AI Chatbot Use and Disclosure for Mental Health Among US Adolescents and Young Adults

Abstract

Importance The rapid expansion of artificial intelligence (AI) chatbots has coincided with a persistent youth mental health crisis in the US, raising a question about the extent to which young people are turning to this technology for mental health advice. Objective To assess the prevalence, frequency, perceived helpfulness, and disclosure of AI chatbot use for mental health advice among US adolescents and young adults in 2025. Design, Setting, and Participants This cross-sectional, nationally representative survey was conducted with adolescents and young adults aged 12 to 21 years in November 2025. Exposures Exposures included self-reported age, sex, race and ethnicity, census region, metropolitan status, and prior discussion with a clinician about mental health in the past 6 months. Main Outcomes and Measures Self-reported use of AI chatbots for mental health advice, including any prior use, frequency of use, perceived helpfulness of responses, and disclosure of use to others. Respondents were also asked whether they had spoken with a physician about their mental health in the prior 6 months. Using multivariable logistic regression analysis, variation in responses was assessed according to respondents’ demographic and geographic characteristics. Results Among a US population-weighted 42 825 655 youth (unweighted, 1009 youth; median [IQR] age, 17 [15-18] years; population-weighted 21 410 663 male [50.0%]), 19.2% of adolescents and young adults (population-weighted n = 8 207 180) in 2025 reported having used AI chatbots for mental health advice. Among those who sought advice from AI chatbots, 42.8% did so at least monthly, and 91.7% rated the advice as somewhat or very helpful. Most adolescents reported they had not disclosed AI chatbot use for mental health advice to anyone (63.3%). Use of an AI chatbot for mental health advice was more common among females compared with males (adjusted odds ratio [aOR], 2.10; 95% CI, 1.36-3.23), respondents aged 18 to 21 years compared with respondents aged 12 to 14 years (aOR, 3.65; 95% CI, 1.98-6.74), and those who had spoken with a physician about their mental health in the prior 6 months compared with those who had not (aOR, 1.89; 95% CI, 1.18-3.03). Conclusions and Relevance In this nationally representative survey study of US adolescents and young adults, a fifth reported using AI chatbots for mental health advice. AI chatbots are already embedded in many youths’ mental health information ecosystem, underscoring the need for parents and clinicians to proactively discuss chatbot use to promote safety, appropriate expectations, and linkages to evidence-based care.