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

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.

A Hierarchical Framework for Evaluation and Informed Decision Making Regarding Smartphone Apps for Clinical Care.

With thousands of smartphone apps targeting mental health, it is difficult to ignore the rapidly expanding use of apps in the treatment of psychiatric disorders. Patients with psychiatric conditions are interested in mental health apps and have begun to use them. That does not mean that clinicians must support, endorse, or even adopt the use of apps, but they should be prepared to answer patients' questions about apps and facilitate shared decision making around app use. This column describes an evaluation framework designed by the American Psychiatric Association to guide informed decision making around the use of smartphone apps in clinical care.