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Robert Neil McLay: Treating PTSD with Virtual Reality

John Commins, for HealthLeaders Media, December 2, 2010

 "The simulator we can control. If it becomes too much, we can tone it down, make it literally a walk in the park if we need to."

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is Robert Neil McLay's story.

Public opinion polls show that the war in Afghanistan and the fragile peace in Iraq have fallen far down the list of concerns for most Americans, replaced by the economy and jobs, the federal budget deficit and spending, healthcare, and even immigration.

But there remains a dedicated group of medical professionals within the military that has not forgotten the wars, and the horrific impact they can have on the bodies and minds of the people who fight; nor have they forgotten the moral obligation this nation has to help these wounded warriors.

While it's hard to feel comfortable about medical advances that owe their development to the violence of war, that should not detract from the valiant work of people like U.S. Navy Reserve Commander Robert Neil McLay, MD, PhD, a psychiatrist and the research director in the Mental Health Directorate at Naval Medical Center San Diego.

McLay's field of expertise involves post traumatic stress disorder and the effects of combat-induced stress on the brain. He is a pioneer in the use of computer-based virtual reality simulators for treating PTSD. His treatment regimens, which include traditional therapy and consultation, have enjoyed success rates of up to 75%, even for patients with a history of treatment resistance.

"We see all types. PTSD can happen to just about anyone," says McLay, who spent seven months in Iraq in 2008. "We see the full range of people who had difficulties before they went and the trauma just made them worse, to at the other end of the spectrum, some Special Forces supermen who had never had any problems in their lives, who had always been the absolute best at anything they had ever done, and are now struggling with the very idea that, 'Hey! Why did this bother me?'" 

Simulators create a variety of scenes with varying intensity. A routine patrol on a Fallujah street can be dialed up into a bloody firefight, if the patient is ready for it.

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