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People experiencing severe distress increasingly use Large Language Model(LLM) chatbots as mental health support tools. Discussions on social media havedescribed how engagements were lifesaving for some, but evidence suggests thatgeneral-purpose LLM chatbots also have notable risks that could endanger thewelfare of users if not designed responsibly. In this study, we investigate thelived experiences of people who have used LLM chatbots for mental healthsupport. We build on interviews with 21 individuals from globally diversebackgrounds to analyze how users create unique support roles for theirchatbots, fill in gaps in everyday care, and navigate associated culturallimitations when seeking support from chatbots. We ground our analysis inpsychotherapy literature around effective support, and introduce the concept oftherapeutic alignment, or aligning AI with therapeutic values for mental healthcontexts. Our study offers recommendations for how designers can approach theethical and effective use of LLM chatbots and other AI mental health supporttools in mental health care.

The Typing Cure: Experiences with Large Language Model Chatbots for Mental Health Support