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Digital media engagement may be in an early stage of transitioning from two-dimensional consumption to three-dimensional participation; the concept of the Metaverse refers to a burgeoning reality where users experience being inside the internet via extended reality technologies. Early attention is being given to the potential application of these technologies in the treatment of mental health conditions, with a future where the Metaverse may serve as an important means for the delivery of appropriate mental health services (Gloeckler and Biller-Andorno, 2023). Appropriate care is a key aim of well-functioning health systems, with the goal of providing services that are evidence-based, draw on clinical expertise, are patient-centered, use resource wisely, and are equitable (Preidler et al., 2017). How the Metaverse might play into such efforts, what challenges should be anticipated, and what possible interventions might contribute to meeting these aims remains to be seen. The primary goal of this project was to support inquiry into the question of the Metaverse’s role in the provision of appropriate mental health care and spark necessary academic and policy debate, bearing in mind the lack of material presently available to engage with these questions.
To do so, the project sought to develop an early map of relevant ethical and regulatory concerns as well as generate early recommendations that would support the development of safe and fair mental health services in the context of the Metaverse. The project achieved this goal through two primary means:
The project was able to achieve its aims. It produced
Financed by: The Commonwealth Fund
Duration: April 2023 to March 2024
The aim of this project is to produce a map of the ethical and policy issues related to the provision of mental health services in the Metaverse. Through a webinar in collaboration with The Forum for Global Health Ethics and a following Delphi study, the project develops recommendations that address key ethical and policy issues for the safe and fair provision of mental health services in the context of the Metaverse. As physical lives become increasingly interwoven with, or even converge with, the virtual, human and civil rights should exert a shaping influence on the structure of the virtual world.
Although still opaque, the Metaverse is understood as an immersive space whereby, using digital selves, augmented reality (AR), and virtual reality (VR), users experience being “inside” the internet, interacting digitally with others, objects, and environments. It is anticipated that the Metaverse will impact billions of people within the next decade, part of a transition from flat media to immersive media as the primary means for accessing digital content (Rosenberg, 2021). Many ethical questions pertinent to this novel setting remain unanswered, from the ontological, moral, and legal status of digital selves to the appropriate protection of privacy and respect for autonomy.
The Metaverse may be an important means for increasing access to mental health services and promoting psychological wellbeing, including for those who are remote, socially isolated, have limited mobility, or specific disabilities. Some innovations may enhance existing modalities, improving outcomes, and some may present alternatives that require fewer resources or otherwise increase availability. Clinical benefit, though, will depend on the extent to which healthcare values exert influence, defining the Metaverse alongside driving forces in pursuit of data, power, and profit.
Commercialization and consumerization can lead to the commodification of people, which is particularly problematic when referring to those who are ill and vulnerable. The ethical questions demanding attention encompass human dignity, freedom, autonomy, and fairness. The intimate knowledge of users and the ability to generate powerful experiences can contribute to the efficacy of therapeutic interventions, but also presents novel concerns. Those who are already vulnerable and marginalized will likely suffer the most from a failure to adequately explore these issues.
This project aims to promote health equity by establishing a clearer understanding of the potential harms that may arise through the provision of mental health services in the Metaverse, keeping in mind the potential benefits in terms of efficiency, access, and affordability. It also aims to reduce disparities by offering suggestions for policy pertaining to virtual spaces that fosters respectful, just, and high-quality healthcare for all. The project has two phases. The first centers on collaboration with The Forum for Global Health Ethics to arrange a digital event on the topic of mental health services in the Metaverse where experts conceptualize the issues at stake and a broad audience participates in discussion on the topic. The second phase uses this preliminary work to inform a following Delphi study that uses expert consensus to identify primary challenges for the provision of appropriate mental health services in the Metaverse as well as early potential interventions to support appropriate mental health services in the Metaverse.
References:
Rosenberg, L. B. (2021, November). Augmented Reality: Reflections at Thirty Years. In Proceedings of the Future Technologies Conference (pp. 1-11). Springer, Cham.
See also:
Forum for Global Health Ethics about the Metaverse
Article: Mental health services in the metaverse: potential and concerns
