The rise of mental health chatbots
January 10, 2024
The Wall Street Journal reported last week on the rise of chatbot digital apps for workers who are feeling “anxious, stressed or blue.” Depression and anxiety are on the rise, and therapists continue to be in short supply. Politico reported on two researchers who have created “digital replicas” of influential psychologists. Advances in artificial intelligence make chatbots better able to emulate communication that feels human, and chatbots can meet the needs of many who need support, but don’t require drug therapy. WTW’s 2023 Best Practices in Healthcare Survey showed that over two thirds of companies reported offering digital mental health therapeutics, although many of these were apps that did not feature chatbots.
Not every AI chatbot performs as expected, though. Last Spring, the National Eating Disorder Association replaced its paid and volunteer hotline staff with a chatbot, which promptly started giving inappropriate diet advice to people with eating disorders. The NEDA disabled the chatbot, and now refers website visitors to other helplines that are staffed by humans. JAMA Pediatrics reported this week that the diagnostic accuracy of a large language model AI system had a diagnostic error rate of 83% in (quite difficult) pediatric medical case studies.
Implications for employers:
Chatbots are a great resource for some health plan members. They can be empathetic and nonjudgmental, and they are available 24 hours every day. They are less expensive than trained professionals.
Chatbots are not a replacement for comprehensive access to mental health and substance abuse care. They cannot prescribe medications and might miss signs of imminent danger. They can give incorrect answers and could be better at listening than giving advice.
Members should always be aware that they are talking to a chatbot, and not a human.
Vendors offering chatbot services should have processes in place to identify suicidality or danger and transfer members to qualified professionals.
Employers should also evaluate the privacy and security of vendors offering such services.
Thanks for reading. You can find previous posts in the Employer Coverage archive
Please “like” and suggest this newsletter to friends and colleagues. Thanks!
Illustration by Dall-E. Note the AI tool doesn’t have an easy time with fingers
Tomorrow: Pharmaceutical investment is NOT going down