Licensed pros whose job description includes nodding while listening to clients unburden themselves about their feelings now face competition from AI chatbots.

AI can see you now: “Therapy/companionship” is the top use case for generative AI, “rated according to perceived usefulness and scale of impact,” a recent analysis of Reddit posts by the Harvard Business Review found. Users of AI therapy report turning to bots for counseling because of their 24/7 accessibility, low cost, and inability to stare judgmentally.

While some folks are processing psychological challenges with the help of general-purpose bots like ChatGPT, dedicated moral-support tech has entered the scene:

• The startup Character.ai allows users to create LLM-powered companions. One of its most popular characters is a chatbot called Psychologist, which bills itself as “someone who helps with life difficulties.” However, the app has been a source of major controversy (more on that later).
• Dartmouth University researchers created an AI therapist called Therabot and recently published a study showing that it was comparable to regular outpatient therapy in leading to improvements among patients with depression, anxiety, and eating disorders.

Other research has found that many people seeking counseling prefer AI therapists and that they can be more compassionate than human pros.

Therapy couch operators are apprehensive

While the bots are a hit with patients, some licensed therapists have sounded the alarm on the dangers of AI tools posing as qualified professionals:

• They claim the chatbots lack a human practitioner’s training to probe patients in conversation and cannot perceive nonverbal cues.
• The American Psychological Association has urged the Federal Trade Commission to impose safeguards to protect patients.

Others have voiced concerns about AI giving outright dangerous advice, pointing to the tragic case of a teenager who died by suicide last year after a Character.ai companionship bot that he turned to for psychological support suggested it.

Humans and AI shrinks can work together: Pro therapists say that therapizing chatbots can fill gaps in care by human providers, especially since there’s a shortage of qualified therapists. Some experts recommend using AI bots for mental health support in coordination with a human mental health professional.—SK

For more on the latest in mental health innovation, check out Healthcare Brew.

When a meeting gets scheduled for 4:30pm on a Friday, it may not feel like your employer has your mental health in mind.

But mental health support has increasingly become a standard part of the employee benefits package, especially as companies look to recruit the work–life balance-prioritizing members of Gen Z and discover that taking care of their employees’ mental health can benefit the bottom line.

A survey conducted by HR consulting firm Mercer found that companies have upped their mental health game since the pandemic sent everyone into a tailspin:

• The 2023 survey found that 94% of employers with 500+ employees had boosted their mental health care coverage, heightened support, or added new programs or systems to address mental health in the preceding three years.
• Of those, 28% expanded what their existing health plans offered for mental health, 72% added virtual and telehealth options, and 68% started offering new supports such as employee assistance programs, classes, or app access. Some employers also increased relevant trainings.

Some large global employers, including JPMorgan, even provide onsite therapists as a resource for their staff, according to the Financial Times.

Not all mental health perks are that direct: Flexible work schedules and PTO policies can help employees achieve the balance required to attend to their emotional needs.—AR

Anyone who has doomscrolled at 1am can tell you that your phone is not always the path to better mental well-being. But there are more than 10,000 apps available that aim to provide some kind of help.

All mental health apps aren’t created equal: Doctors recommend being selective and making sure any app you try relies on research-based evidence and has an airtight privacy policy, including a promise not to collect or sell sensitive data. Many also stress that using an app is not a substitute for seeing a medical professional—especially during a crisis—but they can be a useful add-on or an option for people without access to traditional care.

Here is a sampling of some of the most popular apps out there.

For therapy:

BetterHelp

What does it offer? BetterHelp bills itself as the world’s largest therapy service. It connects users with a licensed therapist for online video, audio, or text sessions.

What does it cost? Between $65 and $100 per week, billed monthly.

Does it accept insurance? No, but the company says it accepts FSA/HSA cards and is generally recognized as reimbursable via those programs.

Talkspace

What does it offer? Talkspace matches users with licensed therapists for online sessions and live messaging. It also connects users with psychiatrists for medication management.

What does it cost? There are different subscription models for therapy and psychiatry. Therapy plans range from $276 to $436 per month.

Does it accept insurance? The company says it is in-network for most major plans.

For mindfulness and meditation:

Headspace

What does it offer? It provides meditation, mindfulness tools, mental health coaching, therapy, and psychiatry.

What does it cost? A subscription for the app, which includes meditations, courses, and guided programs, costs $69.99 annually or $12.99/month. Therapy is billed separately.

Does it accept insurance? The company says therapy is covered by some insurers or can be reimbursed through FSA/HSA accounts by some providers.

Calm

What does it offer? Calling itself the No. 1 app for sleep, meditation, and relaxation, Calm provides guided meditations, sleep stories for deeper sleep, and music for focus, relaxation, and sleep.

What does it cost? A premium subscription costs $69.99 per year or one $399.99 “forever” payment.

Does it accept insurance? A separate Calm Health app, which features psychologist-created programs, is open only to users with certain health insurance plans, medical care teams, or employers.

For getting support from AI:

Wysa AI

What does it offer? Wysa provides a therapy chatbot that it calls an artificial intelligence-based “emotionally intelligent” service that responds to emotions 24/7 with therapy, meditation, yoga, and breathing techniques.

What does it cost? Talking to the AI is free, but Wysa charges a subscription fee for access to premium features. A premium subscription is $74.99 per year.

Does it accept insurance? Wysa does not directly accept insurance from users, but some insurance companies offer access to it as a member benefit.

For kids:

Breathe, Think, Do with Sesame

What does it offer? The app teaches kids problem-solving and self-control by having them help a monster friend calm down.

What does it cost? It’s free.—AR

You can learn a lot from a bite-sized video: how to steam carrots, mend a pair of socks—but maybe not how to diagnose yourself with a personality disorder. Mental health providers worry that although TikTok and other online communities can provide meaningful connection, they can also trivialize and simplify the symptoms of conditions like ADHD, OCD, autism, and even rare personality disorders, and push kids and teens into self-diagnosing.

Mental Health content on apps like TikTok and Instagram is wildly popular, and since the pandemic, kids and teens have consumed a lot of it. A 2023 report from Amnesty International and the Algorithmic Transparency Institute, which used automated accounts meant to represent 13-year-old users, found that within five-to-six hours on TikTok, almost 1 in 2 videos served to them was about mental health.

Experts warn that these apps tend to prioritize content that erases the nuances of symptoms. Plus, creators who make mental health content aren’t always doing it from the goodness of their hearts. Some urge people to self-diagnose and head to the link in their bio for something they sell. According to a recent study published in the academic journal PLOS One:

• Around 50% of the most popular mental health videos on TikTok were misleading, according to two licensed psychologists who reviewed them.
• Additionally, over 50% of the creators making ADHD-related videos on TikTok appeared to be selling a product or asking for donations.

But it’s all likely a symptom of a bigger issue. Younger generations may have normalized talking about mental health, but it’s still difficult to lock down an in-network therapist. Getting a formal diagnosis can be expensive and time-consuming, and sometimes—especially for Black boys and women—a misdiagnosis can still happen.—MM

Growing research shows that the pastime associated with basement dwelling and the childhood friend who taught you swear words can actually be a boon for mental health…in moderation:

• “Cozy” games, a subgenre that took off during the pandemic with Nintendo’s Animal Crossing: New Horizons, have become a popular haven because of their wholesome quests and artistic visuals, which fans (and science) say help induce flow states.
• Overall, playing one hour of video games every day can improve mental health and life satisfaction, according to a study conducted in Japan and published last year.

It’s starting to go mainstream (medicine)

Games created specifically as mental health interventions have also mildly reduced sadness and boosted focus for people with depression and ADHD, respectively, according to a recent Johns Hopkins review of gamified treatments.

With gaming undergoing a reputation reversal in some corners, businesses are getting…creative:

• A Seattle-based company got FDA clearance last year to offer a VR game it calls a “mental health action shooter” (players shoot wizard beams, not guns) as a treatment for stress and high blood pressure.
• Tapping the gamer crowd, psychiatrist Dr. Alok Kanojia launched the online coaching platform Healthy Gamer after streaming mental health conversations with gamers on Twitch (which got him reprimanded by his state’s medical licensing board last summer for crossing ethical lines).

Big picture: Amid a shortage of therapists and a youth mental health crisis—about 20% of teens are estimated to have a mental, emotional, developmental, or behavioral disorder, according to the Agency for Healthcare Research and Quality—gamified treatments “could be nice first steps for children while waiting to start individual therapy,” the author of the Johns Hopkins study said.—ML