Habicht J, Viswanathan S, Carrington B, Hauser TU, Harper R, Rollwage M. Closing the accessibility gap to mental health treatment with a personalized self-referral chatbot. Nat Med. 2024;30(2):595-602. doi:10.1038/s41591-023-02766-x
This multisite observational study examined the efficacy of a self-referral chatbot, Limbic Access. The implementation of the personalized chatbot was carried out using the UK’s NHS online talking therapies services. Patients (n = 42,332) were referred to 28 different NHS talking therapies services, 14 of which implemented the Limbic Access chatbot, while 14 remained the same. The chatbot guides patients through personalized care options and provides customized feedback and mental health assessments. The referral information is provided to the NHS service and the clinician, facilitating clinician assessment and triage. Compared to the three months preceding implementation, the chatbot increased overall referrals by 15%. The chatbot also performed better than standard referral protocols implemented across the study period. This increase in referrals was largest for gender non-binary individuals and ethnic minorities (Asian and Black). This referral increase for gender and ethnic minorities is a huge success for the UK. While the efficacy data was promising, the feedback from users based on linguistic data was mixed. Positive feedback included the convenience and speed of the referral process, the hope the conversation agent provided, the removal of anxieties occurring when talking to a human, and the self-realization of the user’s need for treatment. Users reported needing to discuss specific mental health conditions, and a desire for more information as neither positive nor negative. Negative feedback included the wait to begin therapy after the referral process, and that their self-realization, while positive, led them to feel their mental health required immediate attention, which the UK system cannot accommodate. The chatbot did not decrease treatment quality, and despite patient feedback, increased wait times to access care.