The integration of chatbots into mental health care is ushering in a transformative era, offering scalable and accessible support to individuals worldwide. This article explores the revolutionary potential of chatbots within clinical psychology, highlighting their role in screening, early intervention, and the personalization of treatment plans. By leveraging advanced natural language processing and machine learning algorithms, chatbots are capable of delivering immediate, empathetic, and user-centric care, complementing traditional therapeutic approaches. However, this integration also necessitates a careful consideration of ethical standards, particularly in safeguarding user data privacy and ensuring that escalation protocols are in place for crisis situations. The synergy between chatbot technology and mental health professionals is crucial for optimizing the benefits of these digital tools. This article advocates for continued research, ethical oversight, and interdisciplinary collaboration to refine and expand the use of chatbots, ensuring they contribute effectively to the global mental health landscape.
References
[1]
Abd-Alrazaq, A. A., Rababeh, A., Alajlani, M., Bewick, B. M., & Househ, M. (2020). Effectiveness and Safety of Using Chatbots to Improve Mental Health: Systematic Review and Meta-Analysis. Journal of Medical Internet Research, 22, e16021. https://doi.org/10.2196/16021
[2]
Aggarwal, A., Tam, C. C., Wu, D., Li, X., & Qiao, S. (2023). Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. Journal of Medical Internet Research, 25, e40789. https://doi.org/10.2196/40789
[3]
Ait Baha, T., El Hajji, M., Es-Saady, Y., & Fadili, H. (2023). The Power of Personalization: A Systematic Review of Personality-Adaptive Chatbots. SN Computer Science, 4, Article No. 661. https://doi.org/10.1007/s42979-023-02092-6
[4]
Andotra, S. (2023). Enhancing Human-Computer Interaction Using Emotion-Aware Chatbots for Mental Health Support.
[5]
Anmella, G., Sanabra, M., Primé-Tous, M., Segú, X., Cavero, M., Navinés, R. et al. (2023). Vickybot, a Chatbot for Anxiety-Depressive Symptoms and Work-Related Burnout in Primary Care and Health Care Professionals: Development, Feasibility, and Potential Effectiveness Studies. Journal of Medical Internet Research, 25, e43293.
[6]
Azaria, A., Azoulay, R., & Reches, S. (2024). ChatGPT Is a Remarkable Tool—For Experts. Data Intelligence, 6, 240-296. https://doi.org/10.1162/dint_a_00235
[7]
Bae Brandtzæg, P. B., Skjuve, M., Kristoffer Dysthe, K. K., & Følstad, A. (2021). When the Social Becomes Non-Human: Young People’s Perception of Social Support in Chatbots. In Proceedings of the 2021 CHI Conference on Human Factors in Computing Systems (pp. 1-13). ACM. https://doi.org/10.1145/3411764.3445318
[8]
Bakare, S. S., Adeniyi, A. O., Akpuokwe, C. U., & Eneh, N. E. (2024). Data Privacy Laws and Compliance: A Comparative Review of the EU GDPR and USA Regulations. Computer Science & IT Research Journal, 5, 528-543. https://doi.org/10.51594/csitrj.v5i3.859
[9]
Banerjee, I., Ling, Y., Chen, M. C., Hasan, S. A., Langlotz, C. P., Moradzadeh, N. et al. (2019). Comparative Effectiveness of Convolutional Neural Network (CNN) and Recurrent Neural Network (RNN) Architectures for Radiology Text Report Classification. Artificial Intelligence in Medicine, 97, 79-88. https://doi.org/10.1016/j.artmed.2018.11.004
[10]
Banerjee, S., Agarwal, A., & Bar, A. K. (2024). Securing Well-Being: Exploring Security Protocols and Mitigating Risks in Ai-Driven Mental Health Chatbots for Employees. American Journal of Computer Science and Technology, 7, 1-8. https://doi.org/10.11648/j.ajcst.20240701.11
[11]
Batra, P., & Dave, D. M. (2024). Revolutionizing Healthcare Platforms: The Impact of AI on Patient Engagement and Treatment Efficacy. International Journal of Science and Research (IJSR), 13, 273-280. https://doi.org/10.21275/sr24201070211
[12]
Beiley, M. R. (2019). Mental Health and Wellness Chatbot.
[13]
Bendig, E., Erb, B., Schulze-Thuesing, L., & Baumeister, H. (2022). The Next Generation: Chatbots in Clinical Psychology and Psychotherapy to Foster Mental Health—A Scoping Review. Verhaltenstherapie, 32, 64-76. https://doi.org/10.1159/000501812
[14]
Bolcer, G. A., & Taylor, R. N. (1998). Advanced Workflow Management Technologies. Software Process: Improvement and Practice, 4, 125-171. https://doi.org/10.1002/(sici)1099-1670(199809)4:3<125::aid-spip100>3.0.co;2-j
[15]
Borah, B., Pathak, D., Sarmah, P., Som, B., & Nandi, S. (2018). Survey of Text-Based Chatbot in Perspective of Recent Technologies. In J. K. Mandal, et al. (Eds.), Computational Intelligence, Communications, and Business Analytics (pp. 84-96). Springer. https://doi.org/10.1007/978-981-13-8581-0_7
[16]
Boucher, E. M., Harake, N. R., Ward, H. E., Stoeckl, S. E., Vargas, J., Minkel, J. et al. (2021). Artificially Intelligent Chatbots in Digital Mental Health Interventions: A Review. Expert Review of Medical Devices, 18, 37-49. https://doi.org/10.1080/17434440.2021.2013200
[17]
Brandtzaeg, P. B., Skjuve, M., & Følstad, A. (2022). My AI Friend: How Users of a Social Chatbot Understand Their Human-ai Friendship. Human Communication Research, 48, 404-429. https://doi.org/10.1093/hcr/hqac008
[18]
Brown, J. E. H., & Halpern, J. (2021). AI Chatbots Cannot Replace Human Interactions in the Pursuit of More Inclusive Mental Healthcare. SSM—Mental Health, 1, Article ID: 100017. https://doi.org/10.1016/j.ssmmh.2021.100017
[19]
Cabrera, J., Loyola, M. S., Magaña, I., & Rojas, R. (2023). Ethical Dilemmas, Mental Health, Artificial Intelligence, and LLM-Based Chatbots. In I. Rojas, et al. (Eds.), Bioinformatics and Biomedical Engineering (pp. 313-326). Springer Nature. https://doi.org/10.1007/978-3-031-34960-7_22
[20]
Clements, M. L., Stanley, S. M., & Markman, H. J. (2004). Before They Said “I Do”: Discriminating among Marital Outcomes over 13 Years. Journal of Marriage and Family, 66, 613-626. https://doi.org/10.1111/j.0022-2445.2004.00041.x
[21]
D’Alfonso, S., Santesteban-Echarri, O., Rice, S., Wadley, G., Lederman, R., Miles, C. et al. (2017). Artificial Intelligence-Assisted Online Social Therapy for Youth Mental Health. Frontiers in Psychology, 8, Article No. 796. https://doi.org/10.3389/fpsyg.2017.00796
[22]
De Freitas, J., Uğuralp, A. K., Oğuz‐Uğuralp, Z., & Puntoni, S. (2022). Chatbots and Mental Health: Insights into the Safety of Generative AI. Journal of Consumer Psychology, 34, 481-491. https://doi.org/10.1002/jcpy.1393
[23]
Ebert, D. D., Harrer, M., Apolinário-Hagen, J., & Baumeister, H. (2019). Digital Interventions for Mental Disorders: Key Features, Efficacy, and Potential for Artificial Intelligence Applications. In Y.-K. Kim (Ed.), Frontiers in Psychiatry (pp. 583-627). Springer. https://doi.org/10.1007/978-981-32-9721-0_29
[24]
Finkler, K. (2000). Experiencing the New Genetics: Family and Kinship on the Medical Frontier. University of Pennsylvania Press. https://doi.org/10.9783/9780812200607
[25]
Fiske, A., Henningsen, P., & Buyx, A. (2019). Your Robot Therapist Will See You Now: Ethical Implications of Embodied Artificial Intelligence in Psychiatry, Psychology, and Psychotherapy. Journal of Medical Internet Research, 21, e13216. https://doi.org/10.2196/13216
[26]
Garcia Valencia, O. A., Suppadungsuk, S., Thongprayoon, C., Miao, J., Tangpanithandee, S., Craici, I. M. et al. (2023). Ethical Implications of Chatbot Utilization in Nephrology. Journal of Personalized Medicine, 13, Article No. 1363. https://doi.org/10.3390/jpm13091363
[27]
Gera, P. (2024). Integrating Mindfulness: Enhancing Art and Design Student Well-Being through AI Voice Assistants and Wearable Technology. PhD Diss., OCAD University.
[28]
Habicht, J., Viswanathan, S., Carrington, B., Hauser, T. U., Harper, R., & Rollwage, M. (2024). Closing the Accessibility Gap to Mental Health Treatment with a Personalized Self-Referral Chatbot. Nature Medicine, 30, 595-602. https://doi.org/10.1038/s41591-023-02766-x
[29]
Hamdoun, S., Monteleone, R., Bookman, T., & Michael, K. (2023). AI-Based and Digital Mental Health Apps: Balancing Need and Risk. IEEE Technology and Society Magazine, 42, 25-36. https://doi.org/10.1109/mts.2023.3241309
[30]
Haque, M. D. R., & Rubya, S. (2023). An Overview of Chatbot-Based Mobile Mental Health Apps: Insights from App Description and User Reviews. JMIR mHealth and uHealth, 11, e44838. https://doi.org/10.2196/44838
[31]
Haque, R., Islam, N., Islam, M., & Ahsan, M. M. (2022). A Comparative Analysis on Suicidal Ideation Detection Using NLP, Machine, and Deep Learning. Technologies, 10, Article No. 57. https://doi.org/10.3390/technologies10030057
[32]
Hardeman, W., Houghton, J., Lane, K., Jones, A., & Naughton, F. (2019). A Systematic Review of Just-in-Time Adaptive Interventions (JITAIs) to Promote Physical Activity. International Journal of Behavioral Nutrition and Physical Activity, 16, Article No. 31. https://doi.org/10.1186/s12966-019-0792-7
[33]
Harrer, S. (2023). Attention Is Not All You Need: The Complicated Case of Ethically Using Large Language Models in Healthcare and Medicine. eBioMedicine, 90, Article ID: 104512. https://doi.org/10.1016/j.ebiom.2023.104512
[34]
Honka, A., Kaipainen, K., Hietala, H., & Saranummi, N. (2011). Rethinking Health: ICT-Enabled Services to Empower People to Manage Their Health. IEEE Reviews in Biomedical Engineering, 4, 119-139. https://doi.org/10.1109/rbme.2011.2174217
[35]
Inkster, B., Sarda, S., & Subramanian, V. (2018). An Empathy-Driven, Conversational Artificial Intelligence Agent (WYSA) for Digital Mental Well-Being: Real-World Data Evaluation Mixed-Methods Study. JMIR mHealth and uHealth, 6, e12106. https://doi.org/10.2196/12106
[36]
Izadi, S., & Forouzanfar, M. (2024). Error Correction and Adaptation in Conversational AI: A Review of Techniques and Applications in Chatbots. AI, 5, 803-841. https://doi.org/10.3390/ai5020041
[37]
Jain, A., Srivastava, G., Singh, S., & Dubey, V. (2024). Application of Artificial Intelligence (AI) Technologies in Employing Chatbots to Access Mental Health. In A. Khang, et al. (Eds.), Computer Vision and AI-Integrated IoT Technologies in the Medical Ecosystem (pp. 311-333). CRC Press. https://doi.org/10.1201/9781003429609-19
[38]
Jia, X., Zhang, B. L., Zhao, Y. X., Zhang, Q. R., Zheng, C. D., Jiang, J. L., Li, H. J. et al. (2023). Evaluation of the Current State of Chatbots for Digital Health: Scoping Review. Journal of Medical Internet Research, 25, e47217. https://doi.org/10.2196/47217
[39]
Jiang, M., Zhao, Q., Li, J. Q., Wang, F. et al. (2024). A Generic Review of Integrating Artificial Intelligence in Cognitive Behavioral Therapy.
[40]
Kane, D. A. (2016). The Role of Chatbots in Teaching and Learning. In S. Rice, & M. N. Gregor (Eds.), E-Learning and the Academic Library: Essays on Innovative Initiatives (pp. 131-147). McFarland.
[41]
Kettle, L., & Lee, Y. (2024). User Experiences of Well-Being Chatbots. Human Factors: The Journal of the Human Factors and Ergonomics Society, 66, 1703-1723. https://doi.org/10.1177/00187208231162453
[42]
Lai, T., Shi, Y. K., Du, Z. C., Wu, J. J., Fu, K., Dou, Y. C., & Wang, Z. Q. (2023). Psy-LLM: Scaling up Global Mental Health Psychological Services with AI-Based Large Language Models.
[43]
Landesman, L. Y. (2005). Public Health Management of Disasters: The Practice Guide. American Public Health Association.
[44]
Madasamy, S., & Aquilanz, L. L. C. (2023). The Evolution of Chatbots: Cloud and AI Synergy in Banking Customer Interactions. Journal of Emerging Technologies and Innovative Research, 10, i127-i137.
[45]
Marriott, H. R., & Pitardi, V. (2024). One Is the Loneliest Number… Two Can Be as Bad as One. The Influence of AI Friendship Apps on Users’ Well‐Being and Addiction. Psychology & Marketing, 41, 86-101. https://doi.org/10.1002/mar.21899
[46]
Martinengo, L., Lum, E., & Car, J. (2022). Evaluation of Chatbot-Delivered Interventions for Self-Management of Depression: Content Analysis. Journal of Affective Disorders, 319, 598-607. https://doi.org/10.1016/j.jad.2022.09.028
[47]
McGorry, P. D., Mei, C., Chanen, A., Hodges, C., Alvarez‐Jimenez, M., & Killackey, E. (2022). Designing and Scaling up Integrated Youth Mental Health Care. World Psychiatry, 21, 61-76. https://doi.org/10.1002/wps.20938
[48]
Meadows, R., Hine, C., & Suddaby, E. (2020). Conversational Agents and the Making of Mental Health Recovery. Digital Health, 6, 2055207620966170. https://doi.org/10.1177/2055207620966170
[49]
Mechanic, D. (2006). The Truth about Health Care: Why Reform Is Not Working in America. Rutgers University Press.
[50]
Milne-Ives, M., de Cock, C., Lim, E., Shehadeh, M. H., de Pennington, N., Mole, G. et al. (2020). The Effectiveness of Artificial Intelligence Conversational Agents in Health Care: Systematic Review. Journal of Medical Internet Research, 22, e20346. https://doi.org/10.2196/20346
[51]
Noble, J. M., Zamani, A., Gharaat, M., Merrick, D., Maeda, N., Lambe Foster, A. et al. (2022). Developing, Implementing, and Evaluating an Artificial Intelligence-Guided Mental Health Resource Navigation Chatbot for Health Care Workers and Their Families during and Following the COVID-19 Pandemic: Protocol for a Cross-Sectional Study. JMIR Research Protocols, 11, e33717. https://doi.org/10.2196/33717
[52]
Nosrati, S., Sabzali, M., Heidari, A., Sarfi, T., & Sabbar, S. (2020). Chatbots, Counselling, and Discontents of the Digital Life. Journal of Cyberspace Studies, 4, 153-172.
[53]
Olawade, D. B., Wada, O. Z., Odetayo, A., David-Olawade, A. C., Asaolu, F., & Eberhardt, J. (2024). Enhancing Mental Health with Artificial Intelligence: Current Trends and Future Prospects. Journal of Medicine, Surgery, and Public Health, 3, Article ID: 100099. https://doi.org/10.1016/j.glmedi.2024.100099
[54]
Pandita, P. (2023). Impact of Artificial Intelligence on Mental and Psychological Health of Working Women. Applications of AI.
[55]
Parviainen, J., & Rantala, J. (2022). Chatbot Breakthrough in the 2020s? An Ethical Reflection on the Trend of Automated Consultations in Health Care. Medicine, Health Care and Philosophy, 25, 61-71. https://doi.org/10.1007/s11019-021-10049-w
[56]
Pereira, J., & Díaz, Ó. (2019). Using Health Chatbots for Behavior Change: A Mapping Study. Journal of Medical Systems, 43, Article No. 135. https://doi.org/10.1007/s10916-019-1237-1
[57]
Poria, S., Cambria, E., Bajpai, R., & Hussain, A. (2017). A Review of Affective Computing: From Unimodal Analysis to Multimodal Fusion. Information Fusion, 37, 98-125. https://doi.org/10.1016/j.inffus.2017.02.003
[58]
Rouhiainen, L. (2018). Artificial Intelligence: 101 Things You Must Know Today about Our Future. CreateSpace Independent Publishing Platform.
[59]
Sánchez Cuadrado, J., Pérez-Soler, S., Guerra, E., & De Lara, J. (2024). Automating the Development of Task-Oriented LLM-Based Chatbots. In Proceedings of the 6th ACM Conference on Conversational User Interfaces (pp. 1-10). ACM. https://doi.org/10.1145/3640794.3665538
[60]
Scheibner, J., Ienca, M., Kechagia, S., Troncoso-Pastoriza, J. R., Raisaro, J. L., Hubaux, J. et al. (2020). Data Protection and Ethics Requirements for Multisite Research with Health Data: A Comparative Examination of Legislative Governance Frameworks and the Role of Data Protection Technologies. Journal of Law and the Biosciences, 7, lsaa010. https://doi.org/10.1093/jlb/lsaa010
[61]
Stade, E. C., Stirman, S. W., Ungar, L. H., Boland, C. L., Schwartz, H. A., Yaden, D. B. et al. (2024). Large Language Models Could Change the Future of Behavioral Healthcare: A Proposal for Responsible Development and Evaluation. NPJ Mental Health Research, 3, Article No. 12. https://doi.org/10.1038/s44184-024-00056-z
[62]
Suppadungsuk, S., Thongprayoon, C., Miao, J., Krisanapan, P., Qureshi, F., Kashani, K. et al. (2023). Exploring the Potential of Chatbots in Critical Care Nephrology. Medicines, 10, Article No. 58. https://doi.org/10.3390/medicines10100058
[63]
Suresh Babu, C. V., & Akshara, P. M. (2024). Revolutionizing Conversational AI: Unleashing the Power of ChatGPT-Based Applications in Generative AI and Natural Language Processing. In A. J. Obaid, et al. (Eds.), Advanced Applications of Generative AI and Natural Language Processing Models (pp. 228-248). IGI Global. https://doi.org/10.4018/979-8-3693-0502-7.ch011
[64]
Suta, P., Lan, X., Wu, B., Mongkolnam, P., & Chan, J. H. (2020). An Overview of Machine Learning in Chatbots. International Journal of Mechanical Engineering and Robotics Research, 9, 502-510. https://doi.org/10.18178/ijmerr.9.4.502-510
[65]
Thakkar, A., Gupta, A., & De Sousa, A. (2024). Artificial Intelligence in Positive Mental Health: A Narrative Review. Frontiers in Digital Health, 6, Article ID: 1280235. https://doi.org/10.3389/fdgth.2024.1280235
[66]
Thieme, A., Hanratty, M., Lyons, M., Palacios, J., Marques, R. F., Morrison, C. et al. (2023). Designing Human-Centered AI for Mental Health: Developing Clinically Relevant Applications for Online CBT Treatment. ACM Transactions on Computer-Human Interaction, 30, 1-50. https://doi.org/10.1145/3564752
[67]
Torous, J., Bucci, S., Bell, I. H., Kessing, L. V., Faurholt‐Jepsen, M., Whelan, P. et al. (2021). The Growing Field of Digital Psychiatry: Current Evidence and the Future of Apps, Social Media, Chatbots, and Virtual Reality. World Psychiatry, 20, 318-335. https://doi.org/10.1002/wps.20883
[68]
Tuerk, P. W., Schaeffer, C. M., McGuire, J. F., Adams Larsen, M., Capobianco, N., & Piacentini, J. (2019). Adapting Evidence-Based Treatments for Digital Technologies: A Critical Review of Functions, Tools, and the Use of Branded Solutions. Current Psychiatry Reports, 21, Article No. 106. https://doi.org/10.1007/s11920-019-1092-2
[69]
Vaidyam, A. N., Wisniewski, H., Halamka, J. D., Kashavan, M. S., & Torous, J. B. (2019). Chatbots and Conversational Agents in Mental Health: A Review of the Psychiatric Landscape. The Canadian Journal of Psychiatry, 64, 456-464. https://doi.org/10.1177/0706743719828977
[70]
van der Schyff, E. L., Ridout, B., Amon, K. L., Forsyth, R., & Campbell, A. J. (2023). Providing Self-Led Mental Health Support through an Artificial Intelligence-Powered Chat Bot (LEORA) to Meet the Demand of Mental Health Care. Journal of Medical Internet Research, 25, e46448. https://doi.org/10.2196/46448
[71]
van Lotringen, C., Lusi, B., Westerhof, G. J. et al. (n.d.). Compassionate Technology: A Systematic Scoping Review of Compassion as Foundation for Blended and Digital Mental Health Interventions.
[72]
Viduani, A., Cosenza, V., Araújo, R. M., & Kieling, C. (2023). Chatbots in the Field of Mental Health: Challenges and Opportunities. In I. C. Passos, et al. (Eds.), Digital Mental Health (pp. 133-148). Springer International Publishing. https://doi.org/10.1007/978-3-031-10698-9_8
[73]
Wiljer, D., Strudwick, G., & Crawford, A. (2020). Caring in a Digital Age: Exploring the Interface of Humans and Machines in the Provision of Compassionate Healthcare. In B. D. Hodges, G. Paech, & J. Bennett (Eds.), Without Compassion, There Is No Healthcare: Leading with Care in a Technological Age (pp. 33-57). McGill-Queen’s University Press. https://doi.org/10.1515/9780228004615-005
[74]
Williamson, S. M., & Prybutok, V. (2024). Balancing Privacy and Progress: A Review of Privacy Challenges, Systemic Oversight, and Patient Perceptions in AI-Driven Healthcare. Applied Sciences, 14, Article No. 675. https://doi.org/10.3390/app14020675
[75]
Xie, T., & Pentina, I. (2022). Attachment Theory as a Framework to Understand Relationships with Social Chatbots: A Case Study of Replika. In Proceedings of the 55th Hawaii International Conference on System Sciences. https://doi.org/10.24251/hicss.2022.258
[76]
Xu, L., Sanders, L., Li, K., & Chow, J. C. L. (2021). Chatbot for Health Care and Oncology Applications Using Artificial Intelligence and Machine Learning: Systematic Review. JMIR Cancer, 7, e27850. https://doi.org/10.2196/27850
[77]
Yang, J., Chen, Y., Por, L. Y., & Ku, C. S. (2023). A Systematic Literature Review of Information Security in Chatbots. Applied Sciences, 13, Article No. 6355. https://doi.org/10.3390/app13116355
