Chatbots Making Mental Health Care Accessible During Pandemic

By Rachana Chotia / In Healthcare / September 3, 2020 / 13 Min read

We are living a year in which we’ve spent the first half locked in the house with no social interaction. There is a rise in the number of people who’ve been impacted psychologically. Clearly, during these unprecedented times, there’s a high demand for mental health care. In this article, we look at how chatbots are making mental health care accessible.

Mental health in the time of Covid-19

The ramifications of mental health are seldom spoken about. People are not living a normal life. On top of the stress of the pandemic and fear of contracting the virus, people are trying to cope with new living standards and a sinking economy. In the US alone, four in ten people have said that the pandemic has had an impact on their mental health. By and large, mental health has been triggered to some extent in everyone, across the world.

Times are uncertain and people are worried about their safety. Jobs are not secure anymore. Students are worried about their class schedules and exams. Stress has gotten to the kids as well because they cannot go outside to play. In addition to all this, we are also seeing a stigma towards doctors and people who’ve tested positive for Covid-19.

Anxiety has shot up. Not only are people going through panic attacks and feelings of loneliness but also frequent mood swings, nervous breakdowns, and sleep disturbances. Consequently, people across the world are falling in depression and living in fear of what’s next. Everything is disrupted. And it should be noted, in all this, mental health care is not accessible.

There is a burden on mental health care in general. Currently, more than 33% of countries allocate less than 1% of their total health budgets to mental health. Many countries have just 1 mental health professional for a population of 10,000. In India, the situation is even worse with an average ratio of 0.03/100,000 people. For this reason, India sees 13.7% mental health morbidity. The struggle is real and there is a dire need to change this. 

Emotional AI

One way to address the challenge of mental health care accessibility is through the use of technology. There has been a lot of development in the AI space. With advances in Natural Language Processing (NLP), AI is now more human-like and conversational. And hey, the idea of talking to a computer isn’t new. 

Back in the ‘60s, Joseph Weizenbaum of MIT created an NLP computer program called ELIZA. It simulated conversations using a pattern matching algorithm and substitution technology. It was so successful that ELIZA became the first chatterbox/program to pass the Turing test!

Source: Wikipedia

Medical chatbots are the way forward to make mental health care accessible. Pandemic is fueling demand for mental health care workers. Undoubtedly, there is an urgent need for a solution that can handle the numbers, is accessible and is also low in pricing. With easy access to smartphones, internet-based solutions would be a boon for mental health care. Chatbots can be all this and more. They are the key to helping people deal with their mental health issues and wellbeing. As a result, interest in conversational chatbots has increased tremendously. 

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Chatbots are making mental health care accessible

There is a rise in the use of chatbots in mental health care. Let’s be clear that they are not substitutes for health care providers. Instead, they support practitioners. Mental health care professionals can analyze data points, track cues and fill information gaps to prescribe the correct treatment. It’s an effective way for psychoeducation and psychotherapy.

A study at the University of Sheffield shows how chatbots are an under-used resource. With physical distancing in place and health care centers working with limited staff, chatbots are proving to be effective in helping people deal with their issues.

The same study also shows that people above 65 find the chatbots more useful and are willing to use them again. If Baby Boomers are comfortable with chatbots, imagine the reach it can have.

There are many hurdles mental health care has to overcome before it becomes accessible. Overall, we can broadly classify them into three categories: stigma, distance and costs. Let’s look at them one by one. 

Stigma and mental health care accessibility

One of the biggest challenges that chatbots overcome is the problem of stigma. Across the world, people consider going to shrink something bad. That’s why a whopping 70% of people prefer monitoring symptoms through mobile apps. But with the help of medical chatbots, people can stay anonymous. They don’t have to meet psychiatrists in the open. 

Another study shows that people were talking more freely to a virtual assistant than real therapists. Experts believe this is because people can speak their minds without being judged. They find chatbots to be a safe space to express their feelings. A great place to start interacting with a mental health care professional. 

Geography and mental health care accessibility

Another advantage of a digital therapist is that it’s not limited by geography. With people being confined to their house and neighborhood, a care provider just a click away is necessary. Chatbots are accessible on your phone. You don’t have to worry about the time of the day you need help or the distance you need to cover to reach a professional. No matter which part of the world you are in, a chatbot can support you at your convenience. 

Costs and mental health care accessibility

Mental health care is expensive and that’s an understatement. The average cost of therapy is $30 to $120 per session. Most people cannot afford this on a long term basis and many don’t have the resources to go for even one session. Conversational chatbots are making mental health care accessible financially. Chatbot apps usually have a free and a premium version available. To get the basic therapy, all you need is a smartphone and internet connectivity.

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Are there any chatbots that are seeing success? Yes, over the years, we have a few candidates that have shown positive results in mental health care. Let’s look at some of the better known virtual therapists that are making a mark.

Ellie – the AI therapist that identifies signs of depression

Developed by the University of Southern California, Ellie is designed to observe micro-expressions. It is a program that asks you a series of questions in a non-judgmental way. Meanwhile, Ellie uses a webcam and keyboard to read cues from your facial expressions, voice tone and body movements. Based on this data, she identifies signs of depression and post-traumatic stress disorder.

Ellie, however, is not a replacement for a real therapist. She is a support tool designed to gather information, based on which clinicians make medical decisions. The US military uses Ellie to help soldiers open up after coming back from a war.

Wysa – a chatbot that provides emotional support

This smart chatbot lets people track their moods, figure out their feelings, reframe thoughts and find optimism. All this through friendly conversational chats. Based on the conversation, the chatbot suggests techniques like meditation and mindfulness audios.

Wysa chatbot gathers data on the user through the chats. With this information, it suggests cognitive behaviour techniques (CBT) and dialectical behaviour therapy (DBT) to help the user feel better and build resilience. During the initial stages of the pandemic, Wysa reported a 77% spike in its usage.

Woebot – a chatbot therapist to help with depression and anxiety

A Google Play Award winner, Woebot is a brainchild of a clinical psychologist at Stanford University. The app allows users to chat with AI and think through situations using CBT tools.

The user interacts with the chatbot to learn about themselves and track moods. Subsequently, Woebot analyzes the user’s response to understand their mood and suggest techniques.

Replika – the open-source chatbot that provides companionship

Replika has seen a 35% increase in traffic since the start of the pandemic. Many people are stuck alone at home during this lockdown. As a result, they are turning to AI for companionship.

At its core, the Replika chatbot is a messaging program. In this case, people can design their avatars to be friends, mentors or even romantic partners. The chatbot asks many questions and based on the answers, it builds a digital library of information. This data goes through a neural network that creates conversations similar to the ones used by the User. With every chat, the chatbot refines the responses.

Tess – a chatbot that thinks like a therapist

Built by X2AI, Tess is a psychological AI chatbot that delivers emotional wellness coping strategies. Most importantly, it makes mental health care accessible through Facebook Messenger, SMS texting, web browsers and smartphone apps, channels people spend time on. With Tess, users can talk to a chatbot to build mental health resilience.

Trained by the real experts themselves, Tess uses AI to improve its responses in real-time. Again, Tess is not a replacement for a real person. On coming across some trigger words, she connects you to a human therapist.

A win for mental health care

In conclusion, we can see that digital intervention in mental health care will let more people reach out. It lets them overcome the stigma and transcend geographic and financial limitations. In these socially-distanced times, chatbots can provide companionship, support and therapy. It also helps lessen the burden on healthcare providers.

With the ease of mental health care accessibility, we will see some other advantages too.  Topping this list is the improvement in diagnosis. Most mental health care chatbots allow mood and behaviour tracking. With this data, health care professionals will have the information to make the right diagnosis. And a sooner one too. Above all, this data will also help in the long run with research and understanding diseases. 

Not only are chatbots making mental health care accessible, but they are also powering research and psychoeducation.

Rachana Chotia

Content and Marketing, Verloop.io

Here to write about all things Customer Support Automation. If I’m not writing, I’m either reading or planning a trip.