Between soaring poverty, cuts to services and worsening NHS staff shortages, the UK is gripped by a mental health crisis. But London’s Daniel Freeman, 47, has been working on a solution and proving that virtual reality is not the preserve of gamers. Patients of his pioneering project Oxford VR are putting on headsets to face their fears and improve their mental wellbeing. And unlike past VR phobia projects, even the therapist is animated.
Freeman studied natural sciences at Cambridge and intended to become a physicist, but he fell in love with psychology – an inevitability, he believes, because of his family. “My mum was a nurse and my dad was obsessed with the arts,” he says. “Psychology sat in the middle of that.” He shifted course accordingly and qualified as a clinical psychologist at King’s College London in 2000.
He took an interest in paranoia and what happens in the brain when people seem to have unfounded fears about others harming them. This was when he first realised how technology could play a pivotal role in a person’s treatment for mental illness. “It can be really hard to know whether it’s paranoia or genuine concern expressed by someone,” he explained. “So you use VR to put someone in exactly the same social situations, programmed to be neutral, and if anyone identifies any hostility, that would indicate genuine paranoid thinking.”
Freeman’s research continued for nearly two decades, investigating the causes of mental health problems. He encountered one continual frustration: Even if he developed groundbreaking treatments, the UK’s extreme therapist shortage meant getting it to everyone who needed it would be impossible.
VR was the answer. He was already working with it for research and it didn’t require anything but an animated therapist programmed to deliver cognitive behavioural therapy (a particularly structured kind of treatment, Freeman explains, meaning no effectiveness is lost with the nuance of human-to-human communication). But it wasn’t until three years ago when the virtual reality industry boomed that Freeman could set his plans in motion.
“Global companies investing in the hardware really transformed things,” Freeman says. “It was no longer a specialist piece of kit. I’d been working in labs that had headsets worth £30,000, then suddenly you could get a better headset for £500. The software got better, computers got better. I always knew its potential, but the shift at that point in time meant using VR in routine services seemed like a real possibility.”
Three years, a handful of investors and 30 staff later, Oxford VR is treating patients in 10 NHS clinics around England while carrying out clinical tests to treat conditions like depression. “It’s backed by science,” Freeman says. “We know what we do works. The potential for large-scale benefits is so exciting.”
More than two-thirds of those treated have reported a total reversal in their fear
One of the most successful treatment packages developed by Freeman and his team is that for people with a heights phobia. More than two-thirds of those treated have reported a total reversal in their fear.
The founder walks The Big Issue through a standard appointment for one such patient: “You come into the virtual therapist’s room and meet the therapist. She’ll ask a few questions then take you into the atrium of a large shopping centre. You can choose which of the 10 floors you’d like to start on – there are various tasks waiting for you on each level and they get progressively more difficult.
“On the early floors, you might go up to the edge of the drop and then you might be asked whether the barrier can be lowered. But on the higher floors, you might go out onto a ledge and rescue a cat from a tree.”
Freeman explains that VR creates a kind of biting point for psychological treatment: When a person knows a perceived danger is not real but every other sense suggests it is, that allows you to act differently than you normally would. And behavioural changes made in the VR environment transfer to the real world.
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One arm of Oxford VR is gameChange, an initiative working on treating schizophrenia using VR. “People with the illness can get very isolated. They withdraw because they’re so anxious,” Freeman says. “That makes it even more difficult for them to get the mental and physical health care they need.” So the gameChange treatment puts patients in everyday situations like being on the bus or walking down the street, with an animated coach that helps them regain their confidence. These clinics are currently operating in Newcastle, Manchester, Nottingham, Bristol and Oxford.
Freeman says the desire to drive change is a common theme among the Oxford VR team, many of whom are former gaming industry experts who moved field because they wanted to get behind a social mission.
But he does not claim to have all the answers. “Mental health is too complex to have one answer for everything,” he says. It all comes down to resources. “If we’re going to treat the many people who need help, we’re going to need more than just VR.”