Extended reality as an assistive technology for mental health and wellbeing: a scoping review

Mental health disorders, including anxiety, depression, post-traumatic stress disorder (PTSD), and neurodevelopmental conditions such as ADHD and autism, represent a global health challenge with substantial social and economic burden. Despite progress in conventional interventions, challenges such as limited accessibility, digital inequality, high costs, and scalability constraints persist. Extended Reality (XR), encompassing Virtual, Augmented, and Mixed Reality, has emerged as a potential assistive technology offering immersive, interactive, and personalised therapeutic experiences.

This scoping review examines whether XR represents a meaningful advancement in mental health care by addressing three questions: (1) What types of mental health conditions have been addressed using XR? (2) What design approaches underpin XR experiences for mental health and wellbeing? and (3) What challenges and opportunities shape XR's integration into mental health practice?

A scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). The Web of Science Core Collection was searched for peer-reviewed empirical studies published between January 2022 and March 2025. Following title and abstract screening and full-text review against predefined eligibility criteria, 277 studies were included and synthesised thematically.

XR has been applied across a range of mental health and wellbeing contexts, including anxiety and stress, depression and mood disorders, PTSD, neurodevelopmental conditions, social isolation, cognitive decline, and workplace stress. The literature most frequently reported short-term or preliminary benefits, particularly in anxiety- and PTSD-related applications. XR experience designs included immersive exposure, mindfulness and relaxation, social interaction, cognitive stimulation, biofeedback, haptic interaction, and adaptive personalised experiences. However, limited longitudinal and comparative evidence, high costs, accessibility barriers, clinician training needs, and ethical, privacy, and regulatory concerns continue to constrain widespread adoption.

XR represents a promising assistive approach for mental health and wellbeing, but its effectiveness and sustainable clinical impact have not yet been fully established. Stronger comparative and longitudinal evidence, inclusive and human-centred design, improved accessibility, and clearer ethical and regulatory frameworks are required to support its integration into mental health care.