Case Study: Tend VR – Exploring the use of Mindfulness-Based Cognitive Therapy (MBCT) through immersive virtual reality to support mental wellbeing, particularly anxiety and treatment-resistant depression

The healthcare challenge

This intervention is 2 to 5 times more affordable than traditional talking therapies, while delivering approximately a 50% reduction in depression and anxiety – making it both cost-effective and highly impactful.

Delivered at scale through virtual reality in community settings, it also helps reduce patient waiting lists and prevents the escalation of mental health issues.

The service is accessible in two flexible ways: either in-person using shared headsets, or remotely at home with a loaned headset.

All necessary hardware and software are provided directly to service providers, ensuring a seamless experience for users.

The innovator’s journey

Tend is a product of lived experience – created as a response to my childhood experience of growing up with my mother who was living with schizoaffective disorder.

Mindfulness Based Cognitive Therapy (MBCT) is a NICE approved treatment for depression, and is an extremely effective therapy with over 20 years of randomised control trials showing its efficacy. It ​​​​​​​​has minimal side effects, can be given alongside other treatments, and helps treat the underlying causes of depression and anxiety.

Until now, MBCT was only available as a talking therapy which was difficult to deliver at scale.

Tend has created a breakthrough immersive adaptation of MBCT that is entirely scalable and can be delivered anywhere, any time and any place.

Across four feasibility studies, it has consistently demonstrated clinically reliable reductions in both depression and anxiety scores.

Dr. Dan Anderson, Consultant Psychiatrist at the Christie NHS Foundation Trust, has completed the Tend VR-MBCT course and is incorporating it into his practice.

Dr. Anderson says: “It’s therapy that doesn’t feel like therapy. The sessions are moments of presence and calm in a virtual world.”

It has been developed in partnership with Britain’s oldest mental health provider, The Retreat Clinics, as well as academics at Cambridge University, University College London (UCL) and Manchester University.

Impact and outcomes

Tend VR has achieved significant milestones:

• Tend continues to grow, having completed four feasibility studies, overseen by UCL and University of Manchester. These studies have shown large, clinically reliable reductions in depression scores (PHQ-9) and anxiety scores (GAD-7) with Tend averaging around 50% reduction in both PHQ-9 and GAD-7 across feasibility studies and live deployments to date.
• ​​​​​Tend is now the first VR-MBCT course to be deployed in the NHS, currently in Tees, Esk and Wear Valleys Foundation Trust (TEWV) and in the community with nine Mind sites, with more NHS and Mind deployments coming alongside further partnerships in the charity sector.
• As these studies and live deployments expand, Tend continues to see ​​​​results that are often better than standard talking therapies in terms of impact on depression and anxiety, and also, in course completion rates.
• Tend is also involved in an SBRI study with farming and rural communities, demonstrating how digital solutions deliver meaningful mental health interventions in areas where patients find accessing healthcare difficult. This project was recently featured on Radio 4’s Farming Today (Starts 03.04 here) . This research and live deployment has led to two delivery models for Tend. The first is in the community where Tend supplied headsets are a shared resource. In this scenario, each headset can provide a mental health intervention for up to 200 patients a year.
• The second, which is designed for those unable to access community resources, is a headset sent by Tend directly to patients for their course, with the headset returned once this has been completed. Both models are delivering the same impact in terms of results and completions.
• Along with the quantitative data we have a wealth of qualitative ​​​​​​feedback from neurotypical and neurodivergent individuals – “It was amazing! Honestly, I came in quite sceptical, because I haven’t found a lot of techniques to be helpful, but I was blown away by this. For the first time that I remember I am able to calm my brain and can feel it slowly learning that it doesn’t have to be worrying all the time.”

Working together for better outcomes

As a digital-first, community-delivered, prevention-focused mental health intervention, that is both cost effective and clinically reliable, we are ideally placed to support the NHS 10-year Health Plan.

In January 2026, Tend will begin a study focusing on difficult-to-treat depression (DTD), which will inform NICE guidance. Tend also aims for its VR-MBCT intervention to be included in NICE recommendations, based on the evidence generated through this research.

We are scaling Tend rapidly in the coming year, building strong UK-wide foundations, and we’re looking for NHS partners to grow with us.

www.tendmentalhealth.com