Mental Health and the Metaverse: Ample Opportunities or Alarming Threats for Mental Health in Immersive Worlds?

As published in https://dl.acm.org/doi/10.1145/3544549.3583750 , with additional information presented during the CHI 2023 Panel Talk today.

Grateful for the loving people I met.

Firstly, I would like to thank Stefanie Herta from International Psychoanalytic University Berlin for connecting with me, guiding me, and trusting me.

Besides, I would also give thanks from the bottom of my heart to the respected and loved legend in the Clinical Psychology and Psychotherapy field, Prof. Dr. Gunther Meinlschmidt. I highly appreciate the kind assistance and all the effort in making this possible.

Our brilliant host, Dr. Stefan E. Germann from Fondation Botnar, inspired me with the way he moderated the entire session to be informative within a short amount of time. Thank you!

In addition, I would like to express my gratitude to the panelists who contributed to this discussion, including Dr. Kremlin Wickramasinghe from World Health Organization whose social responsibility in helping more people resolve mental health issues with care was palpable.

Dr. Sebastian Klöß from BITKOM e.V. provided valuable insights on stage, acknowledging the flaws of the current metaverse while accepting its existence as claimed by the audience and others. He also posted the pictures in the conference when he visits in real life!

Also, thanks, Moritz Borrmann from International Psychoanalytic University Berlin for the detail information in the publishing.

Thank you ACM, Association for Computing Machinery and ACM SIGCHI for hosting CHI 2023 in a hybrid mode as well.

I attended it virtually while the event is hybrid. I really hope to be there in real life for the intense discussion and long mingle sessions.

We sparked disagreements, in a respectful and exciting way.

While I still have much more to learn from the panels and the engaging audience, I am grateful for being able to convey my piece of the 'truth' to everyone who cares to put the pieces together.

In between discussions, we have so many points to make that the terms’ definitions of ‘metaverse’, ‘social VR’, ‘official mental health tools’ could even be debatable. While the debate on any motions starting with the definitions would take up much time, I actually enjoyed it and the use of it. In life and in the academics, we often generalise the terms we use and even misuse some of them unintentionally. Without anyone to debate with us on that, unless we join some debate championships, we could barely see the real issues that are associated with these words. It reminds me of the Spoon Boy from The Matrix. Although I could have been more serious when I am typing on such a serious and big topic, but hey, we are inspired by one another, including the major motion pictures of course. So, back to the Spoon Boy who taught Neo that the spoon does not exist. In the world which most things are algorithms, Neo imagine the spoon to not be there at all, so it bends itself. That is also the start of how Neo could dodge bullets and believe in himself for saving the world and of course, Trinity.

For those who have not watched The Matrix before, well, it’s about a story where everyone lives in a place where everything is constructed out of codes, imagination and more by the robots, or artificial intelligence to be precise. In the animation version of it, it explains that the AI did that to protect us and keep us alive in the safest ways by giving us an entire real-life-mimicking world to stimulate the brain. Before I get too excited with the story plots, let me relate that it has these coincidences in the movie that I could not ignore. The terms we misuse, the beautiful fake reality that we immerse ourselves in and… the Smith virus that so many of my friends on Twitter are saying that they look like AutoGPT. Well, except that with Neuralink developed, there might be a slight chance of us getting there… or not?

I’ve raised our disagreement on conceptions and the movie for reasons. However, the main reason is that we make up the terms ourselves. And, I do mean that each definition is just being developed by the way we perceive it as it is. That affects the way we view the world, the way we take actions and the way we think about how the others would view the world.

Then, what should we do? Instead of the “should/shouldn’t'”, I’d like to say that we are the free beings who could enjoy the way our minds flourish. Enjoy the different perspectives crashing like the waves hitting the seashore. Isn’t that beautiful? Isn’t that the way we developed ‘Philosophy’ by diving things deeper in the very first place?

So, now we know it doesn’t matter and it does matter of the different opinions, since we embrace all the differences yet standing firm on our stances, what to do with the side of the voices that the risks outweigh the benefits?

Spirituality, something AI, XR & Web 3 wouldn’t take over us.

Years ago, I was in this debate championship about technology that discussed about AI. Yes, I have to associate it here, because I’m fully inspired by Nick Bostrom’s Superintelligence: Paths, Dangers, Strategies to break the eco-chamber I had years ago. It’s a great big book, with the diagram showing me how even the smartest human being, Albert Einstein is far behind Superintelligence, something AI would evolve into, which it really does, right now! I was so sure that creativity could not be taken away back then until I read this and thought, okay, I have to think of another thing that AI could not replace.

It’s funny how I saw people discussing about the famous diagram from the books again recently. Yes, of course, thanks to the ‘AI heat’. This time, it is intriguing to see some saying that it is a myth while others saying that it is in fact true to understand that even the dumbest human would stand near to the smartest one compared to Superintelligence. I would accept all these pieces of truths and complete my puzzle bit by bit.

While it’s fun and torturing at the same time, I realise that we, humans are slowly drawing cycles back to understanding that spirituality is the only irreplaceable trait in us, for now. However, without spending much time on it and the science of it now, we understand that AI has come as a tool we create for our own convenience and also out of our desires. Desires to be more healthy, wealthy, joyful, beautiful, relaxing and much more… While I’m about to quote Attack on Titan here, let us leave the topic of chasing after our desires for another day.

Back to how we view the technological advancement now, are we that special after all? No, not really.

Are we more special compared to all the emerging technology? Yes, definitely, at least it is a big ‘yes’ from me.

That was just the tip of the iceberg, but definitely a great start!

Since there is no word count here, let us go on with what’s yet to discover. Before that, let us compare the pictures taken in the Mozilla Hub Mental Health Metaverse of CHI ‘23, shall we?

Mental Health and the Metaverse. Risks?

a. What are the challenges for mental health in the metaverse?

• Let me take a case scenario that comes with the details. People with a history of seizures should avoid entering the metaverse with flashing lights. Last month, I partnered with BE LIGHT, a light and sound therapy company. We collaborated to provide the sessions while increasing the stimulation in the sensorial metaverse. BE LIGHT sent out medical disclaimers to everyone in the sessions to inform them of the risks. While some treatments are amazing, immersive, and alter brain signals instantly, not all treatments are suitable for everyone.

  The challenge is to pair suitable treatments with the appropriate group of people, or patients. That was also one of the reasons that I have started developing Theralove to match the therapies with the people with different symptoms. But it looks like I’ll have to add up about the conditions as the input.

• Of course, there are other risks to cover. The most widely talked ethical issues. Is it ethical to have AI NPCs in the metaverse? Not something I would have an answer for now. While there are the other potential negative consequences, such as addiction and privacy concerns, there are also many benefits that we can look forward to.

Mental Health and the Metaverse. Benefits?

b. What are the opportunities for mental health care in the metaverse?

• One of the most exciting opportunities that the metaverse provides is an immersive feeling. By transporting ourselves to a virtual world, we can experience a sense of presence that allows us to feel more connected to the world around us. We can explore new environments, meet new people, and engage in experiences that we may not have had access to otherwise. Did I mention that in my current ongoing study about the VR environment being used by the therapists and tested using BCI via Alpha/Beta ratio, the counsellors and psychiatrists I talked to actually love using the environments in nature. While the innovative mental health therapists would love to cerate more otherworldly experiences, such as but not limited to dreamy scenes.

• Another potential benefit of the metaverse is its ability to bring people together on a global scale. Imagine being able to interact with people from all over the world in a virtual space, without the need for physical travel. Personally, I met so many international friends in the metaverse, especially Spatial. Yes, a kind of Social VR we talked about in the conference. Yet, I didn’t answer quite straightforwardly. The metaverse has the potential to break down barriers and bring people from different cultures and backgrounds closer together. Well, I am trying to clarify that people who would like to seek for mental health aid could just seek for it using the metaverse or other tools that are the the tools being ‘officially’ accessed with the mental health assessment tools we would talk about. If you’ve been following me, you have probably heard about it so many times now as well. When it comes to socialising though, the people who attempt to seek a 100% cure are not advisable to do so, just as how we do not encourage self-diagnosis in the mental health field. So, let us get back here. Socialising to be happy generally by using Social VR, go ahead. Afraid of being addicted to it, choose consciously instead of being afraid or attached to the unknown. Easier said than done? We could practice.

• The metaverse also has the potential to improve mental health. By incorporating tools such as cognitive-behavioral therapy as well as light and sound therapy, the metaverse can provide a safe space for people to work on their mental health. Combining all the traits that we mentioned, you’ve understood why immersive is better, just that why is it more immersive? Because everything is in your dimension, 3D, 360-degree, in XR (extended reality).

• Gamification in mental health can also help to destigmatise the issue and alter brain signals in a more effective way. Such a not popular thought, you may say. The Healing Quest I’m developing in the mental health metaverse’s foggy scene in version 1, they help to guide others. In the future, when more tasks are added, I could imagine them bringing in interest of more people. This breaks the stigma, brings in the understanding and fun.

Mental Health and the Metaverse. Precautions?

c. What are potential steps and what actions should be taken to make the metaverse a place that is safe and supportive for mental health?

• Firstly, it is crucial to exercise caution when using AI to suggest treatments for mental health conditions. TheraLove, for example, has used Cohere AI to match therapy with certain symptoms. Additionally, mental health assessments should be conducted to provide detailed reports.

• One way to conduct such assessments is through urinalysis. High specific gravity in urine can indicate stress, as the body produces more substances in response to stress. Certain hormones such as cortisol and adrenaline may be released by the body in response to stress, which can affect fluid balance and potentially increase specific gravity. Urine can be tested using clinical devices and the data can be analyzed using ANOVA or MATLAB.

• Another way to conduct mental health assessments is through EEG, which measures electrical signals in the brain. Electrodes can be attached to the scalp using hydrogel or water, and the data can be connected to systems such as OpenBCI or g.tec. Stress reduction can be achieved by increasing alpha waves and decreasing beta waves.

• Metaverse creators who create mental health metaverse spaces could first research and collect information from the trustable sources with consent. After building them, we can use these tools or connect with experts who know how to use them for mental health assessments and clinical trials. Big companies could even consider sponsoring biomedical engineering students with the latest devices and clinical equipment to test their metaverse assets as mental health services or products before publishing them to the public specifically for the cure of a mental health disease.

• Other ways of doing it? Share with me and the public! We need it.

Other Remarkable Notes I Keep

Kremlin talks about a balance we keep.

In the metaverse after our public discussion, Gunther suggested on clinical usage of VR, first do clinical research based on:

1. Age group

2. Then, choose the representative example (we discuss the categories e.g. nationalities, genders, physical diseases etc),

3. Draw out who not to use these, a.k.a. know which group of people do not suit this particular method of healing in the metaverse.

Lovely Wrap-up

My personal humble #conclusion is this: we do not lower the risks by avoiding them, but instead by consciously choosing our actions. It is important to have mutual respect when using big terms even if we may define them differently. Furthermore, as generative AI is advancing with VR, we need to analyse AI NPCs in the metaverse with careful consideration

Lastly, I still stand firm with my stance. 'To make the future Metaverse mentally healthy, we need to leverage our philosophical, critical and spiritual thinking. Give a professional chef a knife and it is used to cook good food. Give a 2-year-old child? You know what will happen without proper training. With love, we must collectively use technological advancement on a humanistic mission to lower the risk and unleash the potential of the metaverse.'

With #love

The same piece on the other socials:

LinkedIn Post (shortened version):

Facebook Posts (Mandarin version 中文):

《心理健康与元宇宙：沉浸式的世界对心理健康是福还是祸？》https://www.facebook.com/clionachee/posts/pfbid0PrWnYzWJScDE6geGHj5ErJRKPBQMNRbTSFTRVAouHT4yHZteRP1nKoAys4wDQ4yNl?notif_id=1682425938066748&notif_t=feedback_reaction_generic&ref=notif

TikTok Posts:

Videos of me explaining on topics related to the metaverse and its conflicts:

Metaverse is an enhancement instead of a replacement because...
https://vm.tiktok.com/ZMY3RVbKp/

The generalisation of the metaverse, is another repetition of the history because... (Its potential when used with love & consciousness)
https://vm.tiktok.com/ZMY38eBKS/

More at: https://clionachee.com/
With #love