Seeking Late Night Life Lines: Experiences of Conversational AI Use in Mental Health Crisis

TL;DR

This study explores how people use conversational AI for mental health crises, highlighting its role as a bridge to human support and emphasizing responsible AI design to promote positive actions.

Contribution

It provides first-person accounts and expert insights on AI use in mental health crises, proposing a framework for responsible AI intervention to enhance human connection.

Findings

People use AI to fill gaps in human support due to access issues.

Human connection remains crucial in managing mental health crises.

AI can be designed to facilitate positive actions and de-escalate negative ones.

Abstract

Online, people often recount their experiences turning to conversational AI agents (e.g., ChatGPT, Claude, Copilot) for mental health support -- going so far as to replace their therapists. These anecdotes suggest that AI agents have great potential to offer accessible mental health support. However, it's unclear how to meet this potential in extreme mental health crisis use cases. In this work, we explore the first-person experience of turning to a conversational AI agent in a mental health crisis. From a testimonial survey (n = 53) of lived experiences, we find that people use AI agents to fill the in-between spaces of human support; they turn to AI due to lack of access to mental health professionals or fears of burdening others. At the same time, our interviews with mental health experts (n = 16) suggest that human-human connection is an essential positive action when managing a mental health crisis. Using the stages of change model, our results suggest that a responsible AI crisis intervention is one that increases the user's preparedness to take a positive action while de-escalating any intended negative action. We discuss the implications of designing conversational AI agents as bridges towards human-human connection rather than ends in themselves.