Conversational AI is now deeply embedded in adolescents' mental health help-seeking and emotional lives, creating both risks and a rare population health opportunity. This debate piece argues that the key question for researchers and implementers to consider is no longer whether adolescents should use general-purpose chatbots for mental health support, but rather how scientists, regulators, and technology companies should shape these systems to reduce harm and promote constructive action. At present, built-in chatbot responses to user expressions of distress often emphasize detection, refusal, or crisis referral, strategies that may protect developers but can fail to meet adolescents' immediate needs. At the same time, open-ended, pseudo-therapeutic interactions with untested agents can reinforce risk, dependency, and inaccurate or harmful beliefs about mental health and help-seeking. We propose that general-purpose conversational AI platforms are well-positioned to function as bridges to evidence-based support, rather than as replacements for formal therapy or treatment. Brief, bounded interventions, including digital single-session interventions, offer a promising model for responding to moments of need while preserving adolescent agency. Ethical AI design should prioritize safeguards, empirical testing, and pathways to evidence-based care.
Schleider et al. (Thu,) studied this question.