Digital Conversational Agents for the Mental Health of Treatment-Seeking Youth: Scoping Review

Digital conversational agents (or "chatbots") that can generate human-like conversations have recently been adapted as a means of administering mental health interventions. However, their development for youth seeking mental health services requires further investigation.

This youth-engaged scoping review synthesizes the recent research on digital conversational agents for youth seeking mental health or substance use services.

Studies were included if they were published between 2016 and 2025 and examined digital conversational agents for youth aged 11 to 24 years with mental health or substance use challenges in clinical settings. Systematic literature searches were conducted in February 2024 in multiple databases and updated in March 2025. Data were extracted using codeveloped forms and synthesized narratively.

Ten studies were included, all focusing on mental health. Seven examined the acceptability and feasibility of digital conversational agents; others explored youth perceptions of use, design, and content, with some exploration of impact on mental health symptoms. Eight of ten studies reported high acceptability or positive user experiences. Three were randomized controlled trials that found potential reductions in depressive symptoms. Reporting on the ethical standards was limited. No studies focused on substance use alone.

Literature on digital conversational agents for treatment-seeking youth is emerging but limited. Future rigorous research is needed that prioritizes data security, safety measures, and youth co-design in the development of safe, engaging, digital conversational agents for youth with mental health conditions.