual Reality Therapy for the Treatment of Social Anxiety Disorder: A Systematic Review , 2021, International journal of environmental research and public health.

[9]  Mark B. Powers,et al.  Integrating virtual realities and psychotherapy: SWOT analysis on VR and MR based treatments of anxiety and stress-related disorders , 2021, Cognitive behaviour therapy.

[10]  Cindy Jones,et al.  Use of virtual and augmented reality-based interventions in health education to improve dementia knowledge and attitudes: an integrative review , 2021, BMJ Open.

[11]  Anne Bartsch,et al.  Stopping the Stigma. How Empathy and Reflectiveness Can Help Reduce Mental Health Stigma , 2021, Media Psychology.

[12]  K. Domschke,et al.  Spider Phobia: Neural Networks Informing Diagnosis and (Virtual/Augmented Reality-Based) Cognitive Behavioral Psychotherapy—A Narrative Review , 2021, Frontiers in Psychiatry.

[13]  W. Mak,et al.  The Effects of Immersive Virtual Reality in Reducing Public Stigma of Mental Illness in the University Population of Hong Kong: Randomized Controlled Trial , 2020, Journal of medical Internet research.

[14]  Daniela Stelzmann,et al.  Can Intergroup Contact in Virtual Reality (VR) Reduce Stigmatization Against People with Schizophrenia? , 2021, Journal of clinical medicine.

[15]  A. Vahabie,et al.  Effectiveness of Virtual/Augmented Reality–Based Therapeutic Interventions on Individuals With Autism Spectrum Disorder: A Comprehensive Meta-Analysis , 2021, Frontiers in Psychiatry.

[16]  S. Konrath,et al.  Virtual reality improves emotional but not cognitive empathy: A meta-analysis. , 2021, Technology, Mind, and Behavior.

[17]  F. Hasson,et al.  Simulated Based Dementia Training: Impact on Empathic Understanding and Behaviour Among Professionals and Carers , 2021, Clinical Simulation in Nursing.

[18]  M. Yücel,et al.  Exposure therapy in a virtual environment: Validation in obsessive compulsive disorder. , 2021, Journal of anxiety disorders.

[19]  B. Loessl,et al.  Virtual reality simulations in nurse education: A systematic mapping review. , 2021, Nurse education today.

[20]  J. Bennett,et al.  A visit with Viv: Empathising with a digital human character embodying the lived experiences of dementia , 2021, Dementia.

[21]  W. Veling,et al.  Advances in immersive virtual reality interventions for mental disorders: A new reality? , 2021, Current opinion in psychology.

[22]  Danko D. Georgiev,et al.  Virtual Reality for Neurorehabilitation and Cognitive Enhancement , 2021, Brain sciences.

[23]  C. Turkelson,et al.  Increasing awareness, sensitivity, and empathy for Alzheimer's dementia patients using simulation. , 2021, Nurse education today.

[24]  A. Bakker,et al.  Efficacy of immersive PTSD treatments: A systematic review of virtual and augmented reality exposure therapy and a meta-analysis of virtual reality exposure therapy. , 2020, Journal of psychiatric research.

[25]  Mingzhen Zhang,et al.  Augment Reality-Based Teaching Practice , 2020, Biomedical Engineering Education.

[26]  Wei Liu The Effects of Virtual Simulation on Undergraduate Nursing Students’ Mental Health Literacy: A Prospective Cohort Study , 2020, Issues in mental health nursing.

[27]  Sara Ventura,et al.  Virtual Reality as a Medium to Elicit Empathy: A Meta-Analysis , 2020, Cyberpsychology Behav. Soc. Netw..

[28]  D. Hamilton,et al.  Immersive virtual reality as a pedagogical tool in education: a systematic literature review of quantitative learning outcomes and experimental design , 2020, Journal of Computers in Education.

[29]  L. Valmaggia,et al.  Virtual reality as a clinical tool in mental health research and practice
 , 2020, Dialogues in clinical neuroscience.

[30]  S. Koukouli,et al.  The Role of Empathy in Health and Social Care Professionals , 2020, Healthcare.

[31]  B. Tran,et al.  Overview of Stigma against Psychiatric Illnesses and Advancements of Anti-Stigma Activities in Six Asian Societies , 2019, International journal of environmental research and public health.

[32]  Pierpaolo Di Bitonto,et al.  BRAVO: A Gaming Environment for the Treatment of ADHD , 2019, AVR.

[33]  A. H. Y. Lam,et al.  The Effectiveness of Virtual Reality-Based Simulation in Health Professions Education Relating to Mental Illness: A Literature Review , 2019, Health.

[34]  Albert Rizzo,et al.  Clinical virtual reality in mental health and rehabilitation: A brief review of the future! , 2019, Defense + Commercial Sensing.

[35]  VR-assisted Curriculum on Depression for Stigma Reduction , 2019, Case Medical Research.

[36]  I. Cabeza Relationship Between Insight, Adherence and Disability in the Diagnose of Paranoid Schizophrenia , 2018, JOURNAL OF MENTAL HEALTH AND CLINICAL PSYCHOLOGY.

[37]  S. Yeh,et al.  The Effect of Augmented Reality and Virtual Reality on Inducing Anxiety for Exposure Therapy: A Comparison Using Heart Rate Variability , 2018, Journal of healthcare engineering.

[38]  J. Bailenson,et al.  Building long-term empathy: A large-scale comparison of traditional and virtual reality perspective-taking , 2018, PloS one.

[39]  Elizabeth Dyer,et al.  Using virtual reality in medical education to teach empathy , 2018, Journal of the Medical Library Association : JMLA.

[40]  F. Lateef,et al.  Going Forward with Pokemon Go , 2018, Journal of emergencies, trauma, and shock.

[41]  A. Furnham,et al.  Mental Health Literacy: A Review of What It Is and Why It Matters , 2018, International Perspectives in Psychology.

[42]  M. Veerbeek,et al.  A virtual reality intervention to improve the understanding and empathy for people with dementia in informal caregivers: results of a pilot study , 2018, Aging & mental health.

[43]  Salsabeel F. M. Alfalah,et al.  A comparative study between a virtual reality heart anatomy system and traditional medical teaching modalities , 2018, Virtual Reality.

[44]  P. Klainin-Yobas,et al.  Effectiveness of information and communication technologies interventions to increase mental health literacy: A systematic review , 2018, Early intervention in psychiatry.

[45]  C. Henderson,et al.  Mental Health Related Stigma as a ‘Wicked Problem’: The Need to Address Stigma and Consider the Consequences , 2018, International journal of environmental research and public health.

[46]  Ben W. Morrison,et al.  Testing the efficacy of a virtual reality‐based simulation in enhancing users’ knowledge, attitudes, and empathy relating to psychosis , 2018 .

[47]  C. Fertleman,et al.  A Discussion of Virtual Reality As a New Tool for Training Healthcare Professionals , 2018, Front. Public Health.

[48]  Plácido Rogério Pinheiro,et al.  Reducing the Schizophrenia Stigma: A New Approach Based on Augmented Reality , 2017, Comput. Intell. Neurosci..

[49]  Adolfo J. Cangas,et al.  Stigma-Stop: A Serious Game against the Stigma toward Mental Health in Educational Settings , 2017, Front. Psychol..

[50]  Noelia Navarro,et al.  Assessment of the usefulness and appeal of stigma-stop by psychology students: a serious game designed to reduce the stigma of mental illness , 2017 .

[51]  Rustin Webster,et al.  Declarative knowledge acquisition in immersive virtual learning environments , 2016, Interact. Learn. Environ..

[52]  Michela Ott,et al.  A LITERATURE REVIEW ON IMMERSIVE VIRTUAL REALITY IN EDUCATION: STATE OF THE ART AND PERSPECTIVES. , 2015, 11th International Conference eLearning and Software for Education.

[53]  Mel Slater,et al.  Virtual Character Personality Influences Participant Attitudes and Behavior – An Interview with a Virtual Human Character about Her Social Anxiety , 2015, Front. Robot. AI.

[54]  J. Haro,et al.  Relationship of Insight with Medication Adherence and the Impact on Outcomes in Patients with Schizophrenia and Bipolar Disorder: Results From A 1-Year European Outpatient Observational Study. , 2014, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[55]  Lori I. Kidd,et al.  Effectiveness of a second life(®) simulation as a teaching strategy for undergraduate mental health nursing students. , 2012, Journal of psychosocial nursing and mental health services.

[56]  G. Thornicroft,et al.  The simulation of hallucinations to reduce the stigma of schizophrenia: A systematic review , 2011, Schizophrenia Research.

[57]  Lance Chun Che Fung,et al.  does desktop virtual reality enhance learning outcomes? A structural , 2012 .

[58]  Veronica S. Pantelidis,et al.  Reasons to Use Virtual Reality in Education and Training Courses and a Model to Determine When to Use Virtual Reality. , 2010 .

[59]  D. Levac,et al.  Scoping studies: advancing the methodology , 2010, Implementation science : IS.

[60]  James D. Ivory,et al.  The Virtual Doppelganger: Effects of a Virtual Reality Simulator on Perceptions of Schizophrenia , 2010, The Journal of nervous and mental disease.

[61]  Danielle L. Fettes,et al.  Public knowledge and assessment of child mental health problems: findings from the National Stigma Study-Children. , 2008, Journal of the American Academy of Child and Adolescent Psychiatry.

[62]  Kurt Squire,et al.  Augmented Reality Simulations on Handheld Computers , 2007 .

[63]  P. Yellowlees,et al.  Education About Hallucinations Using an Internet Virtual Reality System: A Qualitative Survey , 2006, Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry.

[64]  Robert Astur,et al.  Virtual Reality Assessment of Medication Compliance in Patients with Schizophrenia , 2006, Cyberpsychology Behav. Soc. Netw..

[65]  A. Korten,et al.  “Mental health literacy”: a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment , 1997, The Medical journal of Australia.

[66]  한슬기 An Integrative Review on Augmented Reality/Virtual Reality Simulation Programs in the Mental Health Area for Health Professionals , 2019 .

[67]  P. Adamczyk,et al.  Associations of insight and treatment adherence with employment status of people with schizophrenia , 2019, Postępy Psychiatrii i Neurologii.

[68]  Tanya Petrovich,et al.  Impact of a Virtual Dementia Experience on Medical and Pharmacy Students' Knowledge and Attitudes Toward People with Dementia: A Controlled Study. , 2018, Journal of Alzheimer's disease : JAD.

[69]  Cixin Wang,et al.  Self‐Stigma, Mental Health Literacy, and Attitudes Toward Seeking Psychological Help , 2018 .

[70]  M. Riepe,et al.  Augmented Reality: Sustaining Autonomous Way-Finding in the Community for Older Persons with Cognitive Impairment. , 2017, The Journal of frailty & aging.

[71]  Patricia McInerney,et al.  The Joanna Briggs Institute reviewers' manual 2015: methodology for JBI scoping reviews , 2015 .

[72]  M. Peters,et al.  Methodology for jbi scoping reviews , 2015 .

[73]  T. Singer,et al.  Empathy and the brain , 2013 .

[74]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2010, International journal of surgery.