Effectiveness and Safety of Using Chatbots to Improve Mental Health: Systematic Review and Meta-Analysis PMC

Still, it may not work for a doctor seeking information about drug dosages or adverse effects. First, the chatbot helps Peter relieve the pressure of his perceived mistake by letting him know it’s not out of the ordinary, which may restore his confidence; then, it provides useful steps to help him deal with it better. During the Covid-19 pandemic, WHO employed a WhatsApp chatbot to reach and assist people across all demographics to beat the threat of the virus. The doctors can then use all this information to analyze the patient and make accurate reports. This allows patients to get quick assessments anytime while reserving clinician capacity for the most urgent cases. Because of this demand, the self-service technology market is predicted to grow at a compound annual growth rate of 6.7% between 2020 and 2027.

The removal of options may slowly reduce the patient’s awareness of alternatives and interfere with free choice [100]. The results indicated that there was little risk of harm with conversational agent use. One study performed by Miner et al.26 in a controlled lab setting, and as such excluded from our review, did assess how

smartphone-based chatbots respond to emergencies related to suicide. Their results found

that the responses were limited and at times even inappropriate.

One of the key advantages of chatbots is their ability to offer up-to-date information about testing centers, vaccination sites, and updated pandemic guidelines. With the constantly evolving nature of the virus, having access to accurate and timely information is crucial. Chatbots can provide users with a list of nearby testing centers or vaccination sites based on their location, ensuring they have easy access to these important resources. Chatbots are poised to offer more personalized and interactive healthcare experiences, adapting to individual patient needs with greater accuracy. They are likely to become an integral part of telemedicine, extending their capabilities beyond simple interactions to more complex medical consultations. This assistance is one of the innovative healthcare app features, enhancing user experience.

These digital assistants are not just tools; they represent a new paradigm in patient care and healthcare management. Embracing this technology means stepping into a future where healthcare is more accessible, personalized, and efficient. The journey with healthcare chatbots is just beginning, and the possibilities are as vast as they are promising.

This relays to the user that the responses have been verified by medical professionals. Before chatbots, we had text messages that provided a convenient interface for communicating with friends, loved ones, and business partners. In fact, the survey findings reveal that more than 82 percent of people keep their messaging notifications on. The higher the intelligence of a chatbot, the more personal responses one can expect, and therefore, better customer assistance. After reading this blog, you will hopefully walk away with a solid understanding that chatbots and healthcare are a perfect match for each other. Obviously, chatbots cannot replace therapists and physicians, but they can provide a trusted and unbiased go-to place for the patient around-the-clock.

Navigating the Landscape: The Current State of Conversational AI in Healthcare

The integration of chatbots in the healthcare industry is redefining patient care and support. These AI-enabled assistants offer a range of benefits, improving both efficiency and accessibility. Furthermore, these chatbots align with the latest trends in the healthcare industry, incorporating advanced technologies for improved patient engagement. Their role in healthcare is increasingly vital, offering an innovative approach to managing health-related concerns and queries efficiently. The use of chatbots in healthcare helps improve the performance of medical staff by enabling automation.

By collecting relevant information from users who may have been exposed to the virus, these bots assist in identifying potential hotspots and preventing further spread. Users can report their symptoms or any recent close contacts they may have had through the chatbot interface, enabling health authorities to take swift action. Moreover, chatbot interfaces provide patients with the flexibility to reschedule or cancel appointments effortlessly. With just a few clicks or taps, individuals can modify their appointment timing according to their needs or unexpected circumstances. This feature not only empowers patients but also reduces the burden on healthcare staff who would otherwise need to handle these requests manually. In the realm of post-operative care, AI chatbots help enhance overall recovery processes by using AI technology to facilitate remote monitoring of patients’ vital signs.

The feedback can help clinics improve their services and improve the experience for current and future patients. Medical chatbots respond to prompts and data shared by users about their health to offer relevant information, guidance, and advice. As healthcare systems grapple with staffing shortages and overburdened resources, medical chatbots could offer a digital lifeline. While a chatbot in healthcare can not be considered a 100% trusted and reliable medical consultant, it can at least help patients recognize their symptoms and the urgency of their condition or answer their questions.

6 CANCERCHATBOT

Healthcare chatbots are AI-powered tools capable of efficiently handling simple inquiries and providing a convenient way for patients to get information. In many cases, they also ensure more personal interactions with healthcare services than browsing a website or communicating with a call center. The healthcare industry has been rapidly changing and advancing in technology over the years. Artificial Intelligence (AI) and Natural Language Processing (NLP) are just one of the few innovations in the healthcare sector. Many hospitals, labs, pharmacies, and even nursing homes have begun incorporating AI-powered conversational chatbots into their workflows.

The ability to scale up rapidly allows healthcare providers to maintain quality care even under challenging circumstances. The introduction of AI-driven healthcare chatbots marks a transformative era in the rapidly evolving world of healthcare technology. This article delves into the multifaceted role of healthcare chatbots, exploring their functionality, future scope, and the numerous benefits they offer to the healthcare sector. We will examine various use cases, including patient engagement, triage, data analysis, and telehealth support. Additionally, the article will highlight leading healthcare chatbots in the market and provide insights into building a healthcare chatbot using Yellow.ai’s platform.

• The groundwork for a focused and efficient conversational AI in healthcare is laid by this action.
• Machine learning (ML) is a subset of AI that improves its performance based on the data provided to a generic algorithm from experience rather than defining rules in traditional approaches [1].
• Navigating yourself through this environment will require legal counsel to guide you as you build this portion of your bot to address these different chatbot use cases in healthcare.
• Although the nature of these studies is very heterogeneous, the

  positive results from each provide evidence that conversational agents show promise in the

  psychiatry field.

• By doing so, chatbots in healthcare extend a helping hand to those in need of mental health services.

Healthcare providers can overcome this challenge by working with experienced UX designers and testing chatbots with diverse patients to ensure that they meet their needs and expectations. Chatbots can handle a large volume of patient inquiries, reducing the workload of healthcare professionals and allowing them to focus on more complex tasks. This increased efficiency can result in better patient outcomes and a higher quality of care.

When customers interact with businesses or navigate through websites, they want quick responses to queries and an agent to interact with in real time. Inarguably, this is one of the critical factors that influence customer satisfaction and a company’s brand image (including healthcare organizations, naturally). With standalone chatbots, businesses have been able to drive their customer support experiences, but it has been marred with flaws, quite expectedly.

Given the sense of fear and watchfulness the virus has evoked among people, it is vital for the healthcare industry to stay ahead of the game. This relieving of pressure on contact centres is especially important in the present COVID-19 situation (Dennis et al. 2020, p. 1727), thus making chatbots cost-effective. However, one of the key elements for bots to be trustworthy—that is, the ability to function effectively with a patient—‘is that people believe that they have expertise’ (Nordheim et al. 2019).

As a result, hospitals can maximize their resources by effectively managing patient flow while reducing waiting times. To illustrate further how beneficial chatbots can be in streamlining appointment scheduling in health systems, let’s consider a case study. In a busy medical practice, Dr. Smith’s team was overwhelmed with numerous phone calls and manual paperwork related to appointments in their health system. Chatbots in healthcare are becoming indispensable in helping patients locate the right healthcare services and facilities. These AI-powered tools quickly provide information on nearby clinics, hospitals, and specialized medical centers.

AI Chatbots also play a crucial role in the healthcare industry by offering mental health support. They provide resources and guide users through coping strategies, creating a safe space for individuals to discuss their emotional well-being anonymously. By doing so, chatbots in healthcare extend a helping hand to those in need of mental health services.

Survey questions were designed in consultation with medical scientists, Web developers, data scientists, and technology specialists with expertise in digital medicine. Due to the rapid digital leap caused by the Coronavirus pandemic in health care, there are currently no established ethical principles to evaluate healthcare chatbots. Shum et al. (2018, p. 16) defined CPS (conversation-turns per session) as ‘the average number of conversation-turns between the chatbot and the user in a conversational session’. However, these kinds of quantitative methods omitted the complex social, ethical and political issues that chatbots bring with them to health care. In the healthcare field, in addition to the above-mentioned Woebot, there are numerous chatbots, such as Your.MD, HealthTap, Cancer Chatbot, VitaminBot, Babylon Health, Safedrugbot and Ada Health (Palanica et al. 2019).

• That’s why hybrid chatbots – combining artificial intelligence and human intellect – can achieve better results than standalone AI powered solutions.
• “The truth is that some of the hardest conversations are easier to have with a bot,” Brad Gescheider, chief commercial officer of Woebot, said.
• Chatbots are unable to efficiently cope with these errors because of the lack of common sense and the inability to properly model real-world knowledge [105].
• The development of more reliable algorithms for healthcare chatbots requires programming experts who require payment.
• There was moderate risk of bias due to confounding in all quasiexperimental studies (Figure 3).
• The results of these studies show that there is potential for effective, enjoyable mental

  health care using chatbots.

Chatbots were effective in decreasing the severity of acrophobia according to one RCT. The effect size of chatbots on acrophobia in this RCT [38] was substantially higher than the total effect size of therapist-assisted exposure treatment on phobias reported by a meta-analysis (2.0 versus 1.1) [46]. This indicates that chatbots may be equivalent to, if not better, exposure treatment delivered by a therapist in treating phobias. The influence of using chatbots on psychological distress was examined by 2 studies, conducted in Japan and Australia [35,36].

This will not only benefit patients by providing immediate and personalized care but also support healthcare professionals in managing workload and improving patient outcomes. The integration of chatbots in healthcare is transforming the dynamics of patient care and medical service delivery. These advanced digital tools are proving to be vital in enhancing the efficiency and accessibility of healthcare systems globally.

Now that we have seen how beneficial chatbots are to the healthcare industry, let us quickly take a look at a few of the use cases of chatbots . This method of collecting feedback works more efficiently, given that chatbots make communication faster and quite straightforward. Collecting feedback is a great way to boost relationships with customers as it shows that you value your patients’ opinions. With an automated pinch and instant response, making it possible just becomes easier.

They are AI-powered virtual assistants designed to automate routine administrative tasks, streamline workflows, and improve operational efficiency across healthcare facilities. They use AI algorithms to analyze symptoms reported by patients and suggest possible causes or conditions. Chatbots are significantly impacting the healthcare industry by automating prescription refills, a growing necessity in modern healthcare management. This functionality aligns with the latest healthcare app trends, emphasizing efficiency and patient convenience. Integration with a hospital’s internal systems is required to run administrative tasks like appointment scheduling or prescription refill request processing.

Chatbots drive cost savings in healthcare delivery, with experts estimating that cost savings by healthcare chatbots will reach $3.6 billion globally by 2022. Chatbots are software programs that use artificial intelligence and natural language processing to have personalized conversations with human users, either by text or voice. In healthcare, chatbots are being applied to automate conversations with patients for numerous uses – we‘ll cover the major ones shortly. Healthy diets and weight control are key to successful disease management, as obesity is a significant risk factor for chronic conditions. Chatbots have been incorporated into health coaching systems to address health behavior modifications.

Most would assume that survivors of cancer would be more inclined to practice health protection behaviors with extra guidance from health professionals; however, the results have been surprising. Smoking accounts for at least 30% of all cancer deaths; however, up to 50% of survivors continue to smoke [88]. The cognitive behavioral therapy–based chatbot SMAG, supporting users over the Facebook social network, resulted in a 10% higher cessation rate compared with control groups [50]. Motivational interview–based chatbots have been proposed with promising results, where a significant number of patients showed an increase in their confidence and readiness to quit smoking after 1 week [92]. No studies have been found to assess the effectiveness of chatbots for smoking cessation in terms of ethnic, racial, geographic, or socioeconomic status differences. Creating chatbots with prespecified answers is simple; however, the problem becomes more complex when answers are open.

Still, from the 10 studies we

identified, it is possible to comment on potential benefits as well as harms, new frontiers,

ethical implications, and current limitations for chatbots in mental health. This human-computer interaction benefits of chatbots in healthcare technology was established academically half a century ago. In 1964, the programmable natural language processing program ELIZA was developed at the MIT

Artificial Intelligence laboratory by Joseph Weizenbaum.

Chatbot is Available 24/7

Many experts have emphasised that chatbots are not sufficiently mature to be able to technically diagnose patient conditions or replace the judgements of health professionals. In this paper, we take a proactive approach and consider how the emergence of task-oriented chatbots as partially automated consulting systems can influence clinical practices and expert–client relationships. We suggest the need for new approaches in professional ethics as the large-scale deployment of artificial intelligence may revolutionise professional decision-making and client–expert interaction in healthcare organisations.

This highlights a pressing need to examine the effectiveness and safety of chatbots targeting patients with autism, post-traumatic stress disorder, substance use disorders, schizophrenia, and dementia. This review showed that there is a lack of evidence assessing the effectiveness and safety of chatbots. Further, they should undertake more studies in developing countries and recruit large, clinical samples given the lack of such evidence, as found in the current review. Unfortunately, we cannot draw a definitive conclusion regarding the effect of chatbots due to the high risk of bias in the evidence. Chatbots can be used to dispense information quickly to a wide audience, which will prove instrumental in beating rapidly spreading diseases such as COVID 19.

If the limitations of chatbots are better understood and mitigated, the fears of adopting this technology in health care may slowly subside. The Discussion section ends by exploring the challenges and questions for health care professionals, patients, and policy makers. Early cancer detection can lead to higher survival rates and improved quality of life.

We can think of them as intermediaries between physicians for facilitating the history taking of sensitive and intimate information before consultations. They could also be thought of as decision aids that deliver regular feedback on disease progression and treatment reactions to help clinicians better understand individual conditions. Preventative measures of cancer have become a priority worldwide, as early detection and treatment alone have not been effective in eliminating this disease [22].

Physical, psychological, and behavioral improvements of underserved or vulnerable populations may even be possible through chatbots, as they are so readily accessible through common messaging platforms. Health promotion use, such as lifestyle coaching, healthy eating, and smoking cessation, has been one of the most common chatbots according to our search. In addition, chatbots could help save a significant amount of health care costs and resources. Newer therapeutic innovations have come with a heavy price tag, and out-of-pocket expenses have placed a significant strain on patients’ financial well-being [23]. With chatbots implemented in cancer care, consultations for minor health concerns may be avoided, which allows clinicians to spend more time with patients who need their attention the most.

Collecting patient data

With these third-party tools, you have little control over the software design and how your data files are processed; thus, you have little control over the confidential and potentially sensitive patient information your model receives. Just as effective human-to-human conversations largely depend on context, a productive conversation with a chatbot also heavily depends on the user’s context. Babylon Health offers AI-driven consultations with a virtual doctor, a patient chatbot, and a real doctor. Chatbot developers should employ a variety of chatbots to engage and provide value to their audience. The key is to know your audience and what best suits them and which chatbots work for what setting.

When another chatbot was developed based on the structured association technique counseling method, the user’s motivation was enhanced, and stress was reduced [83]. Similarly, a graph-based chatbot has been proposed to identify the mood of users through sentimental analysis and provide human-like responses to comfort patients [84]. Vivobot (HopeLab, Inc) provides cognitive and behavioral interventions to deliver positive psychology skills and promote well-being. This psychiatric counseling chatbot was effective in engaging users and reducing anxiety in young adults after cancer treatment [40]. The limitation to the abovementioned studies was that most participants were young adults, most likely because of the platform on which the chatbots were available. In addition, longer follow-up periods with larger and more diverse sample sizes are needed for future studies.

However, healthcare data is often stored in disparate systems that are not integrated. Healthcare providers can overcome this challenge by investing in data integration technologies that allow chatbots to access patient data in real-time. While chatbots can provide personalized support to patients, they cannot replace the human touch. Healthcare providers must ensure that chatbots are used in conjunction with, and not as a replacement for human healthcare professionals. In terms of specific health-related outcomes of chatbot use for patients, an average of 45% (45/100) of physicians believed in some type of physical, psychological, or behavioral health benefit to patients (Table 3).

Chatbots are artificial intelligence (AI) programs that can generate and retrieve information for the interaction with human users via text or computer voice generation. When chatbots are developed by private healthcare companies, they usually follow the market logic, such as profit maximisation, or at the very least, this dimension is dominant. Through the rapid deployment of chatbots, the tech industry may gain a new kind of dominance in health care. AI technologies, especially ML, have increasingly been occupying other industries; thus, these technologies are arguably naturally adapted to the healthcare sector. In most cases, it seems that chatbots have had a positive effect in precisely the same tasks performed in other industries (e.g. customer service). The app helps people with addictions  by sending daily challenges designed around a particular stage of recovery and teaching them how to get rid of drugs and alcohol.

However, these bots can at least help patients understand what kind of treatment to request and what might be the issue, which is already a good start. The healthcare industry is constantly embracing technological advancements, as every new innovation brings significant improvements to patient care and to work processes of medical professionals. And while some innovations may be too complex or expensive to implement, there is one that is highly affordable and efficient, and it’s a healthcare chatbot.

Data were analyzed using descriptive statistics and frequencies to examine the characteristics of participant responses to survey items on health care chatbots. Preliminary analyses revealed no major differences across factors of age, gender, or years of practice. You can foun additiona information about ai customer service and artificial intelligence and NLP. A total of 100 practicing physicians across the United States completed a Web-based, self-report survey to examine their opinions of chatbot technology in health care.

Yes, many healthcare chatbots can act as symptom checkers to facilitate self-diagnosis. Users usually prefer chatbots over symptom checker apps as they can precisely describe how they feel to a bot in the form of a simple conversation and get reliable and real-time results. Everyone wants a safe outlet to express their innermost fears and troubles and Woebot provides just that—a mental health ally. It uses natural language processing to engage its users in positive and understanding conversations from anywhere at any time. These mental health chatbots increase access to support and show promising results comparable to human-led treatment based on early studies.

However, one of the downsides is patients’ overconfidence in the ability of chatbots, which can undermine confidence in physician evaluations. The goal of healthcare chatbots is to provide patients with a real-time, reliable platform for self-diagnosis and medical advice. It also helps doctors save time and attend to more patients by answering people’s most frequently asked questions and performing repetitive tasks.