How does a mental health chatbot work? A ‘conversation design’ concept of mental health intervention

Abstract

Mental health chatbots, along with computerised treatment in general, have gradually entered the realm of acceptability. This article looks at a chatbot called ReMind. It begins with an overview of the development of computerised mental health interventions, drawing links between the invention of cognitive behavioural therapy and automated therapy. The focus then moves to analysis of ReMind's conversational system. The bot acts as a sympathetic guide which directs the user to mental health activities, and as we will see, a concept of mental health is produced through this system which is unique to the way that chatbot conversations are designed. The bot is tasked with interpreting the user's typed inputs in terms of keywords. Keywords are identified in terms of predetermined tags (‘sad’, ‘can’t sleep’, ‘relationship’, etc.). The bot then ‘predicts’ what the most appropriate response should be. ‘Prediction’ will be focused on to draw out how users interact with the bot in terms of conforming to the conversational logic imposed by the bot. This article illustrates a concept of mental health which is produced in the conversational dynamic between the users and the bot, and in how these conversations are directed on an abstract level by the ReMind company. The article concludes that the tautological cycle that the ReMind app facilitates represents a model of mental health which is correspondingly tautological in terms of users adopting an attitude of adaptation. This article addresses an urgent need to critically assess new forms of mental health interventions, and especially, technologically informed interventions.