Sarah Ticho and the Revolutionary Potential of Immersive Tech for Health and Wellbeing

In 2022, she received the International Virtual Reality Healthcare Association’s Hero Award, her immersive meditation game DEEP was selected as part of the Cannes Unity for Humanity Showcase, and her XR project, Soul Paint (narrated by Rosario Dawson), won the XR Jury Award at SXSW 2024 and was a finalist in the AWE Auggie awards and Games for Change Awards

Sarah is the co-founder of the XR Health Alliance, a contributor to the XRConnect Toolkit, and co-authored the industry report “The Growing Value of XR in Healthcare in the United Kingdom,” which led to a £20m investment in XR by the UK government.

We caught up with Sarah to discuss the transformative potential of XR for health and wellness.

You studied anthropology and ended up as a ‘VR for health and wellness’ pioneer. That seems like an unconventional path. Can you tell us a bit more about your journey and what motivated you to work with immersive tech?

I think they’re both connected to being fascinated by people. I studied biological and social anthropology and I was always interested in the overlap of how culture and science can come together.

In my final year of study, my dad died of pancreatic cancer. Then, after graduating, I went through a challenging time where I was wondering what to do with my life. I worked for the NHS briefly, then I got a job working with a contemporary arts organisation called Fabrica Gallery, which curated large-scale site-specific installations. One of my roles was to ask people what art meant to them and that’s when I got really hooked on how large-scale and immersive art can be used as a way of talking about things that are often taboo to talk about, especially grief and loss.

Then I ended up going through my own mental health journey, navigating the NHS and seeking support. Through my disappointment in how limited we are both in the time and space we had and the medical approach to mental health, I began to explore how storytelling and particularly VR can help to shed light on different people’s lived experiences, improve patient-doctor communication and even act as a therapeutic tool.

That led you to launch your company ‘Hatsumi,’ which describes itself as ‘a multidisciplinary agency dedicated to advancing human-centred experiences at the intersection of immersive art, scientific research, and healthcare’.  What does ‘Hatsumi’ mean and is there a story behind the name? 

Hatsumi actually comes from the Japanese word ‘hatsumimi’, which means ‘to hear something for the first time’.

I thought it was fitting because my project is about body mapping, which involves tracing around your body to help visualise things like anxiety or pain, and making invisible feelings visible for the first time – that work evolved into ‘Soul Paint’.

That’s interesting, what do you mean by social prescribing? 

Many people go to their doctors for help with issues that aren’t easily fixed with a pill, like loneliness, anxiety, depression, or chronic pain, to name just a few. Social prescribing allows doctors to prescribe social experiences and support that acknowledge the broader needs we have as humans, promoting a more holistic understanding of wellness.

For the pilot, we did with StoryFutures and Royal Holloway University, we worked with social prescribers to inform what that process could look like. We investigated a pathway where we could have something like a Soul Paint installation in a local library, so people could be referred there by their GP to experience the piece. That was just a pilot, but we’re hoping to scale it in the future.

Virtual reality is often inaccessible, typically available only at big festivals or art spaces in major cities. But VR experiences like Soul Paint can significantly improve well-being, either because they are created with that intent, or simply because interacting with the arts is inherently beneficial.

We’ve demonstrated that this model can work in a library and now we’re proposing a national, and potentially international, strategy to make VR available in community settings and create impact for broader audiences.

Is Soul Paint something that people can experience by themselves, or does it need a facilitator? 

The experience of VR happens before you even put on the headset, it is a performance and an experience that is shared and always needs a facilitator. Using VR for the first time can be confusing, and a facilitator helps prepare users, provides the right environment, and guides post-experience conversations.

Facilitators can also provide mental health support if needed. The experience is designed to be psychologically safe, but the human element is crucial, especially for sharing and creating spaces for conversations after they have experienced the piece.

Alongside the VR piece, we have also designed a live installation where artworks can be viewed and discussed together.

Another project you worked on was ‘Deep’. Can you tell us about that? 

Deep started from a collaboration between game designers and mental health professionals. The idea was to create a VR experience that helps people with anxiety and stress through deep, diaphragmatic breathing exercises.

In Deep, you move through a magical underwater world controlled through diaphragmatic breathing, controlled by either a belt strapped around your diaphragm or using tai chi moving that you can sync your breath to.  It’s set in an immersive underwater environment that is designed to be calming and meditative.

We’ve undertaken a range of scientific studies — which are listed on our website — including randomised control trials with our collaborators, as well as having received a lot of positive feedback directly from users who find the experience incredibly relaxing and helpful for managing anxiety.

In some cases, users have reported significant reductions in their stress levels after just a few sessions. The anecdotal evidence is also very encouraging.

One memorable story is from a participant who had severe anxiety and found it difficult to engage in traditional therapy. After trying Deep, she reported feeling a sense of calm and control that she hadn’t experienced in a long time.

She started using it regularly and found that it helped her manage her anxiety better on a day-to-day basis. Another user, a teenager with ADHD, found that Deep helped him focus and stay calm, which had a positive impact on his school performance and social interactions.

You’re also a driving force behind the XR Health Alliance. Can you tell us more about that and how it got started? 

When I was starting with Hatsumi I would have investors laugh at me, or laugh at the idea that a hospital would buy a headset to use my weird drawing experience. I was extremely frustrated because I knew I wasn’t the only one having that experience.

So, I started to reach out to organisations like the Immersive Tech Network for example, and I said, ‘Hey, you’re funding all of these great collaborations, but there is nothing happening in hospitals because they don’t know this tech is out there and there are no regulations’.

I became really passionate about exploring ways to enable collaborations between academics, hospitals, and great artists.

Soon I was running conferences and hackathons with people who had been in the games industry for years – like the radio announcer of Grand Theft Auto, for example – and we did  hackathons where we brought together game designers, NHS workers, psychologists, psychiatrists and people running VR health-tech companies to see what could happen if we worked together.

So I did that for a few years. Then one day, the BBC closed down their virtual reality lab and someone tweeted asking if they could just give it to the NHS. We had a meeting and in that meeting, the NHS said that they were interested, but they needed evidence, so they gave us a report template and told us to fill it in and tell them about the key implications and how it could save them money.

So me and a small team brought in a bunch of collaborators and did the report and that’s how the XR Health Alliance was formed. That report led to a £20m investment by the UK Government into VR for mental health and well-being.