# AI Chatots for Mental Health: A Scoping Review of Effectiveness, Feasibility, and Applications
## 3 Results
### Usability and Engagement  
One notable study by [PERSON] et al. (2017) conducted a randomized controlled trial to compare the usability of an anthropomorphic digital human with a text-based chatbot for responding to mental health queries among healthy participants. Specifically, the authors conducted a study on the development and evaluation of a mental health chatbot named BETSY (Behavior, Emotion, Therapy System, and You) using a participatory design approach. This approach involved a multidisciplinary team and extensive public engagement through surveys and workshops. Two versions of BETSY were developed: a digital human interface enabling voice interaction and a text-only interface. The chatbot was offered as a standalone intervention in this study, which specifically evaluated the effectiveness of the chatbot in providing mental health support and did not combine it with any other therapeutic approaches. The study recruited 45 participants, excluding those with high anxiety scores, and divided them randomly into groups interacting with either the digital human or text-only BETSY. The pre-chat procedures included biometric measurements and questionnaires, while during the chat sessions, EEG data were recorded. Post-chat, participants completed additional questionnaires to assess usability and emotional responses. The results indicated higher usability scores for the text-only chatbot compared to the digital human interface. The emotional responses varied, with the digital human group reporting higher nervousness. EEG data revealed higher alpha wave activity in the text-only group, correlating with higher usability scores. Table 2 provides an overview of the various application areas of the AI chatbots analyzed in this review, summarizing the corresponding studies and their strengths and flaws. The application areas covered include mental health support during COVID-19, interven  
tions for specific health conditions, addressing substance use and addiction, preventive care and well-being, panic disorder management, health promotion, and usability and engagement. For each area, relevant studies are cited, followed by a description of the main strengths and the noted flaws. Table 3 describes a comprehensive technical overview of the various AI chatbots analyzed in this review, with detailed information on the technologies used, protocols followed, and levels of usability and engagement. \begin{table}
\begin{tabular}{c c c c} \hline \hline
**Application Area** & **Studies** & **Strengths** & **Plaws** \\ \hline Mental Health Support & [PERSON] et al. [58]; & Accessible, scalable interventions & Challenges with engagement, technical glitches \\ During COVID-19 & [PERSON] et al. [59] & during the pandemic & Limited impact on clinical \\ \hline Interventions for Specific & [PERSON] et al. [60]; & Personalized support, remote & Limited impact on clinical \\ Health Conditions & [PERSON] et al. [61]; & monitoring potential & outcomes, usability issues \\ \hline Addressing Substance Use & [PERSON] et al. [63]; & Accessible, scalable interventions, & Small effect sizes, need for more \\ and Addiction & [PERSON] et al. [65]; & positive outcomes & intensive therapist involvement \\  & [PERSON] et al. [66] & & \\ \hline Preventive Care and & [PERSON] et al. [67]; & Promising for prevention, & Engagement challenges, need for \\ Well-being & [PERSON] et al. [68]; & well-being promotion & larger trials \\ \hline Panic Disorder & [PERSON] et al. [70] & Potential for promoting healthy & Usability issues, need for \\ Management & & behaviors, privacy protection & cultural tailoring \\ \hline Health Promotion & [PERSON] et al. [71]; & Accessible intervention, & Technical challenges, lower \\  & & improvements in panic symptoms & usability ratings \\ \hline Usability and Engagement & [PERSON] et al. [72] & Evaluation of different & Limited to healthy participants, \\  & & interface designs & varied emotional responses \\ \hline \hline \end{tabular}
\end{table}