Popularity of Mental Health Chatbots Grows

Abstract

Back to table of contents Previous article Next article Clinical & ResearchFull AccessPopularity of Mental Health Chatbots GrowsNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:22 Apr 2022https://doi.org/10.1176/appi.pn.2022.05.4.50AbstractConsumers have shown an interest in the empathic dialogue available 24/7 through an AI-powered mental health chatbot. But high-quality research into the effectiveness of these tools is lacking.iStock/NicoElNinoOver the past few years, people experiencing symptoms of mental distress have started to turn to a new type of service for support: mental health chatbots. With a few clicks of a cell phone, chatbots can offer a channel through which one can receive empathic and nonjudgmental text communication at a moment’s notice, 24 hours a day.Chatbots are programs that use language-processing software and artificial intelligence (AI) to engage in dialogue with humans. Well-known chatbots include Apple’s Siri and Amazon’s Alexa, which respond to commands (“Alexa, set timer for five minutes.”) and answer one-off questions (“Siri, what’s the weather forecast for today?”). But many companies believe chatbots can fill an important health care gap by providing an outlet for people who want to talk about their mental health outside of a regular clinical visit.Consumers certainly seem interested in mental health chatbots. A 2021 national survey commissioned by Woebot Health, one of the leading therapeutic chatbot companies, found that 22% of adults had used a mental health chatbot, and 47% said they would be interested in using one if needed. Among the respondents who had tried a mental health chatbot, nearly 60% said they began this use during the COVID-19 pandemic, and 44% said they used chatbots exclusively and do not see a human therapist. The most common reasons people cited as to why they used and/or might be interested in using a chatbot included that the tool was cheap, easy to use, and accessible anytime.“It’s rare in psychiatry that we see really novel advances in clinical care, but chatbots could be transformative because they can offer constant access to care,” said John Torous, M.D., director of the Division of Digital Psychiatry at Harvard-affiliated Beth Israel Deaconess Medical Center. Torous said that he has been monitoring the progress of chatbots over the past several years.He noted that the acceptance of these tools has been a pleasant surprise, since people inherently distrust objects that try to pass as human. He said the success of chatbots such as Woebot may be that the programs are upfront about their artificial nature and do not try to pretend to be human. For example, Woebot appears as a robot during chats while another chatbot known as Wysa takes the form of a cartoon penguin; the programs also acknowledge their AI nature in conversations.The Potential of AI DialogueWoebot founder and President Allison Darcy, Ph.D., came up with the idea for Woebot while conducting postdoctoral research at Stanford University. As a clinical psychologist who specialized in child and adolescent mental health, Darcy was familiar with the challenges of keeping youth engaged with behavioral therapy—particularly the “homework” assignments therapists ask patients to complete between sessions. Recognizing that technology might offer a natural conduit to engage youth with therapy, she began developing self-help programs that included AI dialogue. However, she quickly realized the potential of making dialogue the star of the show, which led her to team with Andrew Ng, Ph.D., an AI expert at Stanford’s Computer Science Department, and create Woebot in 2017.Chatbots are not meant to be surrogates for human-delivered psychotherapy, even as they become more sophisticated, said Allison Darcy, Ph.D.WoebotMany other companies have leveraged smartphone technology to increase people’s access to live therapeutic support via chat or video communications, but these apps are constrained