Using AI for Mental Health Effectively


“How are you doing today?” “What’s going on in your world right now?” “How do you feel?” These might seem like simple questions a caring friend would ask. However, in the present day of mental health care, they can also be the start of a conversation with your virtual therapist. Advancements in artificial intelligence (AI) are bringing psychotherapy to more people who need it. It is becoming clear that AI for mental health could be a game changer.


Innovative technology is offering new opportunities to millions of Americans affected by different mental health conditions. Nonetheless, the benefits of these methods need to be carefully balanced against their limitations. The long-term efficacy of AI for mental health is yet to be thoroughly tested, but the initial results are promising.

Mental Disorders Are the Costliest Condition in the U.S.

According to National Institute of Mental Health (NIMH) findings from 2017, approximately one in five adults in the United States (18.9%) experiences some type of mental health disorder. Mental illness not only reduces an individual’s quality of life, but also leads to increased health spending.

Charles Roehrig, founding director of the Center for Sustainable Health Spending at Altarum Institute in Ann Arbor, Michigan, notes that in 2013, mental disorders, including dementia, topped the list of medical conditions with the highest estimated spending.

According to data from that year, mental health became the most expensive part of our healthcare system, overtaking even heart conditions.

Approximately $201 billion is spent on mental health annually. As more people reach old age, the increase in prevalence of certain age-related health conditions, such as dementia, is expected to push this figure higher.

Because of the costs associated with treatment, many individuals who experience mental health problems do not receive timely professional input. Cost is not the only contributing factor; other reasons include a shortage of therapists and the stigma associated with mental illness.

AI for Mental Health and Personalized CBT

Clinical research psychologist Dr. Alison Darcy created Woebot, a Facebook-integrated computer program that aims to replicate conversations a patient might have with his or her therapist.

Woebot is a chatbot that resembles an instant messaging service. The digital health technology asks about your mood and thoughts, “listens” to how you are feeling, learns about you and offers evidence-based cognitive behavior therapy (CBT) tools. Interactions with Woebot aim to emulate a real-life face-to-face meeting, and the interaction is tailored to the individual’s situation.

Darcy is careful to point out that Woebot is just a robot and cannot replace human connection. Also, some people might require different types of therapeutic engagement and treatment than a virtual session can provide. Nonetheless, many experts agree that options like Woebot make CBT more accessible to a modern generation that chronically lacks the time and is accustomed to 24/7 connectivity.

This carefully designed software offers private sessions that do not need to be pre-booked and are affordable.

Woebot is not the first attempt to treat people by placing them in front of an avatar. Other attempts have been made to improve people’s mental health using chatbots. Some of the early chatbots were designed in the 1960s at the MIT Artificial Intelligence Laboratory. Their program ELIZA was able to simulate a short conversation between a therapist and a patient and is considered the grandparent of systems being used today.

Advances in natural language processing and the popularity of smartphones have made chatbots the new starlets of AI for mental health care.

Chatbots are constantly improving to become more human-like and natural. They also offer different language options. For example, Emma speaks Dutch and is a bot designed to help with mild anxiety, while Karim speaks Arabic and has been assisting Syrian refugees struggling to cope after fleeing the atrocities of war.

Both programs were designed by Silicon Valley startup X2AI. Currently, the company is promoting its latest psychological AI product—Tess. Tess can perform CBT, as well as purportedly improve the burnout associated with caregiving.

What Makes AI for Mental Health So Appealing?

When evaluating the use of chatbots in health care, the International Committee of the Red Cross notes in its 2017 report that initial reviews of the messaging-app bots have been mixed. While it has been recognized that they are not expensive and are easy to deploy, some limitations have also been described, such as technical glitches. Furthermore, robots do not have a mind of their own; they follow a pre-defined script. Therefore, they are not always able to understand the user and his or her intent. Therefore, some experts suggest that this medium probably should be used in conjunction with a human therapist to ensure nothing gets missed.

Nonetheless, some initial studies on the efficacy of chatbots for mental health have been promising.

The first randomized control trial with Woebot showed that after just two weeks, participants experienced a significant reduction in depression and anxiety. Furthermore, a high level of engagement was observed, with individuals using the bot nearly every day.

A virtual therapist named Ellie has also been launched and trialed by the University of Southern California’s Institute for Creative Technologies (ICT). Initially, Ellie was designed to treat veterans experiencing depression and post-traumatic stress syndrome.

What is so special about the technology is that Ellie can detect not only words but also nonverbal cues (e.g., facial expression, gestures, posture). Nonverbal signs are very important in therapy, yet can be subtle and difficult to pick up. The ICT team led by Louis-Philippe Morency and Albert “Skip” Rizzo developed their virtual therapist so it can gather and analyze multisensory information and help assess a user. Ellie’s creators argue that this virtual human can advance mental health and improve diagnostic precision.

What makes Ellie (and other members of the chatbot family) able to perform so well?

Some studies show that we react to avatars as if they were real humans. Mel Slater of University College London, UK, and his colleagues observed this behavior when they conducted experiments where people were aware that they were interacting with robots, yet they related to them as if they were real.

Some psychologists also argue that we find it easier to share potentially embarrassing information with a virtual therapist. In human-to-human interaction, there is often a degree of self-restraint. Shame can prevent people from sharing openly with another person. However, when sitting with a virtual therapist, subjects were found to be more willing to express themselves, which could have an important therapeutic advantage. When patients talk to a psychotherapy bot, they report not feeling judged. Ellie, Karim, and Woebot can make them feel at ease. In addition, robots are always available and can offer a much higher frequency of therapeutic interactions compared to a human therapist.

Heading Towards an AI-based Mental Healthcare System?

AI is already transforming different industries, including mental health. Machine learning and advanced AI technologies are enabling a new type of care that focuses on providing individualized emotional support. For example, combine machine learning and a clinical network to provide you with the right level of emotional support at the right time. This platform, founded more than six years ago, integrates clinicians with AI and offers 24/7 online CBT, mindfulness and resilience training.

The company is constantly updating its technology so it can support users appropriately and track their progress, through a collaborative approach of coaches, therapists, and psychiatrists. With machine learning as the backbone, each person’s progress helps improve its platform and make it smarter and more scalable.

By downloading the app, users first get matched with a dedicated team of three emotional support coaches to help them around the clock. And when needed, the users may be escalated to licensed therapists or board-certified psychiatrists, through video consults in a couple of days, compared to weeks under the current model. Interactions with coaches and therapists can range from unlimited live chats to video sessions, depending on the needs of the individual.

The example of signals that we might be moving towards an AI-based healthcare system that could transcend the temporal, geographical and, to some extent, financial boundaries and limitations. “Using digital technology and machine learning, we can make behavioral health more accessible and convenient, while reducing the stigma attached to the traditional solutions,” says Rebecca Chiu, former Head of Business Development at

Staff shortages have been another huge barrier to seeing everyone who experiences mental health difficulties. Chatbots and online platforms, on the other hand, can see you whenever you require their support. In addition, they have probably already worked with more users than an average therapist would have. Adam Miner of Stanford University calls this group of technologies “conversational artificial intelligence” and predicts they will expand even further in 2018.

Although AI for mental health still needs to deal with many complexities, research shows that behavioral health interventions are benefiting from continuity, and technology seems to be offering an improved user experience. Good mental health is now at our fingertips.

Preventing Social Isolation Among Young People Using AI

Social networking is very important for young people dealing with mental illness. Extreme social isolation and difficulties building close relationships are often a feature of their lives. Therefore, social networks on the Internet can foster a sense of belonging and encourage positive communication. Although the benefits of online health communities have already been widely recognized, scientists are now tapping into the potential AI can play in making people feel socially more connected.

Simon D’Alfonso of the University of Melbourne’s Centre for Youth Mental Health in Melbourne, Australia, and his colleagues have been working on the Moderate Online Social Therapy (MOST) project. The MOST model is being used with young people recovering from psychosis and depression. The technology helps create a therapeutic environment where young people learn and interact, as well as practice therapeutic techniques.

The MOST system has several parts, including The Café section where users can share experiences and gain support and validation from other members. Users can also nominate a problem in the Talk It Out section where problems get solved in a group. Or, they can engage in a behavioral task that uses mindfulness and self-compassion in a Do It! section of the site.

MOST has been used in a series of research trials and was evaluated as a viable mental health tool. Currently, the program is facilitated by human moderators. However, designers of the system plan to eventually replace humans with innovative AI solutions. User content is being analyzed so in the future an individualized therapy might be offered.

D’Alfonso’s team is also looking to connect with other systems and provide appropriate mobile notifications. For example, if an anxiety attack is detected by the user’s wrist sensor, MOST could immediately offer therapy input on an individual basis.

Virtual Counselor to Reduce Student Stress

Another AI mental health innovation, this one aimed at young people, has been developed by a multidisciplinary group of scientists from Australia and China. They have been pilot testing a novel virtual advisor for university students.

Manolya Kavakli, associate professor at the Macquarie University in Sydney, is leading this project that aims to help students develop better-coping techniques, particularly in connection with exam stress. Exams often put tremendous pressure on young people, which can have negative health implications such as depression, insomnia, and suicide. When exposed to excessive stress, timely counseling can be imperative to maintaining health.

Kavakli and colleagues proposed a virtual companion that can be readily available to provide support. Based on preliminary tests, the group believes that the embodied conversational agent they developed could be very useful during busy exam periods. The virtual counselor mimics a psychologist and offers advice and support with stress management.

During their pilot studies, researchers also wanted to establish how to design a virtual therapist so it was better accepted by users. They found, for example, that the voices of male virtual advisors were perceived as more credible and pleasant. Female voices, on the other hand, were assessed as clearer, more competent and more dynamic. This could have interesting implications regarding AI for mental health in the future—developing different personas to maximize the effect of the treatment on the end-user.

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