# AI Chatots for Mental Health: A Scoping Review of Effectiveness, Feasibility, and Applications
## 4 Discussion
[71] reported satisfactory engagement and completion rates, with the latter study indicating comparable engagement to human-delivered CBT. The reviewed studies also emphasize tailoring chatbot interventions to specific populations and contexts. The success of mental health chatbots during the COVID-19 pandemic underscores the need for adaptive solutions in crises. Similarly, cultural sensitivity and localization are critical for chatbots addressing substance use disorders and HIV prevention in vulnerable groups. Personalization and context-specific adaptation are key to their effectiveness and acceptability. These sensitivities are also critical in human-delivered interventions, where cultural biases and misunderstandings can hinder progress. Conversational agents offer advantages in accessibility, confidentiality, and tailored information [73]. They provide consistent care, infinite patience, and can bridge literacy gaps with anthropomorphic features. Chatbots can also address healthcare provider diversity disparities by matching racial features with patients, fostering trust. Additionally, as outlined by [PERSON] et al. [74], chatbots are perceived as less judgmental, creating a safe space for users with sensitive information, which is vital for managing conditions like PTSD. These advantages make chatbots a compelling complement to human health care, especially in behavior change and diverse population support. While AI chatbots offer scalable solutions for mental health support, their integration with existing healthcare systems remains a challenge. The results indicate that AI chatbots can effectively function as standalone interventions and adjuncts to therapy for improving mental health (see Table 3). For instance, [PERSON] et al. [58] demonstrated that XiaoE, used independently, reduced depressive symptoms in college students. Conversely, [PERSON] et al. [60] found that an AI chatbot paired with iCBT improved program adherence. Similarly, [PERSON] et al. [61] utilized chatbots within a broader telemedicine approach for [PERSON]'s patients, enhancing patient engagement. The effectiveness of standalone AI chatbots is further supported by studies from [PERSON] et al. [63], [PERSON] et al. [67], [PERSON] et al. [70], and [PERSON] et al. [71]. However, [PERSON] et al. [59] and [PERSON] et al. [68] showcased the benefits of AI chatbots as components of multi-faceted interventions for mental health and HIV prevention, respectively. These findings suggest that AI chatbots are versatile tools in mental health interventions, and ongoing research will help optimize their use and determine their long-term efficacy relative to human therapists. Nonetheless, studies exploring the usability and acceptability of chatbots among healthcare professionals and policymakers are needed to facilitate their adoption and integration into clinical pathways. Establishing trust and addressing ethical concerns related to data privacy, safety, and accountability will be crucial for the widespread implementation of AI chatbots in mental healthcare settings.