VR Painting as a School-Based Mental Health Support in Exam-Oriented Education Systems: A Narrative Review

Adolescents in examination-oriented education systems face substantial and persistent psychological stress, yet school-based mental health support often remains didactic, time-limited and stigmatizing. Virtual reality (VR) painting has recently emerged as a potentially engaging modality that combines immersive technology with creative expression, but its role in supporting student mental health is not yet theoretically or empirically clarified. This narrative review develops a conceptually coherent account of VR painting at the intersection of three strands of literature: (a) VR interventions for student and youth mental health, (b) creative VR artmaking and VR painting, and (c) school-based arts or art-therapy programmes targeting emotional well-being. Drawing on a structured but selective search of Scopus (2010 onwards) and a thematic synthesis across these strands, the review shows that VR-based mental health interventions can yield small to medium improvements in anxiety, depression and stress, while immersive VR artmaking supports positive affect, absorption and emotional self-expression. Evidence from arts-based and school-based programmes further suggests that creative activities can reduce internalising symptoms when they are well integrated into existing school structures. However, empirical research specifically on VR painting with secondary school students remains sparse, small-scale and heterogeneous. The review proposes an integrative mechanism framework—combining emotion regulation, expressive arts and self-determination theory—to explain how VR painting might alleviate stress, and argues that VR painting is best positioned as an embedded component of wider school provision rather than a stand-alone intervention. Finally, it outlines a research agenda for rigorous, context-sensitive trials in exam-driven secondary education systems, with particular relevance for psychology and education scholars working in East Asian school contexts.