Most patients are admitted to our ward by direct referral from the psychiatric emergency service, a service delivered by Community Mental Health Centers. Some are referred by our own out patient clinic, often these patients are shown around the ward before admission but these patients are the exception to the rule of acute admittance. Most patients are without prior knowledge of the ward or even the slightest idea about psychiatric wards, mostly scary imaginations from movies and such.
Misconceptions about these wards, however, are so prevalent that patients, especially those newly admitted to a ward for the first time, are anxious and become reluctant or even refuse to receive in-patient psychiatric management.
Wouldn’t it be great to let future first time patients have a look around the ward in virtual reality?
Recent research looked at virtual reality as a way of reducing anxiety for first time patients going to be admitted to a psychiatric ward and how good is virtual reality in raising the level of understanding of the new environment. They made a virtual ward for a virtual guided tour that led the patients to different rooms and locations. The patients had to preform certain interactions on the computer with visual and audio feedback before they could move to the next location. Most of the feedback was on rules and regulations on the ward and about procedures and their explanation such as the need for locked doors. Interaction was with keyboard and mouse. Admitted patients giving informed consent were randomly assigned to the virtual reality group (n=27) or to a non virtual reality group (n=27). Patients in the latter group were allowed to read the information on rules and regulations from a computer screen.
All patients were monitored with heart rate variability measurement, State Trait Anxiety Inventory and a test for their level of understanding of the information offered.
Patients did not differ on anxiety as measured with the heart rate variability but they did differ between groups on the State Trait Anxiety score. Physiologically their anxiety on admission was not reduced by the virtual reality introduction but the participants did find the new approach with virtual reality very helpful to orientate them in the new environment.
This study was done in China, with only females included in the two small groups, randomization was not double blinded, and severe mental illness was an exclusion criterion. To me this procedure looks promising, what do you think?
By the way this picture on the top of this post was made of the building served as the location for virtually all interior movie scenes of “One Flew Over the Cuckoo’s Nest.”
Oregon State Hospital – The largest, oldest, and most famous structure within the institution is the J Building, built in 1883. This building. The Oregon State Government wanted to demolish the J Building in 1988 due to life-threatening health and safety dangers posed to patients and staff. There is an abundance of lead-based paint and asbestos throughout the building. Presently, the J Building is on the brink of collapse and mostly abandoned. Patients continue to be held in remodeled portions, but many believe that a minor earthquake could send the dilapidated structure and patients to their demise.
Lau, W., Choi, K., & Chung, W. (2010). A Virtual Psychiatric Ward for Orientating Patients Admitted for the First Time Cyberpsychology, Behavior, and Social Networking DOI: 10.1089/cyber.2009.0107