Virtual reality in the assessment , understanding , and 2 treatment of mental health disorders

9 Mental health problems are inseparable from the environment. With virtual reality (VR), computer-generated interactive 10 environments, individuals can repeatedly experience their problematic situations and be taught, via evidence-based psy11 chological treatments, how to overcome difficulties. VR is moving out of specialist laboratories. Our central aim was to 12 describe the potential of VR in mental health, including a consideration of the first 20 years of applications. A systematic 13 review of empirical studies was conducted. In all, 285 studies were identified, with 86 concerning assessment, 45 theory 14 development, and 154 treatment. The main disorders researched were anxiety (n = 192), schizophrenia (n = 44), substance15 related disorders (n = 22) and eating disorders (n = 18). There are pioneering early studies, but the methodological quality 16 of studies was generally low. The gaps in meaningful applications to mental health are extensive. The most established 17 finding is that VR exposure-based treatments can reduce anxiety disorders, but there are numerous research and treat18 ment avenues of promise. VR was found to be a much-misused term, often applied to non-interactive and non-immersive 19 technologies. We conclude that VR has the potential to transform the assessment, understanding and treatment of mental 20 health problems. The treatment possibilities will only be realized if – with the user experience at the heart of design – the 21 best immersive VR technology is combined with targeted translational interventions. The capability of VR to simulate 22 reality could greatly increase access to psychological therapies, while treatment outcomes could be enhanced by the tech23 nology’s ability to create new realities. VR may merit the level of attention given to neuroimaging.