Conversational artificial intelligence (CAI) presents many opportunities in the psychotherapeutic landscape—such as therapeutic support for people with mental health problems and without access to care. The adoption of CAI poses many risks that need in-depth ethical scrutiny. The objective of this paper is to complement current research on the ethics of AI for mental health by proposing a holistic, ethical, and epistemic analysis of CAI adoption. First, we focus on the question of whether CAI is rather a tool or an (...) agent. This question serves as a framework for the subsequent ethical analysis of CAI focusing on topics of (self-) knowledge, (self-)understanding, and relationships. Second, we propose further conceptual and ethical analysis regarding human-AI interaction and argue that CAI cannot be considered as an equal partner in a conversation as is the case with a human therapist. Instead, CAI’s role in a conversation should be restricted to specific functions. (shrink)

Advances in applications of artificial intelligence and the use of data analytics technology in biomedicine are creating optimism, as many believe these technologies will fill the need-availability gap by increasing resources for mental health care. One resource considered especially promising is smartphone psychotherapy chatbots, i.e., artificially intelligent bots that offer cognitive behavior therapy to their users with the aim of helping them improve their mental health. While a number of studies have highlighted the positive outcomes of using smartphone psychotherapy chatbots (...) to handle various anxiety related problems no conclusive data illustrate their effectiveness or warrant their use in mental illness diagnosis and treatment settings. Yet smartphone psychotherapy is highly endorsed by experts in the field of mental health research. In this paper, I focus on the specific features of smartphone psychotherapy chatbots intended for the diagnosis and treatment of mental illness and criticize three popular promises; i.e., they enable early diagnosis and intervention through digital phenotyping; they defy the stigma of mental illness diagnosis and treatment; they offer increased access to mental health treatment globally. Going against the popular enthusiasm, I argue smartphone psychotherapy chatbots have epistemic and ethical limitations in the diagnosis and treatment of illnesses. In light of these, I encourage researchers, clinicians, policy makers, patients, and caregivers to pause before jumping on the artificial intelligence bandwagon to seek solutions for mental illness on the grounds of these three promises. (shrink)