JMIR Publications

ABSTRACT

Background:

Chatbots are an emerging technology showing potential in mental healthcare applications to enable effective and practical evidence-based therapies. Since this technology is still relatively new, little is known about the recently developed apps, their characteristics, and their effectiveness.

Objective:

In this paper, we aim to provide an overview of the commercially available popular mental health chatbots and how they are perceived by users.

Methods:

We conducted an exploratory observation of 10 apps that offer support and treatment for a variety of mental health concerns with a built-in chatbot feature, and qualitatively analyzed 3621 consumer reviews from the Google Play Store and 2624 consumer reviews from the Apple App Store.

Results:

We found that while chatbots’ personalized, human-like interactions were positively received by users, improper responses, and assumptions about the personalities of users led to a loss of interest. As chatbots are always accessible and convenient, users can become overly attached to them and prefer them over interacting with their friends and family members. Furthermore, a chatbot may offer crisis care whenever the user needs it due to its 24/7 availability, but even the recently developed chatbots lack the understanding of properly identifying a crisis. Chatbots considered in this study fostered a judgment-free environment and helped users feel more comfortable sharing sensitive information.

Conclusions:

Our findings suggest that chatbots have great potential to offer social and psychological support in situations where real-world human interaction such as connecting to friends or family members or seeking professional support is not preferred or possible to achieve. However, there are several restrictions and limitations that these chatbots must establish for the level of service they offer. Too much reliance on technology can pose risks, such as isolation and insufficient assistance during times of crisis. Recommendations for customization and balanced persuasion to inform the design of effective chatbots for mental health support have been outlined from the insights of our findings.