Chat for Hope: Cultivating mental health among Ukrainian youth

Tell us about your project Chat for Hope, which uses a smartphone app to screen and treat young adults for mental health conditions. 

The question that we're asking is: How can we close the treatment gap in a way that doesn't replace human care, but also provides adolescents what they might need? The app lets young people share what they're experiencing and then they can be connected to treatment and skills tailored specifically to their mental health needs. That can include mindfulness and communication skills, the reduction of the stigma around mental health and the willingness to seek help.

How will kids interact with the app? Will it be the kind of open-ended AI-powered chatbot that we’re hearing about lately?

For participants in the program, what they encounter is all already thoughtfully developed, culturally tailored content. It's not ChatGPT style: it’s deterministic and decision-tree-based.

Let's say I'm a 14-year-old in Ukraine, and I'm experiencing anxiety and depression. What would my experience be?

You would download the app, and from there you would choose your own avatar in terms of what your guide would look like. And then you will have a back-and-forth with an avatar, related to: "Let's check in about how you have been feeling lately. Tell me about the past two weeks."

Based on those answers, we would know the level of depression or anxiety that you feel. And if you pass a certain threshold, based on those symptoms, the treatment program can be tailored to you. All of the responses kids will receive through their avatar will be written ahead of time by my colleagues and myself.

For example, if you have traumatic stress, there's specific content related to understanding how trauma works and the impact of trauma on the body. Then there’s guidance on how to self-regulate emotions and also understanding how the nervous system works. This would be followed by simple somatic exercises that you can do to help regulate the nervous system. 

There's definitely trade-offs with the generative AI versus this type of style that is predetermined, but still can be relatively tailored based on what we know about your symptoms and your level of your exposure to the war.

For generative AI, it can feel more exciting for adolescents because you don't know what the program will say. And for that reason, it can also be a little addictive. It's also unpredictable and unsafe from a research standpoint because we don't know if the AI model might say dangerous things to adolescents.

After more than two years of planning, you’ve received funding and are preparing to travel to Ukraine. Tell us about this upcoming journey.

We just had our project launch meeting with our Ukrainian partners: the National Academy of Education Sciences of Ukraine and the Institute of AI Problems for Ukraine. It just feels a very important part of the work to actually be there. You know, we can't just make decisions sitting here in Providence. That's not how it works. It's a collaboration, and the bidirectional exchange of knowledge is a very important part of it.

Where are you in the research phase so far?

It will be a few years before the app is in the hands of Ukrainian children. I hope the war ends tomorrow. But when the war ends, the work doesn't end. The recovery of the nation for Ukraine is only going to be starting at that point.

I mean, we are now in the fifth year of war, so we already have a generation of young people whose formative years have been spent during wartime. So regardless of when the war will end, and I do hope it ends soon, the impact of war cannot be undone and the work is only starting.

If your project is successful, what will that look like?

There's several ways. One is that it works in quantitative terms and we see a reduction in depression, anxiety and PTSD symptoms right after treatment, as well as after three to four months during follow-up, compared to people who did not receive this program. 

It would also be sustainable in terms of funding. What often happens in research is that the intervention works, and then once funding runs out, all of the resources are also gone. And a lot of that is shaped fundamentally by how incentives work. For academics, the incentives are often grants and papers, with faculty often on a treadmill chasing the next grant and next thing. But this is unfair to the local communities. 

So we're quite intentional in thinking in terms of “What would sustainability look like?” It could look like a bigger grant for another five years. But we're also interested in working with policymakers in Ukraine, thinking about policy guidelines for this work that make mental health screening more routine and continually available for adolescents, along with continuing education for school counselors.