Can Your Phone Be Your Therapist? Young People's Ethical Perspectives on the Use of Fully Automated Conversational Agents (Chatbots) in Mental Health Support

Kira Kretzschmar, Holly Tyroll, Gabriela Pavarini, Arianna Manzini, Ilina Singh, NeurOx Young People’s Advisory Group, Kira Kretzschmar, Holly Tyroll, Gabriela Pavarini, Arianna Manzini, Ilina Singh, NeurOx Young People’s Advisory Group

Abstract

Over the last decade, there has been an explosion of digital interventions that aim to either supplement or replace face-to-face mental health services. More recently, a number of automated conversational agents have also been made available, which respond to users in ways that mirror a real-life interaction. What are the social and ethical concerns that arise from these advances? In this article, we discuss, from a young person's perspective, the strengths and limitations of using chatbots in mental health support. We also outline what we consider to be minimum ethical standards for these platforms, including issues surrounding privacy and confidentiality, efficacy, and safety, and review three existing platforms (Woebot, Joy, and Wysa) according to our proposed framework. It is our hope that this article will stimulate ethical debate among app developers, practitioners, young people, and other stakeholders, and inspire ethically responsible practice in digital mental health.

Keywords: Chatbots; apps; artificial intelligence; conversational agent; digital mental health; human-computer interaction; mental health; therapy; young people; youth mental health.

Conflict of interest statement

Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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