The Problem With Mental Health Bots

Experiences of Teresa Berkowitz with therapists had been a godsend. “Some are good, some helpful, some just a waste of time and money,” she says. Six years ago, when childhood trauma was reactivated, Berkowitz — who is in her 50s and lives in Maine — downloaded Youper, a mental health app with a chatbot therapist function, instead of connecting with a real person through artificial intelligence.

Once or twice a week, Berkowitz keeps a guided journal with the Youper chatbot, where the bot asks her to identify and change negative thought patterns as she writes down her thoughts. The app, she says, forces her to reconsider what triggers her anxiety. “It’s available to you all the time,” she says. When triggered, she doesn’t have to wait a week for a therapy appointment.

Unlike their living and breathing counterparts, AI therapists can lend a robotic ear at any time of the day or night. They are cheap, if not free – an important factor considering cost is often one of the biggest barriers to accessing help. Also, some people are more comfortable expressing their feelings to an insensitive bot than to a person, research has found.

The most popular AI therapists have millions of users. However, their explosive popularity has coincided with a glaring lack of resources. According to the World Health Organization, there is an average of 13 mental health professionals for every 100,000 people worldwide. In high-income countries, the number of mental health professionals is more than 40 times that in low-income countries. And the mass fear and casualties unleashed by the pandemic have compounded the problem, widening this gap even further. An article published in That lancet in November 2021 estimated that the pandemic triggered an additional 53 million cases of depression and 76 million cases of anxiety disorders worldwide. In a world where mental health resources are scarce, therapy bots are increasingly filling the void.

Take Wysa for example. The “emotionally intelligent” AI chatbot was launched in 2016 and now has 3 million users. It is being made available to teenagers in parts of London’s public school system, while the UK’s NHS is also conducting a randomized control trial to see if the app can help the millions who are on the (very long) waiting list for specialist mental health care Problems face health conditions. The Singapore government licensed the app in 2020 to provide free support to the population during the pandemic. And in June 2022, Wysa received breakthrough device designation for the treatment of depression, anxiety and chronic musculoskeletal pain from the U.S. Food and Drug Administration (FDA) to expedite review and approval of the product.

In a world where there aren’t enough services to meet demand, they’re probably a “good enough” move, says Ilina Singh, professor of neuroscience and society at Oxford University. These chatbots could just be a new, accessible way to present information on how to deal with mental health problems that is already freely available on the internet. “It’s going to be very helpful for some people, and that’s great, and we’re excited,” says John Torous, director of the Division of Digital Psychiatry at Beth Israel Deaconess Medical Center in Massachusetts. “And for some people, it won’t be.”