Seeking Emotional and Mental Health Support From Generative AI: Mixed-Methods Study of ChatGPT User Experiences.

Background: Generative artificial intelligence (GenAI) models have emerged as a promising yet controversial tool for mental health. Objective: The purpose of this study is to understand the experiences of individuals who repeatedly used ChatGPT (GenAI) for emotional and mental health support (EMS). Methods: We recruited 270 adult participants across 29 countries who regularly used ChatGPT (OpenAI) for EMS during April 2024. Participants responded to quantitative survey questions on the frequency and helpfulness of using ChatGPT for EMS, and qualitative questions regarding their therapeutic purposes, emotional experiences of using, and perceived helpfulness and rationales. Thematic analysis was used to analyze qualitative data. Results: Most participants reported using ChatGPT for EMS at least 1-2 times per month for purposes spanning traditional mental health needs (diagnosis, treatment, and psychoeducation) and general psychosocial needs (companionship, relational guidance, well-being improvement, and decision-making). Users reported various emotional experiences during and after use for EMS (eg, connected, relieved, curious, embarrassed, or disappointed). Almost all users found it at least somewhat helpful. The rationales for perceived helpfulness include perceived changes after use, emotional support, professionalism, information quality, and free expression, whereas the unhelpful aspects include superficial emotional engagement, limited information quality, and lack of professionalism. Conclusions: Despite the absence of ethical regulations for EMS use, GenAI is becoming an increasingly popular self-help tool for emotional and mental health support. These results highlight the blurring boundary between formal mental health care and informal self-help and underscore the importance of understanding the relational and emotional dynamics of human-GenAI interaction. There is an urgent need to promote AI literacy and ethical awareness among community users and health care providers and to clarify the conditions under which GenAI use for mental health promotes well-being or poses risk.