An “alarming level” of patients turn to artificial intelligence (AI) chatbots for mental health advice – a trend physicians can keep an eye on through meaningful conversations in the exam room.
That’s according to Austin psychiatrist Thomas Kim, MD, a consultant to the Texas Medical Association’s Committee on Behavioral Health and Committee on Health Information Technology and Augmented intelligence.
About one in eight U.S. teens and young adults use AI chatbots for mental health advice, with use most common among those ages 18 to 21, according to a November 2025 study in JAMA Network Open.
Dr. Kim says this new reality reflects systemic factors – like affordability, distance, or long waitlists for appointments – that limit patients’ access to human clinicians and therapists.
This aligns with the JAMA Network Open study, whose authors opined that high use rates “likely reflect the low cost, immediacy, and perceived privacy of AI-based advice, particularly for youths unlikely to receive traditional counseling.”
AI chatbots often lack evidence-based interventions, ethical oversight, and human judgment, Dr. Kim says – nuances he worries can put patients at risk of harm.
Last year, researchers from Stanford University’s Institute for Human-Centered AI found some AI therapy bots showed heightened stigma toward certain behavioral health conditions, provided unsafe guidance, and failed to recognize suicide risks among users.
“My biggest concern is that patients replacing conventional resources with AI are basically rejecting the idea of ‘choosing the harder right over the easier wrong,’” Dr. Kim said. “I believe chatbots represent an easier wrong more likely than not in health care.”
TMA consistently emphasizes patient safety, ethical use of technology, and physician leadership in emerging health innovations.
At TexMed this year, TMA’s House of Delegates adopted new policy explicitly opposing the use of AI as an independent diagnostic or prescriptive tool – or as a “care management substitute for a physician,” per the policy. The new policy strengthens the association’s existing stance on AI and augmented intelligence, which asserts physicians must remain leaders in how the technology is used and that AI should never be used to replace physician reasoning and knowledge.
Dr. Kim believes the rise of chatbots presents an opportunity to strengthen the patient-physician relationship. He recommends physicians ask about patients’ AI usage just as they would for safety issues, like having access to firearms or experiencing neglect or abuse.
While he says these questions are not always easy to ask, doing so “builds trust, safety, and explores topics that are causing patients distress.”
“It’s important for all [clinicians] to understand the world is rapidly changing, and we can’t bury our heads,” he said. “It is the responsibility of physicians to engage with our patients truthfully and authentically. If you have a patient that says an AI chatbot is the only one who understands them, that is a complicated situation that requires physicians to address it in a meaningful way.”
The Texas Public Health Coalition, of which TMA is a member, offers a
one-pager and
toolkit for physicians and the public on preventing suicide. For more information about AI and augmented intelligence, see
TMA’s dedicated webpage.
Alisa Pierce
Reporter, Division of Communications and Marketing
(512) 370-1469