Bruce Bassi#FuturePsychiatryPodcast discusses novel technology and new ideas in the field of mental health. New episodes are released every Monday on YouTube, Apple Podcasts, etc.
Summary
Xavier Palomer, founder of Amelia Virtual Care, speaks about virtual reality treatments in mental health & psychiatry: adoption, evidence, uses, challenges.
How did you get started? How does the multicultural background at Amelia contribute to success?
What evidence is there for virtual reality in mental health treatment?
What are difficulties in adaptation?
What is “presence” and why does that matter for treatment?
What precent use mobile phone-based headsets?
What FDA category does VR care fall in? Why is it important to include a mental health professional when using VR for mental health treatment?
What is exposure therapy and how is it done in VR care?
What is the biggest challenge for Amelia moving forward?
Chapters / Key Moments
00:00 Preview
00:57 Introduction
04:22 Amelia’s Multicultural Background
05:50 Where is Amelia Most Popular?
07:22 Going Up Against Competition
08:39 Why Should Someone Choose Amelia?
10:31 Working Between Engineering and Clinical Teams
12:50 If More Data Not Needed, Why Is It Not More Popular?
15:49 Applications of VR
17:41 Using Smart Phone Based Headsets
19:06 Prescribing Amelia and FDA
20:49 Deciding Upon FDA Approval or Not?
21:23 Why VR Works – Breaking Assumptions
23:14 “Immersivity” or “Presence” Does Not Require “Perfect” Graphics
25:50 How Does Exposure Therapy Work?
28:49 A Use Case of VR: Mindful Meditation
32:26 Biggest Challenge for Amelia?
34:38 Why Should It Be Combined With A Therapist?
Transcript
Preview
Xavier Palomer: When you talk to someone that is suffering anxiety, OCD, PTSD or whatever, these kinds of things, these are complex conditions. So for me, it’s difficult today– maybe tomorrow someone changes my mind– but today, for me, it’s difficult to imagine how you can completely standardize that. I don’t see it clearly. I can be 100% wrong, but have a fully standardized treatment for it’s hard for me to believe and to trust that that’s possible way. Having said that, I don’t think it’s a matter of fully automatized, self applied versus all-human-based-whatever. I think that the beauty of technology is to combine the human strength, the human with the technology.
Bruce Bassi: Hello and welcome to the Future Psychiatry podcast. I’m your host, Dr. Bassi. Here we explore novel technology and new innovations in mental health. We speak to guests to better understand their contributions to this space and dig deep into underlying motivations for key features, technical challenges, and future directions. We look behind the curtains to see how these creations are made and how they expect them to evolve in the future. As a reminder, new episodes are released every Monday. Additional resources and a full transcript can be found on our website telepsychhealth.com, and then click podcast in the top right corner. If you’d like to support the show, the main way you can help us is by subscribing to our channel on YouTube and leave a comment, even if it’s just an emoji. It also would mean the world to me if you can share it with your network on social media. I appreciate it and hope you enjoy the show. Today, we’re speaking with a rising star in the world of virtual reality, Xavier Palomer. Xavier founded Amelia Virtual Care in 2014, which helps psychologists and mental health professionals around the world get better results in less time by applying virtual reality therapies in their clinical practice. Xavier, I welcome you to the show.
Palomer: Thank you. Very nice seeing you.
Background
Bassi: Nice to meet you as well. So, like you, I had started a PhD program when my interest drew me in another direction. Tell us a little bit about yourself and your company, your background, and why you felt so passionately about virtual care to pull you away from the PhD program.
Palomer: Of course, my background: I have a double degree in physics and electrical engineering. I did my masters. As you can notice from my accent, I’m not from the US. I did my undergrad in Barcelona, Spain, then I moved to the US to do my master thesis and then starting a PhD program, which, as you said, I did not finish, because since I was a kid, I wanted to start my own business. And I was in that moment in life. I needed to take a decision whether to finish the PhD or come back to Barcelona and start a company. Right. So I took the second way, the second option, and I came back to Barcelona, and I started looking for what started company meant for me at that time. So at some point, chatting with two friends, one of them was afraid of flying, the other one was a psychologist. And the magic came through. And I found out how virtual reality back then, 2013 or even earlier, how virtual reality was very well known in the space with a very well proven scientific data and validation and very strong evidence, right? So for me, that was a surprise of saying, wow, how can we have this very strong technology that has proven, that has like a clinical value, that can improve the clinical outcomes in mental health? How can we have that sitting on the science wall but not helping real patients and real people? So I want to change that. And at that moment, I was looking to start a company. So it was the perfect mix, the perfect mix that for me was like magic. And this is when Amelia was born.
Bassi: I totally see why you were so attracted to virtual reality back then. And we will get into the adaptation of virtual reality as a culture in a minute. But I want to understand a little bit more about your company. You mentioned you’re from Spain, you live in Barcelona, and I know that Amelia, from what I’ve been researching online, is very multicultural, operates in many countries, and also your staff is also very diverse too. And how does that multicultural elements contribute to your success?
Palomer: I mean, I think it’s one of the key elements, right? I mean, having different people with different backgrounds, with different cultures, with different whatever the other day, it enriches us what we think, what we see, what we discuss, right? So I think it’s critical. And I love Barcelona. I’m from Barcelona. I love Barcelona. But when I think where I’m from, I think a global citizen, right? So I don’t understand life differently, and of course, I don’t understand a company in a different way, right? Different colors, different languages, different opinions, and always have this umbrella to discuss and to make things happen, right? Because at the end of the day, different options sometimes slow down, so, yes, let’s discuss, let’s share, but let’s execute together. And I think that’s even better. Not just multiculturality, but also executing in different languages. We speak I don’t know how many languages at our office, we have 60-70 employees. And although we are not that big, I don’t know how many languages. I would say like 10 to 15 languages for sure at the office. Right.
Where is Amelia Most Popular?
Bassi: What country keeps you the busiest? Where are you most popular? And why do you think that is popular?
Palomer: In terms of employees of Spain, of course, we got started here.
Bassi: No, in terms of sales.
Palomer: In the United States, this is where we are more popular–
Bassi: Is that just because of population or do you think it’s something about the culture or psychiatrists there? It’s a combination of everything, right? The mental health culture that you have is well more advanced than any other country in the world. Any other country in the world. The appetite for technological solutions is also quite high. So I think it’s a very good combination, right. The maturity of the market, of the industry, the appetite of the patients and professionals, or the customers, if you want. And it’s a very nice combination. And honestly, there is no other country for us, at least in the world, that is really working that well for us.
Going Up Against Competition
Bassi: So you’re sitting down, you talk to your friend, you know you have a very poignant story and you can reach a lot of patients there, and you have this amazing technology that’s essentially sitting on the shelf in the science world and nobody’s really adapting it. And believe it or not, as a background, I actually worked on a virtual reality project at Johnson Space Center affiliated with NASA, and we were trying to reduce not the difficulty astronauts had with nausea and motion sickness when they got into space. And I thought virtual reality was amazing. It’s so real and you feel so present. But I would have never felt comfortable going up against tech giants in the space, like Google, Facebook, and obviously, Mark Zuckerberg has taken this on a personal journey for himself. What kind of mindset were you in at that time, in 2013-14, to feel that you were ready to take on these other major companies? I think that’s incredible. Very brave.
Palomer: Honestly, we didn’t think about it. And we are not against them. At the other day, in big worlds, they are interested in healthcare, but mental health is a small niche within healthcare. Right. And my hope is that at some point, I’m pretty sure that today they don’t look at us. And my hope is that by making noise and by making this technology useful, they will look at us and they will realize that mental health is something to look at, something interesting from both because you have real problems from real people, but also from the business side. So it’s a very nice combination. Right. So they are way more than going against them, I would say. I’m trying to make as much noise as I can to attract their vision and their attention. Right.
Why Should Someone Choose Amelia?
Bassi: How do you stand out currently among your competitors? Say somebody, a clinician really wanted to adapt, bring in virtual reality to help their patients, and they saw a few companies. What would you say? Why Amelia?
Palomer: Because we are the best. We are the best in terms of the control and interface for the technology, for the customer attention that we have, the customer service that we have, a lot of different aspects. But again, when I talk to competitors, of course I know that I’m better than them, but when I talk to them, I try to change the position and say, hey, guys, we are not competing. I hope we are not competing today because we are building something together, right? We are building something together which is making virtual reality a healthcare technology, right. Not just a very nice thing to have that this and that, a must to have something that is the deep roots on the deep, the very core of healthcare. And we need to push together to that. Right? So when I talk to my “competitors,” I try to work with them more than competing with them. Yes, there are a few competitors, but there are a few different companies doing this. But if we compete today, we have a problem, right. The market is not big enough to start competing today. We need to really create that market and make it way bigger (get the word out more). Exactly. And eventually we’ll compete. I’m looking for that day, but today we need to build that before competing.
Working Between Engineering and Clinical Teams
Bassi: In the early days of Amelia, when you were first starting out, you had to straddle this line between being engineer and clinician and getting those teams to talk together. And sometimes they use different vocabulary and they have different mindsets and they have different priorities. And I think that’s one of my main motivations for this podcast is because I consider myself to be both. And I feel often the clinicians kind of in a way, we feel left out a little bit at conferences talked about the movement of technology and where it’s going and they feel that they’re on the periphery kind of watching things transpire. And I think this is a cool position that you were in to be able to bring those two together. Can you talk a little bit about the challenges you’ve had in communication with these two teams when you’re first starting out and what that was like?
Palomer: Of course. I mean, going back to your previous question, I think meeting people from different backgrounds, different talk and interact and execute and work together, you said it. It can come from different cultures, but also from different backgrounds. So I think that’s key to success. The wall is like, plenty of different people, different ways of looking stuff and understanding stuff, and physicians and technologies or developers are not different. We need both sides of the equation to make a successful product, otherwise it’s not going to work. And those are two profiles. And honestly, I’m super excited when both of them talk and understand each other. Not just talk, but understand each other, but also when you start bringing in like salespeople or business development or finance or regulatory or this and that. The crowd is like extremely complex. Right. So going back to again, to your first question, having different cultures, I think it helps in this kind of situation because we speak different languages. So we need to make an effort to communicate, to understand each other. We do that since day one. Right? So we are used to work for the communication. So when I explained to the clinical or engineering on whatever side or whatever knowledge I have, we are already used to work hard for our communication. So I think it’s another element again, it’s diversity, different ways of thinking, different, visions different and make them work and talk and execute together.
If More Data Not Needed, Why Is It Not More Popular?
Bassi: And you mentioned that you knew that there was a lot of data there. And I think virtual reality is kind of almost a no brainer. It has evidence there’s numerous trials now that have been completed that show it’s helpful for anxiety, pain, eating disorder, psychosis (in developing interpersonal skills), addiction (for cue reactivity), autism even. It’s almost like would additional research or data even help at this point? Or do you think there’s some other element as to why it’s not becoming more widespread at this point?
Palomer: Yeah, that’s an excellent question, by the way. Honestly, I don’t have an answer for that because it’s true. I mean, the data is there. If you Google like VR healthcare, whatever healthcare mean for you, you will find thousands of publications on the data. Exactly. It’s a very good question, why the adoption is not higher. I mean, there are different things, right? But of course we do not have as human beings, we don’t have like a VR headset in our desks. I have a smartphone, I have my computer, I have this and that. But I don’t have a virtual reality headset and I work in this space. Right. I think it’s a matter of for everyone to really know the technology and not just know, but use it. This is for virtual reality. Virtual reality in mental health or in healthcare in general, I think will come after. But I don’t see another way around. So we need to get like a mass adoption of this technology for whatever reason, and then the healthcare side of the equation will be ready. Will be ready. But having said that, it’s true that on the patient side, if you want, there is no super mass adoption. But on the professional side, I’m quite impressed you see the number of hospitals that use our technology or someone else’s, not just ours. But I think the adoption on the professional side, meaning hospitals, meaning clinics, meaning providers, or of any size and type, I don’t think it’s bad. I think it’s actually quite good. The adoption and the growth rate that we are seeing adoption in this business world, if you want, it’s quite exciting, but it’s quite exciting. I think it’s a matter of time that we’ll see a virtual reality headset. Maybe not all the hospitals, clinics or whatever out there, but in a very vast majority, for sure.
Bassi: It almost reminds me a little bit about telehealth and the runway that it has had and taking off in its trajectory. Telehealth has been around since the late 90s, I would say. There are people doing telehealth. It was very slow and I think there was a lot of stigma against it because there was maybe a lack of trust. There any particular reason why it took essentially 20 years from 2000 up until 2020, when we had the COVID epidemic, to really set it free and everyone started to embrace it? I think my theory on the VR thing is that maybe in the general population, it’s still seen as a gaming console. In 2021, Oculus sold more headsets than Xbox, and I think the main platform that it’s really geared to is people who are interested in gaming and entertainment and having fun. But it’s good to see that the professionals are also embracing it too. Do you know any of the data there about the growth rate among professionals?
Applications of VR
Palomer: I mean, you see lots of data there. But a week ago, I was in Lisbon Portugal with International Virtual Reality Healthcare Association. Plenty of people from the US. And someone at that conference showed that the adoption rate of virtual reality today, the slope is way higher than the smartphones at the beginning. Right. So, I mean, we, meaning the people that are using VR for some reason, for good, of course, gaming I’m not saying gaming is not good, but for different reasons. We need to believe ourselves that this is being adopted and stopped saying that this is not adopted. Right. I think there are plenty of very interesting use cases. Healthcare is of course one of my favorite uses; you are actually helping people. Right. But also education, training, I mean, thinking on how you can use VR for education, for training, gaming, I don’t play games. I cannot answer for you. Same. But I see plenty of very positive use cases. Right. So I’m confident that it’s a matter of time. Things don’t happen one day to another. Right, so it’s a matter of time to see more and more.
Bassi: And I know that you all build your own native headset. And the users also, they make these headsets where you could pop your mobile phone in there. And mobile phones are so large these days. I don’t know what that experience is like. The only time I’ve ever used VR was with a native headset that was built for it. Do you think that or does Amelia offer an app where you can use your own mobile device in there in an adapter or whatever you call those things that you put the mobile phone into to maybe reach a broader audience that doesn’t want to spend a few hundred dollars on a headset?
Using Smart Phone Based Headsets
Palomer: Yes, of course, we call it the “Smartphone-based Headset.” But yes, of course. And why you are using one since, when we are using that is since COVID, right. COVID changed a lot of things telemedicine as you mentioned, so in our case as well, so we needed to adapt super quick to the telehealth ecosystem that was happening in 2020. So that’s why we developed the app based Amelia’s solution. And when you use it on the smartphone, you can use it in 2D, but also with this smartphone based headsets. Right. So, yeah, you can go online on the App Store and download our app. You will be able to do very limited things, but you’ll have the app at least. Through the app, professionals can push content, can push sessions to your smartphone so you can be treated remotely.
Bassi: Is that actively being developed on your guys’ back end to continue improving that component of it?
Palomer: Of course. And today in the US, I don’t remember the numbers, but it’s 40% of our sessions that our customers contact with our system are conducted with a smartphone. Oh, wow.
Bassi: That’s more than I would have thought.
Palomer: So, yeah, it’s developed and it’s fully deployed and it’s being used quite a lot.
Prescribing Amelia and FDA
Bassi: Tell me a little bit about the FDA approval process. Amelia virtual reality is prescribed, so prescriber needs to actually prescribe it in order to clear it for use as a medical device. So I know you probably had to seek FDA approval and what was that like and does that help or hurt versus getting an exemption? How does that all work for somebody who’s not familiar with it?
Palomer: So, in terms of regulatory approval, we are under enforcement discretion. Okay. But we have interacted with the FDA several times to find the best place for us. Right. So having said that, our system is prescribed and it is a tool for mental health professionals. So ‘prescribing’ for me is like, take this pill every 8 hours, the next five days, whatever. And you go and do it alone at home. You do the treatment alone at home. Our system is always being used under professional supervision. So it’s a recommendation or guidance more than a prescription. So that’s why I think we are under enforcement discussion, we’re in this middle step.
Bassi: So enforcement discretion means it’s not FDA approved yet, because I know that has insurance implications. And for us in the US, that’s probably something that’s on a lot of people’s minds is, will insurance cover this? And I believe that it has to have been cleared by the FDA as an approved treatment for a particular disorder in order for insurance companies to start to adapt it and pay for it.
Palomer: Correct. That’s the typical healthcare path. Correct. Although we are not following you’re correct. That’s the typical healthcare path: development, validation, regulatory, and then market access or get the payers on board as well. We are not following this path. But in order to interact with payers, you need to follow this path completely.
Deciding Upon FDA Approval or Not?
Bassi: And what was the reason that you wanted to not follow the path? Or was that intentional or not?
Palomer: Of course, because it’s long, it’s costly, it’s complicated, it’s risky, and we don’t need it. There are different ways of doing stuff in life. And we took a different path. That was the main reason we look for it, and we decided to take that path.
Why VR Works – Breaking Assumptions
Bassi: Awesome. So let’s talk a little bit about the experience one has when they use virtual reality. I had the pleasure of being able to experience VR headset in real time at a national conference, and I tried it. I was in an airplane. I was in a seat and was able to get that vestibulo-ocular feedback moving around and almost in a way, and kind of engaging with the environment. In a word, that’s called the “presence” of VR, that allows people to feel like they’re there, where the technology element is kind of removed and you’re just interfacing directly with the environment. Rather than thinking about the technology there interfering. And I think that’s the main advantage of using VR for mental health is because people have assumptions about reality, about how they’re going to be perceived or how they might have fear on an airplane. And in order to break those assumptions, you need to actually see feedback in real time from the environment and how it’s reacting in a different way than what your assumption was to kind of break that link there that contributed to anxiety or what have you. And I was very disoriented when I took the headset off. And I wouldn’t say the graphics were perfect, but I don’t think they needed to be perfect necessarily in order to feel presence in that moment. And I think that’s one of the main criticisms of VR. A lot of people criticize Mark Zuckerberg because the graphics just look really dated still. And I almost think that’s kind of a cheap shot in a way, because you don’t really need it to feel perfectly realistic in order to feel the “presence,” quote, unquote. So tell me a little bit about what your experiences are with the graphic design and the reality of the VR headset.
“Immersivity” or “Presence” Does Not Require “Perfect” Graphics
Palomer: That’s a very good point. Very good point. Because the reality is that chit-chat is all over the place, right? “This is not high quality, this is this and that” or whatever. But when you actually use it is what you said, you don’t need that much quality. I’m not saying that we should not improve. You actually don’t need it. Right. We should improve. Always. But to get something out of this technology, you don’t need a super high quality. When I watch movies that are like a little bit scary or whatever, I cannot watch them. And I know it’s a really good point and I know it’s on a TV and I know that it’s fake and I know that everything right, and I know that I’m sitting in my bedroom or my living room or whatever, but still, I can look, I cannot watch it. Those movies, right? So this is the same thing, right? And instead of a big or small TV, like, fades away from you, you are fully immersed there. So the sense of presence, the immersivity of this technology is like so much that you don’t need super high quality, right? And actually in mental health, super high quality, it might trigger bad effects, right? In the sense that when you’re facing, let’s say in a phobia I hate talking about phobias because it looks like this is the only example that we have. But it’s easy to explain, right? When you face your phobia, for example, let’s say a plane, or let’s say if you are exposed to a very, very real scenario in virtual reality that is actually giving you physical feedback, that is actually you will avoid that because this is what you are afraid of, right? So actually, to really start getting better as a patient, from anxiety, from trauma, from lots of different things, the first steps are usually conducted in a very low resolution, a very low realism kind of a scenario because otherwise patients just don’t want to deal with it. They avoid it, they reject it. And when they are in that mood, if you want, that’s not therapeutic. We should improve the quality of what we do always. And the graphics are one of the things. But for therapeutic usage you need to start with low quality because otherwise well rejected.
How Does Exposure Therapy Work?
Bassi: For the listeners out there who don’t have the clinical background, what Xavier is saying is spot on. Because “exposure response prevention” is the name of the type of therapy that’s used to treat anxiety and OCD situations where it’s very, very well thought out beforehand with preceding therapeutic sessions to outline what level of distress an individual is going to experience with different scenarios. And so just plopping on a virtual headset is not really how it works in a clinical respect. It’s much more logical and progressive where you start off with very, very lightly distressing situations and work your way through that. So individual can gain a sense of confidence and they feel like they have control over the situation and they can sequentially march through each subsequently more challenging scenario. Otherwise obviously it’s going to backfire and they’re going to lose trust from that clinician and not want to go forward with anymore environments. And in real life, in vivo clinicians have to become very creative and say an individual has a fear of flying or a fear of standing on a train platform and you’re in a city that doesn’t readily have one available. What do you do to mimic that scenario when those aren’t readily available to you? It’s very, very difficult because you’re trying to come up with elements that model the scenario but aren’t actually the scenario. And in VR you can do that with a click of a button and it’s just kind of a no brainer because you can quickly alter the size of individuals, a number of individuals, animals, objects, heights and spaces and presence of protecting elements on top of a building or et cetera.
Palomer: And you have control over that situation, right? Because if you take a real plane, a real train, who knows? Imagine that you take a plane with like someone is afraid of flying and suddenly you start having going through turbulence or you have whatever thing when you are landing, right? So, yeah, it’s not just therapy being creative, but it’s also allowing the exposure to this very specific situation that is going to help you in terms of intensity of exposure. The defensive elements that you said that there are there, but also know that monitoring of the patient. If you go just out there and do stuff out there, how do you monitor that patient, right? Is he or she is really getting to where you want, too much? Not enough? In VR you have everything under control. Remember that you are in a therapeutic wall. So better having everything under control, just leave random stuff. Imagine that you go into cardiac surgery and not everything is under control, right? I mean, you probably wouldn’t complain, right? Yeah.
Bassi: So we touched on a number of misconceptions that the general public might have, but is there anything that you would like to tell somebody who maybe has never experienced VR or is contemplating using it? What do you think they would benefit from knowing?
A Use Case of VR: Mindful Meditation
Palomer: There are lots of different uses now, but for example, one very interesting use case I think is to step into VR is meditation. Mindfulness meditation. I don’t know about you in our audience, but if you ask me to meditate, it’s going to be super complicated, at least at the beginning, right. The first ten sessions if you want. Meanwhile, if you use some kind of VR immersive experience, it makes your life way easier, right? So that’s a very good approach and we all know today how important and how helpful it can be to meditate, right? So I think that’s a very interesting use case to step into VR, right? I’m not going to say gaming because that’s the easy answer. Right, so meditation also learning, right? So not that far away. I remember talking to one of my friends, that when we started doing this in San Francisco, Silicon Valley, but I don’t know, so many years ago they were doing a startup for training, right? For me, learning history at school was super complicated. But this guy developed a solution to teach how to see the Romans or whatever, right? So I remember going through these experiences. Oh wow, now I understand what this is about, right? And remember my city in Barcelona that they had the simulation of how the cathedral was built in Barcelona? Trust me, I walked through that cathedral for like 10 million times before. Never pay attention before. After trying that VR training simulation where they were explaining how the cathedral was built, that was a completely new building for me. Meditation, training, different things that can really have an impact on your. Daily life, of course, gaming. But again, things that are really, really impactful and they can really help you, like in a lot of different aspects, right? So, yeah, think of what you do in your daily life and Google VR with whatever and probably there is a solution for that, an app or something that can help you on that. And when you start, you cannot stop.
Bassi: It does have an addictive element to it. What do you predict for the future? in the VR world. How clinicians adapt it, the progression of it, where do you see it going in ten years?
Palomer: When I talk to competitors or people in the industry, we need to become one key element in healthcare, a core element in the healthcare world, if you want. Don’t get me wrong, telemedicine is super important. But telemedicine is just a communication channel, has no therapeutic value by itself. Technology is just something to communicate to people. VR, because of this immersivity, because of this sense of present, because of this for me has a therapeutic value. So VR, using this rationale, VR will have a very important place, a very important role in healthcare because it has therapeutic value, it can help people, can improve clinical outcomes, it can improve the engagement, the adherence, whatever word you want to use of patients to the treatment. Better clinical outcomes, better engagement. I mean, it should become a key element in healthcare, period. A key core element in health care.
Biggest Challenge for Amelia?
Bassi: Absolutely, I absolutely agree with you. What is the biggest challenge for your company moving forward? Is it marketing? I don’t think it’s the data anymore. You can point to plenty of data. Maybe five years ago there was a call for more data, but at this point I feel like it’s pretty cut and dry. That is very helpful.
Palomer: Adoption, yeah. Marketing, or more than marketing, because marketing is like educating both professionals and patients. When I say patients, anyone is going to be a patient at some point in our lives, right? So when I say patience, I say people in general, right? It’s just educating, but in a positive way. Not educating like you are not understanding what we VR means or what we VR can do. Just educating in the sense that hey, this is here, it’s not just a cool gaming technology that is used just for gaming. Something that can help you in your daily life, right? So why don’t you try it in a positive way, not just a random gaming experience that is playing with some like whatever laser stuff you do with mindfulness, for meditation, for anything. If you meditate for 15-20 minutes in VR, you’re not going to stop using it for sure. So when I say educating, it’s this kind of thing in a positive way and not just in a random conference that you walk through a booth and you just put the headset on for 30 seconds and done, right? At your home in a peaceful manner, in a positive manner, right? So, yeah, I think that’s the key element for us and for everyone in VR.
Bassi: Yeah, I think education and spreading awareness about the utility of VR as a clinical option definitely helps reduce the stigma associated with it, that it’s not just a gaming modality where that’s the main population using it. As we get more and more clinicians adapting it, I think it’s going to reach that critical mass that Telehealth had experienced where a lot more people are going to feel like this is normal, this is the normal way of treating OCD. Now, rather than going out with your therapist and doing an in vivo exposure, first, start off with a virtual reality exposure and work from there.
Why Should It Be Combined With A Therapist?
Palomer: I think always it’s going to be through a professional.
Bassi: Can you speak to that real quickly for maybe the computer science engineers out there who feel like they can just market it to the general population without clinician assistance? Why do you feel that it is more useful or safer for a clinician to be kind of helping coach an individual through?
Palomer: It’s a very good question and there’s a lot of like, discussion and argument around that. When you talk to someone that is suffering anxiety, OCD, PTSD or whatever, these kinds of things, these are complex conditions. So for me, it’s difficult today, maybe tomorrow someone changes my mind, but today for me, it’s difficult to imagine how you can completely standardize that. It’s hard for me to believe and to trust that that’s possible today. Having said that, I don’t think it’s a matter of fully automatized self-applied versus like all human-based whatever. I think that the beauty of technology is to combine the human strength, the human with the technology. And by combining human approach with technology, you can now really improve the outcomes. And I think that’s the secret sauce then, combining both the technology and the human touch from a professional.
Bassi: I 100% agree with you, because I think that there’s so many self help apps out there that want to essentially get that market very easily and they just say, look what you can do on your own without seeing a clinician, because it’s so difficult to see a clinician. And you can do this at any time. And I think the problem lies in the fact that if it’s not working, they get the impression that maybe all mental health treatment or all apps or all therapy is kind of like that, and then we lose that individual because the average time to actually seeking treatment is about ten years. People ruminate about what their issue is, they think about going to seek treatment. There’s a lot of barriers, there’s a lot of stigma already in talking to somebody. And if you hop on an app and it’s not working, or you feel like this AI based app is just not getting me, I’m getting worse, I’m going to feel even more resistance to seeking treatment. Whereas if you had a human who can adapt the technology, kind of explain why, help guide that individual through an exposure. Talk to them about supplemental treatment options, you have that individual who you can kind of track through treatment and make sure that they get to the right place. So I really appreciate the fact that Amelia makes it very obvious on your guys’ website that this is designed for mental health professionals with patients and not just patients and you’re not just trying to bypass mental health providers. I think that’s very commendable and very rigorous of you too, to be able to understand how that’s going to affect the patient rather than just try to capture the largest market share.
Palomer: Having said that, I think there’s a huge market share as well, a huge market target. Again, yes. I don’t see this being different today. Who knows the future? But today it’s hard for me to believe that fully automatised system can help. I don’t know, I mean, maybe that’s somehow against technology, but talk to a patient or someone that is suffering these kind of problems, it’s a complex solution, it’s a complex situation. The causes of these problems can be like social plus individuals plus family plus work plus million different reasons. You and I can have the same diagnosis but a completely different approach to that solution because you might have family problems and I have problems with my boss or whatever. Right. So, I don’t know, today I think it’s over simplification saying, hey, this and I go for it, everything is solved.
Bassi: 100% agree. I love that. I love the fact that you said that, and I think that will earn a lot of respect in a lot of clinicians’ minds when they hear that from the CEO of the company, Amelia Virtual Care. Xavier, I really appreciate you being on the show and talking to us and giving a little bit of an inside look into your guy’s beginnings and how you progressed and where you see things going in the future. I think you’re doing a lot of really good work for the mental health world in general. It has so many good applications and I think we’re all going to have to bookmark your site and watch along. I think that we’re going to be hearing a lot about you in the future. I really do appreciate it.
Palomer: Fantastic. I’m the founder. Not the CEO, but the founder.
Bassi: I’m sorry, yep, that’s right
Palomer: I used to be CEO and I’m the chairman and the founder, which I always be. But thanks for inviting me today. I’m super excited to talk to you. And yeah, I think it’s important that we all work towards awareness and helping people see that there is virtual reality out there that can help you, that can make you feel better and have a better life. So thanks for that. Thanks for inviting me today.
Bassi: I appreciate it. As a reminder, if you’d like to support the show. One way you can help us is by subscribing to the channel on YouTube and leave a comment if you’d like. It also mean the world to me if you can share with your social media network, maybe there’s somebody out there who might be interested in the podcast. Hope to see you next week. Next Monday, new episodes are released every Monday morning. Thanks a lot. Take care.
