The kids, to twist the old saying, aren’t alright. In the wake of the Covid pandemic, youth mental health shows persistent, elevated rates of anxiety and depression , according to the National Institutes of Health (NIH). While pre-existing upward trends began before 2020, pandemic school closures, social isolation, and disruptions significantly amplified these mental health challenges, with recovery varying widely among different age and minority groups.

Evidence-based practices for improving adolescent mental health and social-emotional learning have been around for decades; but that doesn’t solve the larger crisis around access to care. The high startup costs, the need for a trained clinician in the room, the weeks of sessions a school schedule can’t absorb, and the small matter of getting a teenager to willingly participate – all of this stands in the way of young people getting the help they need.

Arche XR , a company founded by Nicholas Thomson, Professor and Associate Dean for Research in the School of Public Health at Virginia Commonwealth University, is trying to solve that last set of problems by translating evidence-based mental health and prevention approaches into immersive, interactive experiences.

"The challenge isn't that we don't know how to help young people. The challenge is delivering evidence-based approaches in a format young people will actually engage with and that schools and clinicians can realistically deploy." says Thomson. “We use immersive technology to make those experiences active, engaging, and scalable.”

The engagement numbers bear this out. “When 98 percent of young people tell us they want this kind of intervention in their schools, that’s a powerful signal,” Thomson says. "Engagement and access have always been the biggest challenges when it comes to youth mental health. An intervention can be evidence-based but it cannot be effective if youth do not have access to it or do not want to participate in it. What excites me with Arche XR, is that we’re seeing children and adolescents enthusiastically engaging in their mental health and wellness. This changes the scale of what becomes possible in youth mental health.”

Thomson, who has been using VR in psychophysiology research since 2010, is careful about what the technology can and cannot do. "The future of mental health care isn’t technology replacing clinicians. It’s technology extending what clinicians and educators are able to do," he says. "If we can give schools and clinicians an evidence-based tool that young people genuinely want to engage with, we can strengthen care, improve engagement and ultimately reach far more young people." The data he cites suggest the programs can do more than improve outcomes on their own. By increasing engagement, they also strengthen the broader therapeutic process and help young people stay connected to care.

The programs offered by Arche XR cover suicide, gun safety and violence prevention, substance and alcohol use, mindfulness and grounding, and social-emotional learning, anxiety, depresion, trauma, and impulsivity, and the formats vary considerably by program. Lumen VR, the mindfulness program, runs four minutes, a constraint that came directly from teachers who told the company that even a brief 30 minute program consumes half a class period. Participants travel to different parts of the world inside a spaceship frame, earn tokens for participating in grounding and mental strength exercises, and pull levers back on the ship that release balloons and bubbles. Arche XR’s art therapy program, runs in passthrough so participants draw in their own physical space, with pencils, paintbrushes, spray cans, and — because the youth advisory board weighed in — a super soaker and water balloons for washing it all away. Thomson says clinicians have children who rarely communicate verbally beginning to open up after sessions, “We’ve had youth create entirely new worlds. What they create becomes the starting point for a conversation that wasn't happening before.”

Thomson credits the youth advisory board for the high acceptability rates. Young people with lived experience are hired to weigh in on storylines, aesthetics, and the specifics of where scenarios take place. “Young people aren’t simply the end users. They are part of the development process,” Thomson says. “They help shape the stories, environments, language and experiences we build, because they understand better than anyone what will resonate with their peers. That is a major reason we see such high acceptability. The future of youth mental health should be built with young people, not simply for them.”

Arche XR is an independent, clinician-scientist-led company with no venture backing. Thomson says the company is profitable, supported by subscription revenue and federal research grants, including Small Business Innovation Research funding from the National Institute of Mental Health, and that every product undergoes a randomized controlled trial. “We’ve built Arche XR differently from a traditional technology company,” Thomson says. “The science comes first. We develop the intervention, rigorously test it, learn from the data and from the young people using it, and then scale what works. Our goal isn’t to move fast simply because the technology allows us to. It’s to build something that can earn the trust of clinicians, schools and families and ultimately become part of the infrastructure of youth mental health.” The company provides organizations with the headset, protective face covers, cleaning supplies and ongoing technical support, while making no profit on the hardware. Revenue comes from subscriptions that amount to just a few dollars per user. That support is intentional: new technology only scales when organizations have the infrastructure to deploy it safely, consistently and with minimal burden on staff. The headsets do not require internet and are shipped locked down to Arche XR content, a decision shaped by deployment in schools, clinics, hospitals and detention centers, giving clinicians and educators certainty about exactly what is on the device, what it can access and that it is ready to use.

The programs are currently used by more than 10,000 young people across schools, clinics, hospitals, nonprofits and detention centers, with a pilot underway with the National Health Service in the United Kingdom. "If we can make evidence-based support engaging, affordable and scalable, we can build resilience across entire populations of young people and ultimately reshape the trajectory of youth mental health." he says.

If you or someone you know is struggling, the 988 Suicide & Crisis Lifeline is available 24/7 by call or text.