JMIR Publications

ABSTRACT

Background:

Anecdotal evidence suggests that an increasing number of people are turning to generative AI (artificial intelligence) tools or AI-assisted chatbots to discuss and manage mental health concerns. However, systematic data on the use and perception of such tools remain scarce.

Objective:

This study examined how young and middle-aged adults in the United States use generative AI and AI-assisted mental health chatbots as mental health resources and assessed their preferences for these tools relative to human mental health professionals.

Methods:

An anonymous online survey was conducted in October 2025 among U.S. adults in a commercial online panel sample of U.S. adults aged 18–49 (N = 1,805). Respondents were asked about the sources they typically turn to when facing mental health concerns, their frequency of using generative AI tools or chatbots for mental health support, and whether the frequency of seeing human mental health professionals had changed since they started using AI tools for mental health support. Attitudes toward AI-based mental health support were assessed in comparison with attitudes toward human mental health professionals.

Results:

In this sample, of all respondents, 638 (35.2%) reported using AI tools at least once a week in a typical week for mental health support, and 99 (5.5%) were classified as “heavy users” who reported regularly spending hours discussing their mental health concerns through AI. However, nearly 60% of respondents reported that they would turn first to family and friends when facing mental health concerns. Respondents who screened positive for moderate to severe depressive or anxiety symptoms were more likely to use AI-based mental health support compared to those without these symptoms (adjusted Odds Ratio (aOR) = 1.71, 95% Confidence Interval (CI) = 1.36-2.15), and those with suicidal ideation were more likely to be heavy AI users (aOR = 2.42, 95% CI = 1.49-3.95). Among those who had ever seen a human mental health professional (N=511), 28.4% (N = 145) reported a perceived decline in visit frequency to human mental health professionals since they started using AI tools for the same purpose. Participants expressed more favorable attitudes toward human mental health professionals than toward AI-based tools. However, among heavy AI users, perceptions of AI-based mental health support and human counseling were nearly equivalent in positivity.

Conclusions:

AI appears to be an important component of the mental health help-seeking landscape among respondents in this sample. Although most respondents still preferred human professionals, a subset reported relying on AI tools for comparable support. Ongoing monitoring and ethical guidelines are needed to ensure that AI technologies expand access to care while being safely and effectively integrated into the broader continuum of mental health services.