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Can ChatGPT answer my mental health questions?

Jan 31, 2024

Want an answer to your mental health question? Your computer or your phone can give you one.

Artificial intelligence programs like ChatGPT and even older versions like Siri and Alexa make it easy to anonymously tell a nonhuman how you are feeling and get a response.

Researchers and mental health professionals caution that as more people rely on technology and become comfortable with different types of virtual mental health services, they are missing the human touch of mental health care.

The responses aren't bad, said Kate Hix, the executive director of NAMI Central Texas, the local chapter of the National Alliance on Mental Illness, but, "It is definitely not a psychologist."

Digital mental health technology has been around since the mid-1960s, said Dr. John Torous, a Harvard professor and the director of digital psychiatry at Beth Israel Deaconess Medical Center in Massachusetts. There are reasons it hasn't replaced a human mental health expert, he said.

In the U.S. and Texas there are a shortage of mental health care providers, especially providers who take health insurance. Locally, it's particularly hard to find treatment for children 12 and younger, Hix said.

In the nonprofit Mental Health America's 2023 survey, Texas ranked last in access to care.

The survey found that in Texas, 29.8% of adults with a mental illness said they couldn't get care, and 74.9% of children with a major depression could not get care. Of the kids in Texas who have private insurance, 74.9% had insurance that didn't adequately cover mental health.

When it comes to mental health apps and AI, "the part that excites everyone is that it's scalable," Torous said. "We can deliver services to everyone."

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The comfort of using AI to ask questions about mental health is anonymity, Hix said, explaining the shame people might feel and that they might not want to open up to their family, especially to parents if they are younger than 18.

"People do come with their own implicit bias," Hix said. "ChatGPT has no personal bias. People feel safer."

Studies done on AI for mental health have indicated these programs can be good for learning skills such as those deployed in cognitive behavioral therapy, but they are not as good in other kinds of therapy.

A 2020 analysis in the Journal of Medical Internet Research of 12 studies on AI chatbots, found some evidence of improvement for people with depression, stress and acrophobia, but the studies had conflicting outcomes on anxiety. Only two of the studies concluded chatbots were safe for mental health.

AI-based programs, though, can't make a person engage in therapy, Torous said. Think about if you had a general health program that told you to exercise, eat vegetables and get plenty of rest; does that make you do those things? Torous asks.

"If you put a mental health app on their phone, some people aren't going to use it," he said. It might give you good information about resources and health conditions, but it's like Wikipedia. "It didn't transform mental health," he said. The problem isn't access to information; it's access to quality mental health care.

Online programs or apps could be useful in conjunction with therapy: Think about meditation apps like Breethe and Calm. They don't replace a mental health professional, but they do help improve mental health if they are used.

AI programs like ChatGPT are designed to mimic a person talking back to you, giving you that false sense that you've connected with someone meaningful. "The biggest limitation is empathy," Hix said. "A computer can never have empathy with you."

Most people would like human contact, Torous said. "We live in a world where people feel isolated because of technology," he said.

The other concern with technology is protecting a person's personal information and how that information is shared.

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Technology's challenge also is "if you spend enough time with it, you could trick it to say something horrible," Torous said. "The psychiatrist and M.D. in me says, we don't want to cause harm," he said.

Many of the suggestions are that ChatGPT, Siri and Google are good for providing links to national resources.

Hix is hoping people will remember three numbers: 988 — the mental health crisis helpline launched last year to connect all the local helplines to one number. In Travis County, that's a direct connection to Integral Care's crisis helpline. A trained therapist will answer the call or text.

Integral Care, the Austin-Travis County mental health authority, answers the mental health crisis helpline for 76 counties in Texas. The therapist on the line will connect you with resources where you live.

If that local person is in immediate danger, that call gets transferred to the Austin-Travis County EMS Mental Health Paramedic Responders team or to the police depending on the nature of the danger.

Calling 988 is confidential, even for children. For those under 18, once treatment is needed, then a guardian would need to be involved, Hix said.

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988 does connect people to resources, including to Integral Care's providers for people who are uninsured or underinsured.

If you cannot find a trained mental health professional, talk to your general health care provider to be linked to care. Only pediatricians can connect with the Child Psychiatry Access Network helpline to consult on how to provide care for patients who haven't connected with a mental health professional.

Austin Public Health and Integral Care, along with the city of Austin and Travis County, launched a new resource program: "Ask, Listen, Talk, Repeat," with the website AskListenTalk.org. It gives parents and caregivers resources on how to have conversations about mental health and how to spot the signs of mental health problems as well as how to improve their own mental health.

It also has a list of resources where you can get help.

Also consider reaching out to one of the following resources for immediate support:

Getting care: More help: Quicker care: