Mental health used to be taboo. While much work still needs to be done to reduce stigma, many strides have been made.

Advancements in both acceptance and treatment benefit a huge sector of the population. Consider this: 1 in 4 American adults lives with a diagnosable mental health disorder each year.

The demand for care has prompted innovative treatment options to emerge, like artificial intelligence (AI) chatbots. Treating mental health disorders is complex. As such, content for mental health chatbots needs to be helpful, evidence-based, and empathic.

Barriers to traditional mental health treatment 

Mental health disorders may be prevalent, but the allocation of resources to help patients has lagged behind. Effective treatment options are limited outside big cities or have long wait times.

Consider these findings from the World Health Organization:

  • On average, countries spend less than 2% of their national health budgets on mental health.
  • In low- and middle-income countries, more than 75% of people with mental health conditions receive no treatment for their condition at all.
  • The lost productivity resulting from depression and anxiety, two of the most common mental health disorders, costs the global economy US$1 trillion each year.

In the United States, only 41% of the people who had a mental disorder in the past year received professional healthcare or other services.

Even when treatment is available, it may not be easily accessible. On average, therapy costs $100-$200 per session in the U.S., and is not always fully covered by insurance plans.

The COVID-19 pandemic has spotlighted mental health, and for good reason. The effects of social distancing and the disruption of “normal life” have been traumatic for people across the globe.

In fact, the prevalence of depressive symptoms in the U.S. was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. Mental health professionals are predicting an increase in diagnoses, even after the pandemic ends.

Chatbots fill the mental health care gap

Even if all mental health treatment was affordable and accessible, there’s still the issue of stigma and privacy. Some people simply don’t feel comfortable speaking to a therapist or doctor face-to-face. Teenagers may need mental health help but aren’t inclined to open up to their parents or other adults.

Enter chatbots. Chatbot applications are like virtual therapists, helping users manage their symptoms using AI-generated dialog. While users pour (or text) out their hearts, the chatbot identifies certain language, allowing it to respond in an empathetic way. It can then suggest appropriate resources.

Chatbots fill the mental health care gap

Many of these chatbot programs are based on Cognitive Behavioral Therapy (CBT). CBT is considered the gold standard for treating depression and anxiety disorders. But other techniques like mindfulness are often included.

The appeal for many chatbot users is that they’re available 24/7—it’s like having a therapist in your pocket. Daily or hourly feedback isn’t offered by traditional therapists. Plus, many of these apps are free to use. Sounds like a win-win.

But as the popularity of chatbots grows, so do hesitations and critiques. The American Psychiatric Association offers an app evaluation model for its members. It warns that choosing a mental health app to use with patients “is not what psychiatrists and mental health clinicians are classically trained to do. It is still a fairly novel process with which many clinicians may be unfamiliar.”

Overall, the value of mental health apps is hard to deny. The FDA recently released guidance related to “digital health therapeutic devices.” It loosened approval rules to make these programs more available during the pandemic.

Content for mental health chatbots matters

Mental health chatbots aim to support a group of people that are often under-served, stigmatized, and vulnerable. In order to make a real difference, the content offered to users must be helpful, evidence-based, and empathic.

In one study that reviewed patients’ perceptions of mental health chatbots, the content was an important theme. Participants were generally satisfied with content like videos, games, topics, and suggestions. But some of the chatbot content was criticized for its superficiality, irrelevancy, and for being too long or overwhelming.

Of course, this AI technology is fairly new and will no doubt improve over time. But at its core, content for mental health chatbots should be:

1. Helpful

The whole point of a chatbot is to help people experiencing symptoms of a mental illness. What does that look like in practice? Although the “chat” itself can be supportive, the app will offer resources like videos, articles, and exercises. They should integrate seamlessly with the chatbot’s personality—easy to understand. Content for mental health chatbots should always be written with this in mind: what would be most helpful for the person reading it?

2. Evidence-based

The most effective content for mental health chatbots to offer those living with a mental illness will be evidence-based. Presenting treatment techniques digitally may require more explanation and context than in a traditional setting. Wysa does a great job explaining how CBT works—without sounding complicated or clinical. Copywriters with a medical background can help present information in this evidence-based way. Our company has medical writers that include Ph.D. Psychologists who write this type of content for mental health chatbots. Contact us for more information.

3. Empathic

Chatbots offer anonymity and privacy. People can be more honest about their feelings than they would with any human. Some users may have already experienced dismissive tones from friends, family, or professionals. Content for mental health chatbots must use non-judgmental, friendly scripts and language, like this example from WoeBot.

Do mental health chatbots work?

We profiled two of the most popular mental health chatbots available today, WoeBot and Wysa, including their efficacy data. The numbers may surprise you.

WoeBot:

WoeBot, “your friendly self-care expert,” assists users with symptoms of depression, anxiety, grief, addiction, and more. Users can chat with WoeBot any time, day or night.

But it’s not just one-sided. WoeBot checks in with users every day. It can guide them through techniques based on Cognitive Behavioral Therapy, Mindfulness, and Dialectical Therapy.

Founded in 2017, WoeBot was created by psychologist Dr. Alison Darcy with the goal of making mental health care accessible to all. She wanted to solve issues that had long plagued in-person support groups like cost, continuity, and effectiveness.

WoeBot addresses hesitations about delivering mental health care via technology: “An important mediator of therapeutic outcomes is the working alliance between patient and provider. A close rapport is a necessary component for change, a challenge still unmet in the digital world—until now. Woebot’s breakthrough is its ability to form a therapeutic bond with users that leads to better outcomes.”

Does it work? A Stanford University study found that after four weeks, participants who used WoeBot showed a 32% reduction in depression and a 38% reduction in anxiety.

They attribute their focus on conversational content as something that sets them apart:  “Focusing on our innate human need to talk through life experiences and feelings, our team of psychologists and writers developed a conversational interface that feels natural and personal, and solidifies a working alliance with users that has been shown in clinical studies to improve outcomes.”

Wysa:

Founded in 2015, Wysa is another chatbot app that helps users improve their mental health. It is focused on conversational chat and self-help exercises.

Founder and CEO, Jo Aggarwal, explains that she and her team didn’t initially set out to create this type of application.

“This was a side project—we were at that time building machine learning models to detect depression, using sensor feeds from [phones]. The detection model worked…but only 1 in 30 people actually took help from a therapist,” she explains.

“However, the chatbot, which we had only built…for the sensor code, turned out to be really popular. I began to wonder what would happen if we helped people learn the skills to build emotional resilience using a simple conversation around their own situation. As we built it, we realized—everyone could use these skills.”

A Cambridge University study on the efficacy of using Wysa proved her theory true. Among the high-user groups, 79% improved their symptoms of depression. Another 68% of users found the Wysa experience helpful and encouraging.

Wysa features over 100 AI-guided self-care exercises in the form of “tool packs to help…with issues ranging from body image to breakups.” The Wysa app uses evidence-based treatment like CBT. All content is reviewed by psychologists and safety professionals.

Its research-backed content has garnered high praise. ORCHA, the health app evaluation agency, awarded Wysa an overall rating 93%, and a 100% rating on clinical safety.

The future of mental health care

The number of people requiring mental health care will continue to outpace the number of available health professionals. Digital therapy isn’t without flaws, but its potential to bridge the care gap is exciting.

Mental health chatbots are already making a real difference to those living with mental illness. With further advancements in the world of AI, many more people will be helped.

Of course, one of the most important considerations of any self-help application is the content. If your company needs help developing content for mental health chatbots, contact The Med Writers. We have mental health professionals who can plan, write or review and edit your content.