As e-health offerings rapidly expand, they are transforming and challenging traditional mental health care systems globally, presenting both promising opportunities and significant risks. This article critically examines the potential and pitfalls of integrating digital technologies into mental health care, particularly in the realms of diagnosis, prevention, and treatment. It explores current advancements and evidence-based practices, and provides a vision for how future technologies can evolve responsibly to meet mental health needs. The article concludes with the TEQUILA framework, addressing essential elements and challenges for fostering a beneficial and ethical future. A responsible future for digital mental health requires building Trust by ensuring data privacy, security, and transparency in AI-driven decisions, along with Evidence-based and robust regulatory oversight to maintain Quality. Usability, design, usability tailored to diverse needs, and ethical alignment with users' Interests will all be essential, while Liability and Accreditation standards will safeguard accountability in this evolving landscape.

The metaverse, defined as a collective virtual shared space created by the convergence of augmented reality (AR), virtual reality (VR), and the Internet, offers new opportunities for mental healthcare by delivering immersive and engaging digital therapies. This study examines the current landscape of metaverse-based mental healthcare applications, analyzing their effectiveness and potential risks. Using a systematic literature review (SLR) and case study research, four digital therapeutic applications-NightWare, Freespira, EndeavorRx, and Sleepio-were evaluated for their ability to address conditions such as PTSD, anxiety, and ADHD. The results indicate that metaverse-based therapies can provide significant benefits, with clinical validation supporting their effectiveness. However, concerns around user privacy, accessibility, and long-term efficacy remain challenges. Overall, metaverse-based digital therapies represent a promising shift in mental healthcare, offering innovative, personalized, and scalable solutions. Further research is needed to address ethical issues, improve accessibility, and confirm the long-term impact of these interventions.

The Metaverse has emerged as a significant trend in recent years, offering solutions across diverse fields. Despite substantial investments and extensive research efforts, a comprehensive understanding of the Metaverse environment and its full potential remains elusive. This article seeks to address this gap by developing a technology tree for the Metaverse based on published standards, prior studies, and frameworks proposed by leading firms.

To construct the Metaverse technology tree, a systematic literature review approach was employed. From an initial pool of 354 scientific papers, conference proceedings, book chapters, and reports, a rigorous screening process -focused on titles, abstracts, and full-texts -resulted in a selection of 81 final sources. These sources were synthesized using a meta-analysis methodology.

The meta-synthesis of the selected literature produced a comprehensive Metaverse technology tree encompassing seven key branches: artificial intelligence, Mirror World, extended reality, network infrastructure, lifelogging, blockchain, and the Internet of Things. Each branch represents a critical technological area necessary for the development and realization of the Metaverse.

The proposed Metaverse technology tree offers a holistic overview and roadmap of the technological domains underlying the Metaverse. By identifying these seven branches, this research provides valuable guidance for future studies and development trajectories in Metaverse technologies.

Several articles on the mental health impact of the metaverse and the need to balance its potential benefits with the risks of metaverse use has recently published. The metaverse consists of a combination of immersive technologies and artificial intelligence algorithms. The metaverse differs from the preceding digital psychiatric interventions due to its complex structure and interactions between components. The diverse functions of the metaverse ensure that it may have a substantial impact on mental health. However, the evidence for its efficacy in treating mental health disorders is limited to a few trials. The mental health benefits of immersive technologies are well-documented and suggest that metaverse-based psychiatric treatment may be similarly efficacious. The mental health risks of the metaverse are largely unknown, and it is not clear whether they will be greater than other digital psychiatric interventions. Much more research is needed to determine whether metaverse-based psychiatric treatment will meet the standards of appropriate mental healthcare.

With the ongoing opioid crisis, there is a continued need to develop multimodal pain management strategies inclusive of non-pharmacological treatments. Virtual reality (VR) offers a non-invasive treatment approach for the management of acute and chronic pain including postoperative pain. The aim of this review is to describe the use of VR and its effect on pain-related outcome measures compared to routine care in various types of surgical procedures.

Severe postoperative pain is associated with an increased risk of medical complications and may lead to the development of chronic pain. VR-based interventions are a form of distraction therapy that attenuates pain perception and have been shown to reduce activity in central pain-processing regions. In patients undergoing cardiac surgery, VR may reduce postoperative pain and improve physiological parameters such as heart rate and blood pressure. VR technology was found to have a high satisfaction rate in patients undergoing laparoscopic abdominal surgeries. Three-dimensional (3D) VR interventions may be useful for postoperative pain control in patients undergoing head and neck surgery. VR technology has revealed mixed results for postoperative pain control following orthopedic procedures although it has beneficial effects on functional outcomes during postoperative rehabilitation. In the pediatric population, VR is notable for its applicability in postoperative pain control and anxiety. VR technology is a novel, non-pharmacologic adjunct in the management of postoperative pain. Current studies are limited regarding therapy adaptations for the elderly population. High-quality randomized controlled trials are needed to establish the clinical effectiveness of VR-based therapies in the postoperative setting.

Traditional medical education often lacks contextual experience, hindering students' ability to effectively apply theoretical knowledge in real-world scenarios. The integration of the metaverse into medical education holds great enormous promise for addressing educational disparities, particularly in lower-middle-income countries (LMICs) accompanied by rapid technological advancements. This commentary paper aimed to address the potential of the metaverse in enhancing basic sciences education within the constraints faced by universities in LMICs. We also addressed learning design challenges by proposing fundamental design elements and a suggested conceptual framework for developing metaverse-based teaching methods.The goal is to assist educators and medical practitioners in comprehensivley understanding key factors in immersive teaching and learning.

By immersing medical students in virtual scenarios mimicking real medical settings and patient interactions, the metaverse enables practice in clinical decision-making, interpersonal skills, and exposure to complex medical situations in a controlled environment. These simulations can be customized to reflect local healthcare challenges, preparing medical students to tackle specific community needs. Various disciplines, including anatomy, physiology, pharmacy, dentistry, and pathology, have begun leveraging the metaverse to offer immersive learning experiences, foster interdisciplinary collaborations, and facilitate authentic assessments. However, financial constraints pose a significant barrier to widespread adoption, particularly in resource-limited settings like LMICs. Addressing these challenges is crucial to realizing the full potential of metaverse technology in medical education.

The metaverse offers a promising solution for enhancing medical education by providing immersive, context-rich learning experiences. This paper proposes a conceptual framework and fundamental design elements to aid faculty educators and medical practitioners in effectively incorporating metaverse technology into their teaching methods, thus improving educational outcomes in LMICs.

to map the literature on the incorporation of the metaverse in the education of undergraduate healthcare students.

scoping review following the recommendations of the JBI and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR), performed on Web of Science, Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed, Embase, Scopus, Cumulative Index to Nursing and Allied Health (CINAHL), Latin American and Caribbean Health Sciences Literature (LILACS) and ProQuest.

a total of 23 records were included, published between 2020 and 2023, and developed in 10 countries. The metaverse allows the simulation of hypothetical cases, making education interactive and attractive. However, it faces limitations, including the possibility of depersonalizing students, concerns about data security and privacy, and the high cost of implementing and maintaining its infrastructure.

the metaverse enables the development of clinical competencies that support the construction of students' professional identity. However, it may not be equitable, as it requires resources and knowledge from educators to implement it, contributing to increasing inequality in the education of healthcare students.

(1) The metaverse is promising in the education of undergraduate healthcare students.

(2) The metaverse makes education interactive and attractive.

(3) It promotes the protagonism of students in the teaching-learning process.

(4) It presents risks related to data security and privacy.

(5) High cost of implementing and maintaining its infrastructure.

The metaverse has enormous potential in health care, continuously developing and offering innovative solutions by combining artificial intelligence (AI), augmented reality (AR)/virtual reality (VR), Internet of Medical Devices, and quantum computing technologies. In addition to using virtual platforms to help and boost medical education, familiarity with this platform is necessary to strengthen medical skills and communication with patients in medical sciences in the future.

We conducted a comprehensive search using keywords and their MeSH synonyms, including "metaverse," "medical education," and "health care," across PubMed, Scopus, and Web of Science. After screening the results, relevant articles were selected to inform the writing of this manuscript.

The metaverse is shaping the future of medical sciences, offering new opportunities for health education, advocacy training, and patient outcome improvement. The combination of real and virtual worlds may advance international relations, facilitate data sharing, increase medical care speed, and reduce infectious diseases. The metaverse, despite its benefits, has some limitations. Only 37% of 15-24-year-olds have internet access, and AR/VR glasses are expensive and may cause eye discomfort. It is also a potential risk for medical students, who may need help understanding the limitations of simulations and develop unrealistic expectations. Considering the metaverse as a supplement to clinical practice, not a replacement for supervised training, is crucial. Ethical concerns, data security, privacy, and lack of instructions for education are also issues. However, providing information about the metaverse can increase health care workers' attribution to use it for patient examinations, students' education, and tests.

This paper explores the impact of the metaverse on medical science education and underscores the need to integrate the metaverse into all areas of medical sciences as a supplement to existing evidence.

Over the last decade, there has been an increase in the evidence base supporting the efficacy of video consultations (VCs) in mental health services. Furthermore, the potential of VC treatment was also demonstrated during the COVID-19 pandemic. Despite these promising results and conducive conditions for VCs, several studies have highlighted that the uptake and implementation of VCs continues to be slow, even after the pandemic. To facilitate and strengthen the implementation of VCs and exploit their potential as a useful tool for mental health disorder treatment, there is a need for a deeper understanding of the issues and experiences of implementing and using VCs as a treatment modality in clinical practice.

The aim of this study was to investigate patients' and clinicians' experiences and attitudes toward using VCs in clinical practice.

Treatment was conducted through the VC modality. Semistructured interviews were conducted individually with patients (n=10) and focus group interview were conducted with clinicians (n=4). Patients had participated in weekly VC treatment over 2 months as part of mental health outpatient services in Denmark. Data from these interviews were analyzed using thematic analysis.

Thematic analysis of the patient interviews yielded two main themes: (1) adjusting to the practicalities of the VC format and (2) the practice of therapy using VCs. Patients experienced that using VCs was easy and convenient, and it was possible to establish and maintain a therapeutic alliance. They also described the contact as different to in-person therapy. The thematic analysis conducted on clinicians' experiences of using VCs yielded three themes: (1) a shift in mindset from resistance to acceptance, (2) the contact is different when using the VC modality, and (3) adapting to a new way of working. Clinicians experienced that their initial concerns and resistance toward VC implementation gradually diminished over time as they gained clinical experience of using the modality. They expressed that contact with patients can be different when using the VC modality and that it took time to adjust to a new way of working therapeutically.

Both patients and clinicians experienced that VCs could enhance access to treatment and be meaningfully integrated into clinical practice. In addition, both groups described the contact when using the VC modality as being different to in-person therapy. Future research could examine patients' and clinicians' perceived differences regarding contact when using the VC modality and the implications for therapeutic interventions.

We review the first pilot studies applying metaverse-related technologies in psychiatric patients and discuss the rationale for using this complex federation of technologies to treat mental diseases. Concerning previous virtual-reality applications in medical care, metaverse technologies provide the unique opportunity to define, control, and shape virtual scenarios shared by multi-users to exploit the "synchronized brains" potential exacerbated by social interactions.

The application of an avatar-based sexual therapy program conducted on a metaverse platform has been demonstrated to be more effective concerning traditional sexual coaching for treating female orgasm disorders. Again, a metaverse-based social skills training program has been tested on children with autism spectrum disorders, demonstrating a significant impact on social interaction abilities. Metaverse-related technologies could enable us to develop new reliable approaches for treating diseases where behavioral symptoms can be addressed using socio-attentive tasks and social-interaction strategies.