Month: December 2011

2011 Winter Editorial

Journal of CyberTherapy & Rehabilitation

Winter 2011, Volume 4, Issue 4


How Can we Help preserve Mental Capital?

First, let me define what I mean by the concept of mental wealth or mental capital. The Foresight Project on Mental Health and Well-being says that it “encompasses a person’s cognitive and emotional resources. It includes their cognitive ability, how flexible and efficient they are at learning, and their ‘emotional intelligence,’ such as their social skills and resilience in the face of stress. It therefore conditions how well an individual is able to contribute effectively to society, and also to experience a high personal quality of life.” The study focused on the U.K., but the 20-year trends cited as affecting the mental wealth of that country are relevant to the rest of the EU, the U.S., and other parts of the world. Trends include the aging of the population (increasing dementia), changes in the global economy (rise of China and India, need for more training and work-life balance), the changing nature and expectations of society and public services (balance of responsibility), and new science and technology (equal access to their benefits).

These same themes emerge in the resulting study article, “The mental wealth of nations,” by Beddington et al., which reported on the group’s evaluation of the scientific evidence to produce this independent assessment involving 450 experts from 16 countries. The authors of this paper urged development of initiatives to support early diagnosis and treatment of childhood learning problems, workplace environments that promote mental health and programs that advance learning among elders to slow cognitive decline. They noted, “How a nation develops and uses its mental capital not only has a significant effect on its economic competitiveness and prosperity but is also important for mental health and well- being and social cohesion and inclusion.”

Pointing to a disproportionate share of investment in mental health relative to its disease burden, the U.S. National Institute of Mental Health (NIMH) created the Grand Challenges in Global Mental Health, identifying research priorities for the next 10 years that will make a difference in people’s mental health. These 25 specific challenges are grouped into broad goals that seek to:

  • Identify root causes, risk and protective factors
  • Advance prevention and implementation of early interventions
  • Improve treatments and expand access to care
  • Raise awareness of the global burden
  • Build human resource capacity
  • Transform health-system and policy responses

NIMH lists guiding principles for funding such research:

  • Use a life-course approach to study
  • Use system-wide approaches to address suffering
  • Use evidence-based interventions
  • Understand environmental influences

So how can we, as clinical and research professionals with spe- cialties in, for example, psychology, physical medicine and rehabilitation, or autism, help our clients boost their mental capital?


  1.  Improved access to education can help: “The [Foresight] Project has identified a number of technologies … ubiquitous and mobile technologies; artificial intelligence; assessment technologies; and tools to support teachers in designing and exchanging learning activities.” A virtual environment to help children with autism learn to cross the street is one example of how we can use the technolo- gies we espouse for early intervention, the most cost-effective way to prevent mental ill health.
  2.  Although the mechanisms are not yet understood, a growing number of studies show that physical exercise may prevent or mitigate the effects of depression, and a Stanford University study showed that a virtual representation of one’s self gaining or losing weight in proportion to the exercise completed motivated volunteers to complete more exercise.
  3.  While we are just beginning to debate the legal and ethical im- plications of using pharmacological (smart drugs) means of improving mental wealth, use of these drugs in controlled clinical trials and publication of results that show minimal side effects from long-term use will pave the way for their mainstreaming.
  4. Neurocognitive activation via cognitive training is a promising area of investigation, as I reported in my recent article co-authored with Dr. Mark Wiederhold. With the aid of fMRI-safe Virtual Reality goggles, we can study the brain while a patient interacts with a virtual environment, and learn how to tailor treatments to pro- duce the desired activations in that individual’s brain.
  5.  Finally, I would encourage you to continue to advocate for mental health funding by governments. As the Foresight study authors noted, “… a cross-governmental approach is needed to realize the full benefits … Interventions may have long timescales before they see any returns. Implementing these recommendations will require significant changes in the nature of governance, placing mental capital and well-being at the heart of policy-making.”



Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute