Artificially intelligent chatbots in digital mental health interventions: a review

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ABSTRACT

Introduction

Increasing demand for mental health services and the expanding capabilities of artificial intelligence (AI) in recent years has driven the development of digital mental health interventions (DMHIs). To date, AI-based chatbots have been integrated into DMHIs to support diagnostics and screening, symptom management and behavior change, and content delivery.

Areas covered

We summarize the current landscape of DMHIs, with a focus on AI-based chatbots. Happify Health’s AI chatbot, Anna, serves as a case study for discussion of potential challenges and how these might be addressed, and demonstrates the promise of chatbots as effective, usable, and adoptable within DMHIs. Finally, we discuss ways in which future research can advance the field, addressing topics including perceptions of AI, the impact of individual differences, and implications for privacy and ethics.

Expert opinion

Our discussion concludes with a speculative viewpoint on the future of AI in DMHIs, including the use of chatbots, the evolution of AI, dynamic mental health systems, hyper-personalization, and human-like intervention delivery.

KEYWORDS:

• Artificial intelligence (AI)
• chatbots
• digital mental health
• digital mental health interventions (dmhis)

Article highlights

• Digital mental health interventions (DMHIs) are an important avenue to address the treatment gap for mental health.

• Artificial intelligence (AI) offers a scalable means of providing support and improving engagement within DMHIs.

• Although AI chatbots have been designed for several mental health disorders and can serve various functions in DMHIs, adoption of chatbots in DMHIs remains limited.

• Research suggests users perceive chatbots favorably, chatbots can help improve engagement, and may help improve mental health outcomes.

• More rigorous research is needed to test the effects of chatbots within DMHIs, including understanding general perceptions of chatbots, the impact of individual and contextual factors, and whether chatbots can improve mental health outcomes beyond non-AI driven DMHIs.

• Given the variability in chatbots and their applications within DMHIs, greater differentiation of types of chatbots, and the corresponding functions they serve, is needed.

Declaration of interest

All authors of this manuscript are current employees of Happify Health. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded, and the pilot study referred to herein was sponsored by Happify Health.