A twenty-year programme of work using immersive virtual reality to assess, understand, and treat mental health disorders will be outlined. A chronological presentation of studies will illustrate the issues addressed, show the evolution of the technology, and highlight key areas for the future. The case will be made that much greater access to the best psychological treatments can be achieved using automated delivery in VR. In this automation process VR therapies need not simply replicate face-to-face therapy but can be used in innovative ways – impossible in the real world - to enhance treatment outcomes. The results of the first trial of automated VR therapy with patients with psychosis will be described.