Susan Shelmerdine and Matthew Nour consider how chatbot use presents both risk and benefit in tackling loneliness

AI chatbot systems, such as ChatGPT, Claude, and Copilot, are used increasingly as confidants of choice. On the one hand, this may be seen as a positive democratisation of emotional support and care at the point of need. On the other, there is growing concern surrounding potential psychological and social harms, particularly pertaining to social isolation and loneliness.

In 2023, the US Surgeon General declared that the nation was experiencing a loneliness epidemic, constituting a public health concern on par with smoking and obesity. The report cited a 26% increase in premature death associated with loneliness, with the overall health impact likened to smoking 15 cigarettes a day. In the UK, nearly half of adults (25.9 million) report feeling lonely either occasionally, sometimes, always, or often; with almost 1 in 10 experiencing chronic loneliness (defined as feeling lonely “often or always”).

Although many studies focus on loneliness in older adults, younger people are also affected. The BBC Loneliness Experiment, involving almost 37 000 individuals, identified that the risk of loneliness was particularly high in younger individuals (aged 16-24 years), and those who are single, have poor health, and lack a sense of belonging. Furthermore, a UK study found that although healthcare costs associated with loneliness increased with age (when compared with non-lonely peers), individuals aged 16-24 years incurred higher health related costs than those aged 25-49 years, suggesting a U shaped relation between age and the health-economic burden of loneliness. Against this background, there is a growing gap between the demand and provision for mental health services, with a third of people in England now waiting three months or more for access to mental health care, and many not receiving any support while waiting.

Given these trends, it’s no wonder that many are looking to alternative sources for companionship and emotional support. ChatGPT, for example, has around 810 million weekly active users worldwide, and some reports place therapy and companionship as a top reason for use.1112 In one survey, 36% of parents reported that their children use AI chatbots for emotional support.

...read more at bmj.com