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Nearly 1 billion people were living with a mental health disorder in 2019. Mental health disorders account for more than $5 trillion USD in economic impacts, lost productivity, and health care costs with more than 418 million years of lost human life annually. Depression, anxiety, post-traumatic stress disorder (PTSD), psychological distress, and sleep problems increased more than 20% during the COVID-19 pandemic. Mental health burdens were particularly harsh for health care workers, nearly half of whom reported symptoms of PTSD, anxiety, and psychological distress. For decades, health care workers have faced unsustainable workloads and escalating burnout with no substantive interventions in sight. Mental health providers are experiencing unprecedented burnout as demand for therapy continues to reach record levels while thousands of clinicians have been leaving the field. Governments and health care systems around the world have changed policies to simplify reimbursement and promote the scalability of mental health care with technological solutions. Virtual reality (VR) is one such technology that can enhance provider logistics and client experiences in mental health care. In the context of health care, VR is a system that completely envelopes the user’s visual and sometimes auditory field to focus the user’s perception in a computer simulation. The combination of these simulation, display, and sensor technologies creates experiences unique to VR: immersion, perceiving the simulation as “real”; presence, feeling as if you are “there” in the simulated place; copresence, feeling that simulated others are “here” with you; embodiment, feeling that a simulated body is “you”; and telepresence, feeling that simulated experiences with simulated others are really happening. VR-enhanced therapies have been well-demonstrated to improve client engagement, provider efficiency, and outcomes in a growing variety for mental health conditions for both clinical and general populations. Dedicated and enterprise VR systems are available for clinical mental health care, in addition to an increasing variety of nonclinical VR applications that may be useful in therapy. VR technologies are also growing in popularity, affordability, and maturity. Meta, Apple, HTC, Google, Samsung, Sony, and other large consumer technology companies are competing to establish VR devices, software, and marketplaces. Advances in consumer technology and growing clinical evidence have positioned mental health care as a leading application of VR technologies. However, only 0.1–13% of mental health therapists have adopted VR in their practices. It is clear that VR can enhance evidence-based mental health care, but mental health therapists report feeling untrained on using VR in practice and unable to find information that is accessible or reputable. Therapists need guidance in the form of advice from experts and peer therapists, endorsement by professional organizations, and accessible evidence and tutorials. Toward these ends, we formed the Mental Health Virtual Reality International Coalition (MHVR-IC) to share insights between professionals in mental health care, research, education, and product development. In collaboration with the American Medical Extended Reality Association (AMXRA) and the Journal of Medical XR, the MHVR-IC assembled these preliminary recommendations in preparation for the development of formal guidelines on the application of VR in mental health care.