‘AI may know me better’: why Hongkongers turn to chatbots for mental health help

Joe*, a 20-year-old Hong Kong student, began seeking emotional support for dating advice, family relationships and stress management a few months ago to ease his anxieties. He asked questions during his commute to school, while studying in the evening and even when he could not sleep late at night. His go-to chatbot: OpenAI’s ChatGPT, which he accesses through the artificial intelligence (AI) aggregator app, Poe. “To a certain extent, AI may know me better than my friends,” Joe said. Joe is among a growing number of Hongkongers turning to AI to navigate emotional distress. While some mental health advocates have cautioned against an overreliance that could slow down recovery, experts suggest AI can complement traditional therapy if used mindfully. The overall average depression and anxiety scores in the city have hit the highest levels on record, according to a survey by the Chinese University of Hong Kong and the Mental Health Association of Hong Kong released in early March. While friends and family remain the primary support network, about 22 per cent of residents now turn to AI chatbots to help manage their emotions. Mental health advocates caution against excessive reliance on AI chatbots, which do not “resolve root distress” and “may delay them from seeking professional help”. A few years ago, Joe was diagnosed with post-traumatic stress disorder, which he attributed to the broader stressors of living in Hong Kong. The 20-year-old has displayed anxiety symptoms and has since regularly attended sessions with a private psychiatrist. But Joe said that while therapists and social workers had been great support, they were not always available when he needed advice. He also did not want to burden his family or friends with negativity. “AI fills that gap instantly,” he said. Joe trained ChatGPT by feeding it information such as his background, anxiety triggers, emotional distress, worries and goals. He also recalled a late-night incident last month involving a friend who said they wanted to commit suicide. He flagged this to ChatGPT, which provided a step-by-step guide on how to locate his friend and contact police. With records of his previous anxiety symptoms, the app also reminded him to take care of his own well-being. After making sure his friend was safe, Joe realised that he, too, was in a state of shock. He suffered a panic attack while gripped by feelings of loneliness. “I texted AI that during the time of deep stress, I cried in the shower, and AI told me crying was a normal form of release when I was in a safe space, that there was no need to feel guilty for that moment of vulnerability,” Joe said. The AI app then helped him analyse his tangled emotions. “AI taught me how to face and solve my problems … that it’s OK, let’s handle it together,” Joe said. Clinical psychologist Dr Leung Chung-ming noted that more clients sought preliminary screenings with AI to determine whether to seek professional help or ask AI to prepare questions before consulting her. She said that unlike traditional therapy, where establishing trust was essential for the client to feel safe enough to divulge secrets, AI as a non-human provided a safe and trusting space for people to open up. “You do not have to worry about being judged. This is comforting,” she said. But Leung said problems could arise as AI reacted based on the information the person fed it, and lacked the capacity of a human practitioner to assess a patient’s condition, such as picking up minor subtleties from body language or facial expressions. She added that if treatment were entirely AI-driven without any human oversight, there could be a risk of erroneous assessments. “The analysis [by AI] may remain too superficial, which carries a risk of misdiagnosis,” she said. While the deep connection between client and therapist was irreplaceable, integrating AI and traditional therapy could be useful for patients, she said. Peter Chan Kin-yan, founder and chief psychology specialist of TreeholeHK Limited, a Hong Kong-based psychology consultancy, echoed Leung’s belief about adopting AI for emotional support. Chan said he disagreed with the framing that AI was a secondary resort when a therapist was unavailable. He said that while traditional therapy healed through relationships, which was evidence-based and provided a strong presence, AI offered an accommodating space and easy access to the psychology knowledge database. “In nature, AI is not an inferior substitute. I think it’s quite a different category,” Chan said. Chan noted AI in general had been fine-tuned to reinforce what the user said. He cited recent studies by Anthropic and OpenAI, which suggested AI could potentially reduce users’ sense of isolation but only under controlled usage levels. Problems could arise when they relied too heavily on AI at the expense of real-life relationships, he said. In 2023, Chan and his team built MindForest, a bilingual mental health AI app that uses Google Vertex AI to power conversations for people to seek emotional support. Chan said the app’s community feature used AI to transform users’ feelings into a story and shared their entries with other users, ensuring AI would not become an echo chamber of the user. When identifying signs that might require intervention, the app would remind the user to seek professional help. Aside from chatting with a mascot, users could also take tailor-made psychometric tests, he added. Since its launch, MindForest has attracted more than 20,000 users, with Hong Kong as the top market followed by Taiwan. Chan said that as long as AI was used in moderation and with awareness, it could be conducive to mental health. “It’s a tool but should not replace what life has to offer,” he said. *Name changed at interviewee’s request

‘AI may know me better’: why Hongkongers turn to chatbots for mental health help

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Survey reveals growing trend of residents seeking help from AI to deal with emotional stress