Open Problems in Chatbots and Mental Health

Jared Moore, Jacy Reese Anthis, William Agnew, Andrea Mock, Kevin Klyman +6

General-purpose chatbots are increasingly used for emotional and mental health support. They can be useful, but issues such as sycophancy, reinforcement of delusional beliefs, and poor crisis response create risks that are difficult for researchers to study and evaluate. In this paper, we review the most critical open problems for researchers and policymakers in the use of general-purpose chatbots and their effects on mental health. First, there are tractable problems in the controlled evaluation of chatbots: establishing the construct and ecological validity of evaluations, evaluating multi-turn interactions, and connecting evaluations to improvements in chatbot behavior. For example, conventional benchmarks that primarily rely on static datasets cannot establish chatbot safety, and novel simulation methods need validation. Second, researchers must connect their studies of chatbots and mental health to real-world evidence. This includes analyzing the chatbot products that AI companies and mental health practitioners have deployed, including their user interfaces and human review and escalation practices for user welfare concerns. However, clinical analysis opportunities afforded…