There were no conflicts of interest. Main text word count: 6498 [6500] Abstract word count: 150 [150] 2 Development, implementation, and evaluation of Altered States of Consciousness: An immersive art exhibition designed to increase public awareness of psychotic experiences Abstract Background: The arts can increase public awareness of mental health. Stigma about psychosis remains high despite common occurrences of psychotic experiences in the general population (e.g. hearing voices, seeing visions, and unusual sensory experiences). Targeted approaches may therefore benefit stigma-reduction. This project aimed to produce an immersive art installation that increased public understanding of psychotic experiences. Methods: Development stages included workshops with people with lived experience, training actors to perform 'voices', sourcing artworks, and producing a voice hearing simulation and video installation. Results: The exhibition was implemented as intended, gained positive visitor feedback (N=150), felt immersive, enhanced subjective understanding of voice hearing, increased compassion, and was not unduly stressful. A production team meeting (N=10) identified exhibition strengths, challenges, and potential modifications. Conclusions: This successful, large-scale pilot of an immersive art exhibition combined creative, academic and experiential perspectives. It enabled visitors to 'hear voices' and increased their understanding of psychotic experiences.

The exhibition and voice-hearing simulation has further potential for public engagement and stigma reduction.