Introduction
It all started with Web 1.0, the ‘read-only’ internet. Web 2.0 replaced it as a more interactive version where the user could send information to the servers. Then social media emerged, soon followed by the inclusion of virtual/augmented/mixed reality. Now, a convergence of all these technological advances has given rise to the metaverse, which is being touted as the future Web 3.0.1
Basic elements of virtual reality (VR) have existed for over 50 years with limited levels of immersion and interaction. Immersive VR is created by wearing a head-mounted device that uses stereoscopic displays with specialised lenses carrying motion tracking hardware which provide the illusion of being physically present in a world that is virtual.2 VR replaces the real world with a virtual one, whereas augmented reality (AR) supplements the real world with virtual content by overlaying digital images on physical objects.3 Consequently, VR allows users to feel psychologically immersed in a virtual environment, while AR provides an environment that enables users to interact with virtual objects in the real world.3 Mixed reality (MR) is a mixture of virtual and actual reality allowing real and virtual elements to interact with one another, enabling users to have more control over virtual objects as compared with AR.3
The metaverse is a digital world created using different technologies like VR, AR, cryptocurrency and the internet. Metaverse is a portmanteau coined from the words ‘meta’ and ‘universe’ taken from Neal Stephenson’s science fiction novel Snow Crash written in 1992.1 In the novel, avatars of real people inhabited a three-dimensional (3D) virtual world. Interest in the metaverse has blown up in recent months, with ‘metaverse’ and ‘non-fungible tokens (NFTs)’ being some of the hottest tech terms in 2021, according to Google Trends search. The metaverse is an expansive network of real-time 3D virtual simulations where users can have a deeply immersive experience of being ‘inside’ the internet interacting digitally with other users, objects, and environments. The virtual universe boasts all the features of the real world where people can gather, socialise, work, and play with others in a different physical space embodying unique avatars.4 The primitive form of the metaverse is already here, and it will evolve in ways we might not be able to foresee.1
Web 3.0 will change the way we socialise, work, and interact. NFTs are unique digital assets that represent objects like art, music, collectible items, and in-game items.5 NFTs are traded online, often with cryptocurrency, and are a unit of data stored on a block chain, a digitised database that is distributed across the internet. Cryptocurrency systems like bitcoin and Ethereum, and NFTs are blockchain-based.5 Blockchain maintains a secure and decentralised record of transactions guaranteeing the security of records of data without third-party control.5 The decentralised nature of the blockchain offers prospects for limitless business opportunities and social interaction in the metaverse.6 NFTs might become the building blocks of the metaverse. For example, NFT digital avatars represent real-life identities that can be used as access tokens for different locations within the metaverse.6
In the realms of the metaverse, NFTs could play a critical role in business ecology. NFT metaverse initiatives would expand the boundaries of exploiting NFTs for transactions of virtual property.6 The impact of NFT metaverse ventures would also have a considerable impact on the identification, social, and communal experiences of metaverse users. By owning NFTs, users may extend their support for certain causes or simply express their thoughts. Consequently, NFT owners with similar preferences could reach out to one another and form communities for interacting, sharing ideas, and working collaboratively.6
While there is much excitement around the metaverse and NFTs, what does this mean for the future of psychiatry and mental health? According to a study by the World Health Organization (WHO), mental illnesses are the leading cause of illness and disability worldwide, but between 30% to 80% of the people with mental health challenges never seek treatment.7 8 This may be due to numerous reasons, including stigma, lack of awareness, limited access to treatment or resources, financial hardship, inability to pay for continued treatment, and conflict with work and school schedules. The metaverse is a 3D amalgamation of social media, virtual gaming, shopping, digital art trading, real estate, and the investment market. Entering the metaverse will surely impact our reality, with possible negative and positive effects on mental health. According to Amara’s law, we tend to overestimate the effect of a technology in the short run and underestimate its effect in the long run.9 Based on this premise, we might overestimate the ability of the metaverse to predict future outcomes while it is in its nascent stage. With the growing global mental health crisis looming over the horizon, our review aims to explore the role the metaverse will play in the epidemiology of mental health disorders.