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Courtesy of Habbo Hotel

Mental health online: will the metaverse just make everything worse?

Experts believe virtual reality could help treat a variety of mental illnesses — but only if tech companies put people before profit

Back in October 2021, Mark Zuckerberg announced that he was rebranding Facebook and changing his company’s name to Meta. In a Founder’s Letter, he gushed about “the next chapter for the internet” and his plans for the social network’s future. “The next platform will be even more immersive – an embodied internet where you’re in the experience, not just looking at it,” he wrote. “We call this the metaverse, and it will touch every product we build.”

While Zuckerberg’s metaverse platform – named Horizon Worlds – is new, the concept of ‘the metaverse’ is almost as old as the internet itself. In layman’s terms, a metaverse is a virtual reality that exists beyond the physical world in which we live. The term was coined by the writer Neal Stephenson in his 1992 science fiction novel, Snow Crash, in which characters use digital avatars of themselves as a way of escaping a dystopian reality.

Many internet users and gamers will have already dabbled in metaverses. In the 1990s there was the online community LambdaMOO, a text-based, early iteration of a metaverse. Then came the massively multiplayer online role-playing game (MMORPG) Second Life, which launched in 2003. Other games and online platforms since then such as Club Penguin, Fortnite, and Animal Crossing are also essentially metaverses in their own right.

Since Zuckerberg’s recent foray into the metaverse, we’ve seen renewed interest – and concern – surrounding the idea. The concept of replicating real-life online throws up urgent questions: how does sex translate in the metaverse, and what do we do about digital sexual assaults? How do you moderate hate speech or abuse? How do we protect children from predators?

The metaverse also raises interesting questions about mental health. Could it cause people to become addicted to virtual realities? Could it harm people with mental disorders linked to psychosis and schizotypy? But, conversely, could it also open up the world to people with disabilities or help people with social anxiety? Could it actually revolutionise the way we treat mental illness?

When the internet first gained traction in the 1990s, the media ran sensationalist stories about how the web could harm young people by exposing them to pornography and predators. Arguably, not much has changed since then: successive moral panics have obfuscated the fact that for some, the internet has helped more than hindered. For Kayla, 24, who suffers from ADHD, social anxiety, and depression, playing the MMORPG game Final Fantasy XIV unequivocally improved her wellbeing. “I used to spend most of my days dissociating. I would go to work, come home, watch YouTube and then just go to bed. I was in this really bad depressive state for years,” she recalls. “I had friends and I would sometimes see them but I wouldn't really talk to them on a daily basis.”

“I was just kind of existing that way until my best friend got me to play Final Fantasy XIV. It really helped to have a community that I talked to every day. Now I’ll play this game with all of my friends for hours, just laughing and giggling. Half the time we're not even playing the game, we're just standing there talking to each other or running around and playing hide and seek,” she explains. “It's been such a genuinely refreshing experience for me. It's caused me to be more sociable and interact more with my life as opposed to just passively letting it happen to me.”

Anna Bailie is a PhD candidate at the University of York, researching mental health cultures on social media. She’s optimistic about how the metaverse could impact our mental health: “The metaverse has been sold as a place for community, sociality, making friends and maintaining relationships. There’s no reason that can’t happen when we already see it on social media platforms like Instagram and Reddit, where people find communities which they wouldn’t have access to otherwise.”

She also adds that it could potentially make treatment more accessible. “The interactive nature of the metaverse could provide a different arena for online therapy to take place, which may even improve access to therapy for disabled people with a better, more life-like experience,” she explains. However, she adds that it would be idealistic to assume that everyone will have the technological resources needed to access the metaverse in the first place: “It will likely divide people further in their access to technology and therapeutic support. Having mental health treatment instantly available in the metaverse will likely benefit the people who already have access to it.”

recent reports suggest that women are being approached inappropriately in virtual environments, potentially leading to perceived trauma and stress” – Dr. Daria Kuss

Dr. Daria Kuss is the Lead for the Cyberpsychology Research Group at Nottingham Trent University. “We know that particular psychotherapy formats, notably virtual reality exposure therapy, can be fantastic tools to help individuals affected by a variety of phobias, depression, psychosis, addiction, eating disorders as well as post-traumatic stress disorder by gradually exposing them to the triggering, feared, or trauma-producing stimulus in a safe space (like the virtual environment),” she says. But Dr. Kuss also highlights “a number of potential risks” in the metaverse: “For instance, recent reports suggest that women are being approached inappropriately in virtual environments, potentially leading to perceived trauma and stress,” she says, adding that thankfully Meta has addressed this by creating the ‘Personal Boundary’ feature.

She stresses that the metaverse could also potentially exacerbate mental health issues by keeping people online: “It’s conceivable that the excessive use of virtual realities, such as [Horizon Worlds], may be associated with the experience of symptoms of mental disorders, including addiction, depression, and anxiety, similar to the overuse of the internet more generally,” she explains. 

Bailie is also concerned about Meta’s long-term strategy for making Horizon Worlds a safe space. “We need to focus on safety and making sure that the risks of harm are limited. When we look at Zuckerberg’s history of this, I’m not feeling too convinced that it will be a safe, protected space to openly talk about mental health online privately,” she says. “We don’t really know enough about the safety aspects of the metaverse and maybe that's because he hasn't fully understood how to create a digital safe space in this context, but we do know he hasn’t with Facebook and Instagram.”

“We know that Zuckerberg is all about the money,” Bailie continues. “He already has incredible levels of power and control over his users’ data. There’s nothing to suggest that they won’t target ads that sell products marketed towards supporting people with their mental health to very vulnerable people in the metaverse, as they already do now on Instagram.”

It’s certainly true that user safety and wellbeing is not a high priority on Meta’s agenda. The Facebook files, released last year by whistleblower Frances Haugen, revealed that the company’s internal research found that Instagram was detrimental to the wellbeing of teenage girls – and, worryingly, these findings were kept secret. Beyond Instagram, the detrimental impact of social media on young people’s wellbeing is well-documented: 85 per cent of Gen Z surveyed in 2021 said their self-esteem was affected by social media. 

We need to err on the side of caution when it comes to the metaverse: we’re only just beginning to scratch the surface when it comes to investigating how social media has impacted our collective mental health. Tech companies need to research and preempt how the metaverse could prove harmful to young people’s wellbeing and, crucially, do something about it before it’s too late.

But we should also look at the metaverse with cautious optimism, too. Of course, it would be misguided to regard the metaverse as a utopia, free from the constraints of capitalism, where we can have another go at building a fairer, egalitarian society. It would be especially naïve to think so when platforms like Horizon Worlds are owned by companies like Meta, who will always prioritise profits over safety. But the concept of the metaverse itself – beyond Zuckerberg’s Horizon Worlds – poses exciting possibilities for mental health. VR is already being used by the NHS to treat social anxiety and has also been shown to promote empathy. After all, in its purest form, social media is meant to be all about fostering positive social connections, and metaverses are simply an expansion of this.

As Kayla puts it: “I met people through Final Fantasy that I would otherwise never have known. They’ve been some of the best people I've known and some of my best friends,” she says. “To imagine that I didn't have these friends anymore? That would be really sad.”