Chatbots and Conversational Agents in Mental Health: A Review of the Psychiatric Landscape

By A. Vaidyam, Hannah Wisniewski, John D. Halamka, M. S. Kashavan, John B. Torous. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2019

862 citations recorded by the source corpus.

Objective: The aim of this review was to explore the current evidence for conversational agents or chatbots in the field of psychiatry and their role in screening, diagnosis, and treatment of mental illnesses. Methods: A systematic literature search in June 2018 was conducted in PubMed, EmBase, PsycINFO, Cochrane, Web of Science, and IEEE Xplore. Studies were included that involved a chatbot in a mental health setting focusing on populations with or at high risk of developing depression, anxiety, schizophrenia, bipolar, and substance abuse disorders. Results: From the selected databases, 1466 records were retrieved and 8 studies met the inclusion criteria. Two additional studies were included from reference list screening for a total of 10 included studies. Overall, potential for conversational agents in psychiatric use was reported to be high across all studies. In particular, conversational agents showed potential for benefit in psychoeducation and self-adherence. In addition, satisfaction rating of chatbots was high across all studies, suggesting that they would be an effective and enjoyable tool in psychiatric treatment. Conclusion: Preliminary evidence for psychiatric use of chatbots is favourable. However, given the heterogeneity of the reviewed studies, further research with standardized outcomes reporting is required to more thoroughly examine the effectiveness of conversational agents. Regardless, early evidence shows that with the proper approach and research, the mental health field could use conversational agents in psychiatric treatment.

Subfields: Applied Psychology, Health Informatics, Social Psychology

View Paper: https://www.semanticscholar.org/paper/54b993bf3463c9ad8e9b5e2bba5c5ea535d341e0

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Citations in the corpus

Introducing Artificial Intelligence Training in Medical Education (2019, neutral): “As use of AI and proactive use of tools such as chatbots [42] increases, physicians and patients will need to be aware of strengths and limitations of such technologies and be trained in how to effectively and safely use them [43,44].”
Conversational AI: Social and Ethical Considerations (2019, background): “So far, CAs have been bestowed with responsibilities including screening diagnosis and treatment of mental health [19] [35] [47].”
An overview of the features of chatbots in mental health: A scoping review (2019, background): “In comparison with the previous reviews [6, 22], the current review is the only review that searched Google Scholar and performed backward and forward reference list checking in order”
On the Safety of Conversational Models: Taxonomy, Dataset, and Benchmark (2021, background): “For example, conversational models are expected to understand the user’s psychological state, so as to avoid giving replies that might aggravate depression or even induce suicides (Vaidyam et al., 2019; Abd-Alrazaq et al., 2019).”
AI-generated characters for supporting personalized learning and well-being (2021, background): “Empirical evidence has shown the potential of conversational agents to induce positive behavioural and cognitive changes 48 .”
Racial mirroring effects on human-agent interaction in psychotherapeutic conversations (2020, background): “These conversational agents promise a feasible, engaging, and effective way to carry out psychoeducation and psychotherapy [63].”
Are We There Yet? - A Systematic Literature Review on Chatbots in Education (2021, background): “Outside of education, typical applications of chatbots are in customer service (Xu et al., 2017), counseling of hospital patients (Vaidyam et al., 2019), or information services in smart speakers (Ram et al., 2018).”
The Moral Integrity Corpus: A Benchmark for Ethical Dialogue Systems (2022, neutral): “For example, socially competent dialogue systems have the potential to transform education (Molnár and Szüts, 2018; Yang and Evans, 2019), healthcare (Laranjo et al., 2018; Vaidyam et al., 2019), and business (Bavaresco et al.”
Too human and not human enough: A grounded theory analysis of mental health harms from emotional dependence on the social chatbot Replika (2022, background): “Similar to clinical mental health chatbots, an effective SC could support users who lack access to mental health care or are hesitant to seek it due to stigma (Kretzschmar et al., 2019; Vaidyam et al., 2019).”
The Personalization of Conversational Agents in Health Care: Systematic Review (2019, methodology): “There have also been other recent reviews on health care conversational agents [3-5].”
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Chatbot for Health Care and Oncology Applications Using Artificial Intelligence and Machine Learning: Systematic Review (2021, neutral): “An area of concern is that chatbots are not covered under the Health Insurance Portability and Accountability Act; therefore, users’ data may be unknowingly sold, traded, and marketed by companies [110].”
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