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This study aims to pilot-test the acceptability, feasibility, preliminary efficacy and user experience of an animated virtual reality (VR) game (“Goliath: Playing with Reality”) aimed at reducing stigma related to psychosis and schizophrenia among health-care students and trainees.

A mixed-methods design was used. Sixteen trainee clinical psychologists with experience working with service users with psychosis/schizophrenia engaged with the VR game using a headset and controllers, and completed measures before and after. Quantitative measures assessing intervention acceptability, appropriateness and feasibility were collected and analysed descriptively. These were complemented by qualitative feedback on user experience, analysed through content analysis. Pre- and post-intervention mental health stigma-related measures were also collected and analysed inferentially.

Most participants found the VR game acceptable, appropriate and feasible for reducing mental health stigma. Although there were no significant changes in stigma-related measures, participants were impressed by the immersive storytelling and the symbolic portrayal of psychosis. Participants also valued the educational aspect, empathised with people living with psychosis/schizophrenia and experienced a range of emotional reactions. However, participants noted usability concerns, and suggestions for improvement were made.

This is one of the first studies to show the potential of “Goliath: Playing with Reality” as a mental health educational intervention for health-care students and trainees. Drawing on narrative theory and immersive-interactive storytelling techniques, the VR game provides experiences that can foster narrative engagement and emotional connection, potentially enhancing its effectiveness in mental health stigma reduction efforts.

This study aims to explore how people with concurrent mental health and substance use disorders and lived experience of deep social marginalization perceived barriers and facilitators to mainstream social participation. The purpose of this study is to identify meaningful and relevant learning content for a virtual reality-based intervention to promote social participation in this group.

This formative qualitative study was conducted in Norway during Autumn 2022. Nine in-depth individual interviews with adults recovering from dual diagnosis were conducted, audiotaped, transcribed and analysed using reflexive thematic analysis in a collaborative analysis process.

Results indicated that social alienation, poor social skills, stigma, low self-esteem and social anxiety were key barriers to social participation in this group. This study suggests a need to learn appropriate social behaviour in mainstream society, in addition to better employability skills, civic literacy and health literacy to improve utilization of social opportunities.

This study implies that virtual reality-based interventions for promoting social participation in people with dual diagnosis should primarily focus on learning and practising appropriate social behaviour in shared public spaces before practising advanced social skills such as employability skills in simulated work environments. Learning and practising social skills appears decisive for using more complex social opportunities, such as in education, health, social services and work.

This research provides suggestions for the content of a novel virtual reality-based intervention to promote social participation among people in recovery from dual diagnosis.