Changes to the Psychiatric Chatbot Landscape: A Systematic Review of Conversational Agents in Serious Mental Illness: Changements du paysage psychiatrique des chatbots: une revue systématique des agents conversationnels dans la maladie mentale sérieuse

Objective: The need for digital tools in mental health is clear, with insufficient access to mental health services. Conversational agents, also known as chatbots or voice assistants, are digital tools capable of holding natural language conversations. Since our last review in 2018, many new conversational agents and research have emerged, and we aimed to reassess the conversational agent landscape in this updated systematic review. Methods: A systematic literature search was conducted in January 2020 using the PubMed, Embase, PsychINFO, and Cochrane databases. Studies included were those that involved a conversational agent assessing serious mental illness: major depressive disorder, schizophrenia spectrum disorders, bipolar disorder, or anxiety disorder. Results: Of the 247 references identified from selected databases, 7 studies met inclusion criteria. Overall, there were generally positive experiences with conversational agents in regard to diagnostic quality, therapeutic efficacy, or acceptability. There continues to be, however, a lack of standard measures that allow ease of comparison of studies in this space. There were several populations that lacked representation such as the pediatric population and those with schizophrenia or bipolar disorder. While comparing 2018 to 2020 research offers useful insight into changes and growth, the high degree of heterogeneity between all studies in this space makes direct comparison challenging. Conclusions: This review revealed few but generally positive outcomes regarding conversational agents’ diagnostic quality, therapeutic efficacy, and acceptability, which may augment mental health care. Despite this increase in research activity, there continues to be a lack of standard measures for evaluating conversational agents as well as several neglected populations. We recommend that the standardization of conversational agent studies should include patient adherence and engagement, therapeutic efficacy, and clinician perspectives.

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Smartphone Health Assessment for Relapse Prevention (SHARP): a digital solution toward global mental health

BJPsych Open ◽

10.1192/bjo.2020.142 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Elena Rodriguez-Villa ◽

Urvakhsh Meherwan Mehta ◽

John Naslund ◽

Deepak Tugnawat ◽

Snehil Gupta ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Serious Mental Illness ◽

Relapse Prevention ◽

Global Mental Health ◽

Digital Health ◽

Phase 1 ◽

Health Assessment ◽

Digital Tools ◽

Two Phase

Background Predicting and preventing relapse presents a crucial opportunity and first step to improve outcomes and reduce the care gap for persons living with schizophrenia. Using commercially available smartphones and smartwatches, technology now affords opportunities to capture real-time and longitudinal profiles of patients’ symptoms, cognition, physiology and social patterns. This novel data makes it possible to explore relationships between behaviours, physiology and symptoms, which may yield personalised relapse signals. Aims Smartphone Health Assessment for Relapse Prevention (SHARP), an international mental health research study supported by the Wellcome Trust, will inform the development of a scalable and sharable digital health solution to monitor personal risk of relapse. The resulting technology will be studied toward predicting and preventing relapse among individuals diagnosed with serious mental illness. Method SHARP is a two-phase study with research sites in Boston, Massachusetts, and Bangalore and Bhopal, India. During phase 1, focus groups will be conducted at each study site to collect feedback on the design and features available on mindLAMP, a digital health platform. Individuals with serious mental illness will use mindLAMP for the duration of a year during phase 2. Results The results of the research outlined in this protocol will guide the development of technology and digital tools to help address pervasive challenges in global mental health. Conclusions The digital tools developed as a result of this study, and participants’ experiences using them, may offer insight into opportunities to expand digital mental health resources and optimize their utilisation around the world.

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