Chatbots can fill gaps in mental health services, study finds

Chatbots offer significant potential for bridging gaps in traditional mental health services, according to a new review of research from Nottingham Trent University (NTU).

Psychologists at NTU reviewed 31 studies published between 2017 and 2023, all of which examined the use of chatbots – AI tools that can mimic human conversation – as mental health interventions.

The study, published in Computers in Human Behavior: Artificial Humans, found that chatbots are generally well-received by users and demonstrate potential for improving mental health, particularly among people with depression.

The chatbots were also found to be beneficial for managing a range of other conditions, including insomnia, eating disorders, panic disorders and ADHD.

While some studies reported significant reductions in anxiety, however, others showed no significant differences compared to control groups.

Dr Andrew Harris, senior lecturer in psychology at NTU’s school of social sciences and co-author on the study, said: “We can see from the research that chatbots can foster a sense of connection and trust, which is crucial for use as therapy.

“Evidence suggests that chatbots can improve access to care, offer convenient support, and potentially deliver effective interventions for specific conditions and severity levels.

“This opens the possibility for them to bridge gaps in traditional mental health services, particularly in terms of accessibility, workforce shortages, and cost-effectiveness.

“They can also be valuable tool to encourage individuals with mental health concerns, especially those facing stigma, to seek professional help.”

The study focused on three areas: engagement, user attitude and effectiveness.

Users perceive chatbots as empathetic

The research studies reviewed by the team had questioned a diverse range of groups, including adolescents, graduates, older adults, IBS sufferers, people with eating disorders, people with anxiety or depression, elderly persons with dementia and people suffering with chronic pain. Some studies reported high dropout rates of more than 50%, though others demonstrated lower attrition rates.

The research found that people with greater psychological distress tended to exhibit higher engagement with chatbots, suggesting that that the tools could be used to reach people hesitant to seek traditional mental health services.

Where users reported positive experiences with mental health chatbots, this was typically down to their perception that the chatbot displayed an empathetic and friendly personality, rather than to the content or technological features.

Some studies even suggested that therapeutic relationships can be established between users and chatbots.

The studies also found that while short interactions can be beneficial, longer engagement might be necessary for significant psychological changes.

Usability was a key concern, with many chatbots scoring below the acceptable threshold for usability, highlighting the need for improvements in design and user interface. This was a particular concern for older adults and individuals less familiar with technology. This suggests there is a need for accessible design and tailored support for different populations.

The authors concluded: “Positive attitudes and engagement with chatbots, as well as positive mental health outcomes, show chatbot technology is a promising modality for mental health intervention. However, implementing them amongst some demographics or with novel features should be carefully considered.”

Harris said: “It is important to note that these technologies should be viewed as tools to supplement, rather than replace, trained mental health practitioners and further work should be done on how to effectively integrate traditional psychological approaches, such as cognitive-behavioural therapy (CBT), and advanced technologies into chatbot design, as well as exploration of the long-term effectiveness and sustainability of chatbot interventions.”

FCC’s 2021 report, Mental Health Tech Landscape Review, explores in detail the innovative tools being developed by tech companies to support mental health.