Recommendations for the development of digital conversational agents for youth with mental health conditions: A position paper

Digital conversational agents ("chatbots") hold interesting potential as a technology that can be used to deliver mental health interventions and supports to people in need. Youth are high users of digital technology and are widely affected by mental health conditions; youth might therefore be particularly interested in using digital conversational agents to support their mental health. We reviewed the literature on digital conversational agents for mental health, then conducted a two-pronged qualitative study of these tools for youth with mental health conditions. While the evidence base is limited, there is some preliminary evidence of utility and acceptability to users of this technology. In our qualitative study, youth were cautiously optimistic about using a digital conversational agent for mental health and identified potential benefits, but also substantial concerns. In terms of content and format, they wanted reliable, accurate, validated information, a flexible format, and a friendly interaction style, with attention to confidentiality and security. From these findings, we propose eight distinct recommendations to guide the rigorous development of digital conversational agents for youth mental health. By following these recommendations, it may be possible to build tools that leverage the strengths and potential of modern conversational agents while mitigating the potential harms to youth.