PROJECT SUMMARY/ABSTRACT Remote delivery of mental health services (i.e., telemental health) has become the new standard of care with equal or greater effectiveness as traditional in-person treatment. As telemental health continues to evolve, the integration of innovative solutions that enhance its clinical utility and patient outcomes will be needed for telemental health providers to continue delivering state-of-the-art telemental health care. At Doxy.me, Inc., we believe virtual reality (VR) is the future of telemental health care. VR uses interactive and immersive simulation to facilitate delivery, engagement, and outcomes of mental health treatment for a variety of conditions. There is abundant support for VR supported mental health therapy in on-site settings, but work in VR supported telemental health care has been limited to preliminary efficacy studies. Doxy.me, Inc is the leading provider of telemedicine in the U.S. and is uniquely positioned to execute upon this potential. In this Phase I SBIR, we propose to leverage our established Doxy.me telemedicine platform with over 775,000 healthcare provider users, 40% of whom are telemental health providers, to develop Doxy.me VR, an innovative and user-centric VR solution to enhance usability, engagement, and outcomes in telemental health. We will accomplish this goal via two specific aims. In Aim 1 we will seek to understand and prioritize the needs, preferences, and barriers of using Doxy.me VR during telemental health care using an exploratory sequential (qual→quant) mixed-methods design that will include individual, semi-structured qualitative interviews with telemental health patients and providers (n=25 each). Data from these interviews will then be used to develop a survey that we will administer a survey to telemental health providers (n=200) to quantitatively prioritize features, evidence-based therapeutic exercises, and determinants of Doxy.me VR adoption. In Aim 2 we will design, develop, and iteratively refine a Doxy.me VR prototype for telemental health. To accomplish this, we will (1) conduct co-design workshops with telemental health providers and patients (n=5 each) that draw upon our Aim 1 findings to create a set of end- user needs, personas, and use scenarios (i.e., user experience assets) to guide Doxy.me VR design decisions; (2) conduct co-design workshops with telemental health providers and patients (n=5 each) that employ user experience assets to iteratively co-design wireframes and mockups of Doxy.me VR features and evidence- based therapeutic exercises; and (3) develop and refine a functional prototype of Doxy.me VR based on formal user testing with telemental health providers and patients (n=5 each). This project will result in the first scalable and widely accessible VR solution for telemental health. Upon achieving the goals of our proposed project, we will be well-positioned to submit a Phase II SBIR proposal to further develop and evaluate user requested features...