With ever-increasing wait times for teenagers to access mental health treatment, could AI chatbots be the answer?
Young people want someone to talk to while waiting for mental health treatment. AI chatbots could keep them from turning to unhealthy coping behaviours in the meantime, new research suggests.
An online survey of over 350 adolescents aged 13-17 years who had sought treatment for anxiety and/or depression in the previous 12 months revealed that, on average, it took teenagers 100 days to be seen by a psychologist after receiving their initial referral. The average wait time increased to 128 days for individuals referred to a psychiatrist.
The study, published in BMJ Open, also revealed that over 90% of participants reported they were experiencing clinically meaningful levels of psychological distress, with two in three respondents indicating their feelings of sadness had worsened while waiting to see a treatment provider. Over 70% of respondents indicated their perceived feelings of worry had worsened.
Concerningly, almost 40% of respondents indicated that their healthcare providers provided little to no additional support after being referred for further treatment.
“Young people reported that they experienced a high level of psychological distress during this period. They felt a strong sense of abandonment and a loss of hope,” said lead author Dr Mirjana Subotic-Kerry, a provisional psychologist from the Black Dog Institute.
The most commonly reported forms of additional support respondents received were having an additional follow-up appointment with their GP and being provided mental health information handouts and brochures.
Respondents indicated they would prefer greater communication and transparency from their waitlisted service provider, as well as practical mental health strategies and resources, emotional support and someone to talk to.
But it’s not all doom and gloom, according to Dr Subotic-Kerry, with many young people turning to healthy coping behaviours while waiting for professional help.
“They were engaging with informal support, such as seeking out information or reaching out to their family and friends. Others found comfort in physical activity, journalling, or simply finding ways to keep themselves occupied and mentally engaged while they waited,” she explained.
“This shows us that young people can self-manage and engage in healthy coping behaviours and find strength during the wait time.”
In addition, over half of the respondents indicated they had engaged with a digital source of support, such as a web- or app-based tool or website. These resources were deemed to be “somewhat helpful”. Generative artificial intelligence chatbots have been suggested as a digital source of support for people who are waiting to receive specialist care. Several chatbots have been designed to provide accessible mental health care online and are being trialled for efficacy.
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Dr Luke Balcombe, digital mental health expert at Griffith University told TMR that AI chatbots can be useful for patients in between sessions and are developing quickly to be capable of suiting individual preferences for mental health care.
“Some people can’t easily organise to access mental health care and if they do, they often find it difficult to find a therapist that they benefit from, so it is not just about waiting times but effectiveness, respect and acknowledgement of an individual’s plight,” he told TMR.
A recent trial of one of these chatbots found that users had a significantly greater reduction in symptoms than the control group as assessed by the Patient Health Questionnaire (PHQ-9, where scores can range from 1 [minimal depression] to 27 [severe depression]).
The randomised controlled trial included 210 people with clinically significant symptoms of major depressive disorder (MDD), generalised anxiety disorder (GAD) or a clinically high risk for feeding and eating disorders (CHR-FED). Half of the participants were given access to Therabot for mental health treatment, while the other 104 formed a waitlist control group who were given access after the trial ended.
After four weeks, the MDD symptoms of Therabot users had reduced on average by 6.13 points from baseline, compared to the average reduction of the control group of 2.63. At eight weeks, the average reduction was 7.93 and 4.22 respectively.
GAD symptoms also reduced at four weeks, with Therabot users experiencing an average reduction of 2.32 as compared to the control group reduction of 0.13. At eight weeks this reduction was 3.18 and 1.11 respectively.
The CHR-FED group using Therabot saw a larger reduction in symptoms; 9.83 at four weeks and 10.23 at eight weeks, while the control group only saw an average reduction of 1.66 and 3.70 respectively.
During the eight-week period, the average patient spent more than six hours interacting with Therabot, which is comparable to seeing a mental health professional for a 50-minute session once a week.
The authors concluded that the fine-tuned Gen-AI chatbot had received high ratings from users and offers a feasible approach to delivering large-scale personalised mental health interventions.
However, Dr Balcombe warned that more work needed to be done on these chatbots to use them to fill service gaps, particularly for dealing with the complexities of neurodivergent and schizophrenic people.
He says GPs would not have enough evidence to be assured in recommending these assistive tools.
“However, they can discuss the risks and benefits with patients – it is better to be informed about these tools than to disregard them or assume things about them,” he said.
Senior author Professor Bridianne O’Dea, also based at the Black Dog Institute, has called for the federal government to follow international trends and bring in national wait time benchmarks to reduce the time between referral and an initial appointment.
“Our finding that young people are waiting a long time to access mental health services is not surprising,” she said.
“Yet, while we can work with young people to improve their self-management, the time is right for Australia to seriously consider the use of national standards.”
