How virtual reality can improve your mental health | Matt Vogl | TEDxMileHigh


Translator: Tanya Cushman
Reviewer: Peter van de Ven So 16 years ago, I was working nights as a stand-up comic. And I’m not going to lie: right now I’d much rather be holding
the microphone in my hand than having it strapped to my face
like some nerd doing a TED … Talk. (Laughter) Comedy is full of crazy highs and lows. Some nights you feel
like you own the world. I got to perform at Red Rocks. I got to work sold-out shows with people like Chelsea Handler,
Dave Chappelle and Jimmy Fallon, with crowds so hot it’s like they were eating out of my hand. But other nights, those are what comics call “hell gigs.” Like a three-lane bowling alley
in Douglas, South Dakota, (Laughter) where the sound of the townies
playing pool in the back room pretty much drowned out
the smattering of laughs I was getting from the nine drunks
half-watching my show, sleeping in my car because the Motel 6 they put me up in
was so infested with bedbugs. Yeah, all for a whopping 200 bucks. And believe me, back then, that barely covered my bar tab,
much less gas for the drive home. (Laughter) But even when it sucked,
the comedy life was amazing because I was getting paid
to make people laugh. And best of all, it provided
the perfect cover for my misery. You see, a lot of people don’t realize there’s a huge difference
between being funny and being happy. I was really funny. And I was really miserable. Lot of comics I knew were the same way. Night after night, we’d go on stage
and tell drunken stories about how much our lives sucked
and how miserable we were, and people laughed. They didn’t know we were serious. I vividly remember one night. I did three shows at the Comedy Works
in downtown Denver, and I killed each one. And then I went home, got drunk and spent the rest of the night
researching ways to kill myself. Eventually it got so bad
that I wrote a note and picked a date. And then I bought a gun. Thankfully, a neighbor
saw me crying, and intervened. She saved my life. It’s crazy how close I came. But what’s even crazier is that almost dying by suicide
wasn’t my rock bottom. My rock bottom came when I tried to access care
in our snarled mental health system. Long wait list, yeah. (Audience) You’ve been there. Long wait lists, misdiagnoses, medications that made me
feel worse instead of better. Hell, I even had a shrink fall asleep
on me in the middle of our session (Laughter) and then have the nerve
to ask me for my copay. That was my rock bottom. And I’m not the only one. Right now in the United States, 80% of people with a mental illness
don’t get adequate care for it. See, this is our mental health system – on a good day. It’s a simple case of supply and demand: more cars than the highway can handle, more patients than our system can treat. We wait until someone’s dangerously sick, and then we scramble to find them care
in a system that’s already overwhelmed. And if you need inpatient help? I’m sorry, but sometimes your best bet
is to just go to the airport, fly somewhere else. It can be that bad. So what’s a solution? Just build more clinics
and train more providers, right? Well, it turns out that’s kind of like
addling lanes on the highway: it will ease congestion
for a short period of time, but then, as more people start to drive, it gets worse than before. It’s something that urban planners
call “induced demand.” And as we get rid of stigma and that remaining 80%
tries to access care in the system, it’s going to get a lot worse. Now, don’t get me wrong. We have amazing providers,
and we need lots of them. But just building clinics
and training providers? That’s not going to solve anything. We cannot clinic our way
out of our mental-health-access problem. After I got diagnosed
with type II bipolar disorder and I got the medication
and therapy that I needed, I eventually co-founded the
National Mental Health Innovation Center to test new ways to make
mental health services of all kinds more accessible to everyone – when they need it and before they need it. Now, we had a suspicion
that technology might be able to help. Now, technology has always been viewed
as the enemy of mental health. But what if that was wrong? What if technology
could be part of the solution? And then one day, we got a call
from an unlikely source, the Department of Corrections in Alaska. (Laughter) They said, “We’re struggling
with a number of issues related to mental health in our prisons. Do you think you guys can help?” What? Alaska? Prison? Yeah, I had been to Alaska, but I sure as hell
had never been in a prison, and I was really content
to keep it that way. (Laughter) But then, as fate would have it, not ten months later, I’m standing there
with two of my colleagues outside of the Spring Creek
maximum security prison in Seward, Alaska. Now, Alaska in the wintertime
is really cold, it’s really windy and it’s really dark. I mean, I’m talking
like hour-of-sunlight-a-day dark. And all of that messes
with your mood and your sleep. People stay inside more
and they socialize less, and it can make you violent
or even suicidal. So what you do if your environment
makes you violent and suicidal? You move, obviously. (Laughter) Not so simple when you’re in prison. In prison, oftentimes, the staff have to resort to things
like sedating medications, or even worse, the use of solitary confinement
to control inmate behavior. We thought that meditation
might be able to help. It’s effective at regulating mood, it can help ease anxiety and it can help control aggression. But it can be hard to learn
and even harder to stick with. And getting a bunch of inmates
to meditate every day? Yeah, that was going to be a tough sell. I mean, Alaska is a long way from Boulder. (Laughter) But VR can help. In virtual reality, your brain processes the virtual image
much like it does a real image: the image in the headset
stimulates your visual cortex, the headphones stimulate
your auditory cortex and the hippocampus
organizes everything spatially. The resulting sense of presence effectively tricks your brain
into thinking that you’re actually there. In VR, you can meditate
anywhere you want to: on the beach, by a beautiful waterfall, in the woods. Hell, you can even meditate
on the moon if that’s your thing. (Laughter) So we presented our hypothesis
to the commissioner, that by using VR, inmates
could escape to a beautiful place and meditate more effectively. They liked the idea. Well, except for the word “escape.” (Laughter) So we’re standing in the common area, and the superintendent
points to the gymnasium and said, “Hey, there’s a couple of inmates
in there, waiting to come out. Why don’t you go in and explain
what we’re going to do?” So I walked in all cool and confident only to discover that
at the Spring Creek Correctional Facility, a “couple inmates” apparently means 20. Yeah, and I mean, look at me,
this chubby nerd, alone with 20 inmates, yeah, who pretty much spend
every waking minute doing chin-ups. Any one of them could have
broken me like a toothpick. So, instinctively, I’m just looking
around the room, scanning, trying to find the exits
in case I have to make a run for it. And then I remembered:
a duh, it’s a prison. (Laughter) So instead, I just said the dumbest thing
I’ve ever said in my life: “Hey guys, how’s everybody doing today? You all ready to have some fun? Okay, show of hands, how many people here
have tried virtual reality?” Half of them had been in
since VCRs were a thing. But one by one, they came in
to try meditating and VR, and it was incredibly powerful. One of the first guys to try it told us
he had been in for nearly 40 years. We put the headset on him, and for two minutes, he was transported
to a beautiful, sunny mountainside. When he took the headset off, he had tears welled up in his eyes, and he said, “I forgot
what free felt like.” Another guy told us that the total sense
of peace and calmness that he felt in VR was something he had
never experienced in prison. Today, we’re using virtual reality to help inmates meditate,
in three prisons in Alaska, on a pilot study. (Applause) Eventually, we hope to integrate
more personalized content. Imagine how powerful it would be
if we could crowdsource video that would allow inmates to meditate in a place that they have
a deep emotional connection to. A native inmate could meditate
in the Inuit village where he grew up or even participate in traditional
ceremonies, using 360 video. We believe that over time,
this program can help us lower the use of sedating medications
and solitary confinement. (Applause) But what about recidivism? You know, that whole
revolving door on prisons? Over 70% of inmates
who get released from prison will commit another crime
and go right back. Prisons have tried a lot of different
things to lower those rates, but nothing’s had much of an effect. One of the inmates I was talking to told me a story about how unprepared
he was for life on the outside when he got released 10 years earlier. He explained that in prison,
your personal space is everything. It’s all you got. So if somebody violates yours
or you violate somebody else’s, there’s consequences, prison consequences. I didn’t ask him what
prison consequences meant, but I’m pretty sure
it wasn’t a good thing. (Laughter) So he gets out, and his dad
takes him Christmas shopping at Walmart. Yeah, you see where I’m going with this. Christmastime at Walmart
is the very definition of mayhem. They go in, and it’s packed,
and everybody’s rushing around, and they’re knocking stuff over, and they’re pushing and shoving
and rolling back prices, and eventually, they’re bumping into him. Everybody – kids, grownups, hell, probably even the greeter,
for all I know – and they’re bumping into him
and nobody apologizes. Nobody stops to say, “My bad.” They just keep going. And he snapped. Prison consequences. He beat the shit out of some guy. Now, anybody who’s ever been
to a Walmart at Christmastime has on some level
wanted to punch somebody. (Laughter) I get it. But unlike the rest of us,
this guy actually did it. He had just gotten released,
and he went straight back to prison. Now, if you’ve been in prison
for, say, 30 years, basic tasks that we take for granted – like crossing a busy street or using the self-checkout
at the grocery story or going on a job interview – they can trigger fear, panic and anxiety. If you have a crippling phobia
like fear of spiders, your therapist might use a technique
called “exposure therapy.” You might start out talking
about spiders and what they look like. Maybe in the next session,
they have you draw a spider. And eventually, before you know it, you can have a live tarantula
sitting in the palm of your hand. By gradually exposing you
to the thing that you’re afraid of, you can learn to overcome that fear. Well, it’s simple enough with spiders,
but what if you have a fear of flying? Good luck trying to find a therapist that will go to the airport
with you every week. But in virtual reality, you can go to the airport,
get on a plane, take off and land – right in your therapist’s office. And multiple published studies have shown that it can be just as effective,
or even more effective, than traditional exposure therapy. And it can cost less, take less time
and be made more personalized. So if VR works to help people
overcome their phobias, it made sense to try it out as a platform
to help inmates close to being released learn skills to make that transition
to life on the outside easier and less traumatic. Right now, we’re working
with a New York-based startup firm to pilot test a series of VR experiences that enables inmates to learn
critical skills to thrive on the outside, things like resolving domestic conflict or dealing with a job interview when the interviewer is grilling you
about your time in prison, or resolving conflict
when someone bumps into you in a bar or a Walmart. Now, the reason I’m telling you
about our work with prisoners is that very often, prisoners have some of the worst access
to mental health services. So if a solution works for them, there’s a good chance
it’ll work for the rest of us. And it is. Right now, doctors are using VR
to de-stress in between patients. Patients in hospice care are using it to check items
off their bucket list before they die, and kids in hospitals
are using it to manage pain without high doses of medication. (Applause) These are my sons, Mark and Sam. There’s a genetic component to bipolar, so I know that there is
a better-than-average chance that one day one or both of them
will develop it, and that scares me. I also know that people
with untreated bipolar have a suicide rate that’s 30 times higher
than the general population. That scares the shit out of me. But prevention, early intervention
and quick access to great care can lower those rates. And that’s what motivates me
to turn that fear into solutions. Technology isn’t the enemy
of mental health; it’s a scalable solution. I know because we’re seeing it work, and in this way, we can make life better, for me, for Mark and Sam,
for inmates in Alaska and for everyone else caught
in that bumper-to-bumper traffic. Thank you. (Applause)

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11 thoughts on “How virtual reality can improve your mental health | Matt Vogl | TEDxMileHigh

  1. Great talk Matt! Thanks for being vulnerable and sharing your story…your team is doing awesome work inventing new models for improving our mental health!

  2. I actually thought about this about 8 years back when playing fallout new vegas, but my idea was for problems like agoraphobia and social anxiety disorder doing things as you would in your normal everyday life like talking to people, driving, going out to grab some food and other simple things that some of us have problems with. Basically pre exposure therapy followed by real exposure therapy.

  3. And I'm all for any type of treatment that doesn't involve medication because with meds you might get the desired effect but it seems like when it comes to meds they help you in one area but cause you problems in another, then they want to put you on another pill for the new problem which might help it but the cycle just repeats itself and causes yet another problem and continues until your a half dead zombie with 20 different meds…

  4. Still love you so, Matt, so I visit you once in a while. Just you and Uncle Bob (I read his obit).

  5. what about the use of VR for non prisoners – those who are struggling with PTSD or other types of mental health concerns like depression? This would be a great way to help some of our young adults who are dealing with these types of concerns in record numbers – is this being explored?

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