360° Video-based virtual-reality simulation: shaping knowledge, attitudes, and social distance towards mental illness in Malaysian contexts

Background: Globally, mental illness is increasingly recognized as a major public health concern, affecting a variety of individuals across diverse populations. In Malaysia, statistics reveal that at least one in three Malaysians face mental health challenges. Overcoming this issue requires comprehensive efforts to educate the public, challenge stereotypes, and foster acceptance. Objectives: Our study aimed to determine the effect of 360° video-based Virtual-Reality (VR) simulation on shaping the attitude, knowledge and social distance among Malaysians. Methods: A randomized controlled trial was conducted involving two groups: a VR-based simulation intervention group and a text-based control group, with 41 participants in each. An online pre-test questionnaire was administered to both groups to assess attitudes, knowledge, and social distance towards mental illness. During the intervention, the experimental group watched 360° videos on smartphones mounted in VR headsets, while the control group read scenarios based on the same content. After the intervention, an online post-test questionnaire assessing the same domains was distributed, along with a VR satisfaction survey for the intervention group. A follow-up assessment using the online questionnaire was conducted one week later. Results: The VR intervention group demonstrated improved attitudes, knowledge, and social distance towards individuals with mental illness both immediately and one week after the intervention, compared to the control group, indicating lasting effects in reducing stigma. Participants were satisfied but suggested higher video resolution could improve the experience. Conclusion: Overall, our study demonstrated improvements in attitudes, knowledge, and social distance towards mental illness individuals, indicating its effectiveness in shaping attitudes.