Can Your Phone Be Your Therapist? Young People’s Ethical Perspectives on the Use of Fully Automated Conversational Agents (Chatbots) in Mental Health Support

TLDR

Digital mental health interventions have rapidly expanded, including automated conversational agents that emulate real‑life interactions. The study explores young people’s social and ethical concerns about using chatbots for mental health support, examining their strengths and limitations. The authors propose minimum ethical standards—privacy, efficacy, safety—and evaluate three chatbot platforms (Woebot, Joy, Wysa) against this framework. The article aims to spark ethical debate and encourage responsible practice in digital mental health.

Abstract

Over the last decade, there has been an explosion of digital interventions that aim to either supplement or replace face-to-face mental health services. More recently, a number of automated conversational agents have also been made available, which respond to users in ways that mirror a real-life interaction. What are the social and ethical concerns that arise from these advances? In this article, we discuss, from a young person’s perspective, the strengths and limitations of using chatbots in mental health support. We also outline what we consider to be minimum ethical standards for these platforms, including issues surrounding privacy and confidentiality, efficacy, and safety, and review three existing platforms (Woebot, Joy, and Wysa) according to our proposed framework. It is our hope that this article will stimulate ethical debate among app developers, practitioners, young people, and other stakeholders, and inspire ethically responsible practice in digital mental health.