Background
Chatbots have been used in the last decade to improve access to mental health care services. Perceptions and opinions of patients influence the adoption of chatbots for health care. Many studies have been conducted to assess the perceptions and opinions of patients about mental health chatbots. To the best of our knowledge, there has been no review of the evidence surrounding perceptions and opinions of patients about mental health chatbots.
Objective
This study aims to conduct a scoping review of the perceptions and opinions of patients about chatbots for mental health.
Methods
The scoping review was carried out in line with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) extension for scoping reviews guidelines. Studies were identified by searching 8 electronic databases (eg, MEDLINE and Embase) in addition to conducting backward and forward reference list checking of the included studies and relevant reviews. In total, 2 reviewers independently selected studies and extracted data from the included studies. Data were synthesized using thematic analysis.
Results
Of 1072 citations retrieved, 37 unique studies were included in the review. The thematic analysis generated 10 themes from the findings of the studies: usefulness, ease of use, responsiveness, understandability, acceptability, attractiveness, trustworthiness, enjoyability, content, and comparisons.
Conclusions
The results demonstrated overall positive perceptions and opinions of patients about chatbots for mental health. Important issues to be addressed in the future are the linguistic capabilities of the chatbots: they have to be able to deal adequately with unexpected user input, provide high-quality responses, and have to show high variability in responses. To be useful for clinical practice, we have to find ways to harmonize chatbot content with individual treatment recommendations, that is, a personalization of chatbot conversations is required.
Chatbots can provide valuable support to patients in assessing and guiding management of various health problems particularly when human resources are scarce. Chatbots can be affordable and efficient on-demand virtual assistants for mental health conditions, including anxiety and depression. We review features of chatbots available for anxiety or depression. Six bibliographic databases were searched including backward and forwards reference list checking. The initial search returned 1302 citations. Post-filtering, 42 studies remained forming the final dataset for this scoping review. Most of the studies were from conference proceedings (62%, 26/42), followed by journal articles (26%, 11/42), reports (7%, 3/42), or book chapters (5%, 2/42). About half of the reviewed chatbots had functionality targeting both anxiety and depression (60%, 25/42), whereas 38% (16/42) targeted only depression, 38% (16/42) anxiety and the remaining addressed other mental health issues along with anxiety and depression. Avatars or fictional characters were rarely used in these studies only 26% (11/42) despite their increasing popularity. Mental health chatbots could benefit in helping patients with anxiety and depression and provide valuable support to mental healthcare workers, particularly when resources are scarce. Real-time personal virtual assistance fills in this gap . Their role in mental health care is expected to increase.
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