Metaverse-Based Psychiatric Consultation for Youths With Mental Health Conditions: Qualitative Descriptive...

Youth mental health is a global public health priority, with rising rates of anxiety and depression, particularly after the COVID-19 pandemic. Despite the early onset and substantial burden of mental disorders in this age group, young people are less likely than adults to seek professional help and face barriers such as workforce shortages, stigma, and low mental health literacy. Although efforts such as outreach initiatives and school-based programs have been implemented, innovative and scalable solutions remain limited. Digital technologies, including the metaverse, may offer flexible and stigma-reducing approaches to mental health care; however, evidence regarding their real-world feasibility and acceptability is scarce.

This study investigated the feasibility and user experience of metaverse-based psychiatric consultations for young people with mental health conditions.

We conducted a qualitative descriptive feasibility study at a single academic institution in Yokohama, Japan, between July and November 2023. A total of 26 participants aged 16 to 25 years (mean age 19.9, SD 2.4; 15 male, 7 female, 3 nonbinary, 1 no response) who self-identified as having mental health concerns were recruited from local psychiatric clinics, schools, universities, and social media. Reported concerns included anxiety, depressive symptoms, and autism spectrum disorder traits. Participants completed a 30- to 40-minute one-on-one metaverse-based consultation with a psychiatrist using avatars in a virtual reality environment, followed by semistructured interviews exploring feasibility, usability, and user perceptions. Data were analyzed using thematic analysis, and data collection continued until no substantially new themes emerged. Reporting followed the APA Journal Article Reporting Standards for qualitative research.

All participants completed the study without any adverse psychological events. Five participants experienced minor, transient physical discomfort (eg, headaches and virtual reality-related sickness), which resolved without medical intervention. Thematic analysis identified 3 primary domains: perceived psychological safety through avatar-mediated interaction, enhanced spatial presence facilitating rapport, and increased autonomy within the virtual environment. Metaverse consultations were perceived as particularly beneficial for individuals experiencing interpersonal anxiety, sensory sensitivities (including autism spectrum disorder traits), difficulty leaving home due to psychiatric conditions, psychological resistance to traditional psychiatric settings, or discomfort with physical self-presentation.

This qualitative descriptive feasibility study provides preliminary evidence that metaverse-based psychiatric consultations are a feasible and acceptable approach for supporting young people with mental health conditions. Unlike conventional telepsychiatry based on videoconferencing, the use of avatar-mediated interaction and immersive virtual environments may reduce psychological barriers related to self-presentation, stigma, and interpersonal anxiety for specific subgroups of youth. These findings suggest that metaverse-based consultations can be effectively integrated into clinical pathways as a complementary, "low-threshold" access point within stepped or hybrid care models, ultimately bridging the gap between initial help-seeking and formal psychiatric treatment.