Stakeholder perspectives on artificial intelligence in schizophrenia care

Artificial intelligence (AI) is explored as a tool to expand access to mental health care, offering support and self-disclosure. To date, the perspectives of individuals with schizophrenia on AI have been absent from the medical literature. This exploratory study represents an effort to report schizophrenia patient perspectives on AI chatbots through a focus group.

We conducted an exploratory, cross-sectional, qualitative study using semi-structured focus groups at a large academic health center in New York City. Participants included patients with schizophrenia spectrum disorders (n = 17), caregivers (n = 7), and providers (n = 4). Discussions explored familiarity with AI, privacy, and perceived utility of a hypothetical AI companion tool. Transcripts were analyzed using thematic analysis.

Five themes were identified in this exploratory analysis: (1) 'Available When No One Else Is', reflecting participants' recognition of AI as a potentially accessible source of between-visit support; (2) 'What Would It Do?' capturing uncertainty about AI's role; (3) 'How Can I Trust It?' highlighting trust as the central barrier, shaped by privacy concerns and schizophrenia-specific vulnerabilities; (4) 'A Tool, Not a Therapist', emphasizing that AI was acceptable only as a supplement to, not a replacement for, human care; and (5) 'Keep It Low-Risk', describing the narrow range of acceptable use cases, limited to supportive functions.

These exploratory findings suggest that AI is perceived as both a promising adjunct to care and a potential risk in schizophrenia. Implementation should emphasize transparency, trust, and clear boundaries, with AI designed to support, not replace, existing care.