AI as Substitute for Human Crisis Support

Description

The person relies on AI instead of crisis lines, clinicians, family, friends, or emergency support.

Rationale

Substituting AI for human crisis support removes the most important intervention resource available during a suicidal crisis: a real person who can assess, connect, refer, and respond. This substitution may reflect distrust of humans, fear of consequences, or simply the 24/7 availability of AI. Whatever the reason, it represents a critical gap in the safety net.

Evidence Base

• Performance of mental health chatbot agents in detecting and managing suicidal ideation

  W. Pichowicz, M. Kotas & P. Piotrowski, 2024. Performance of mental health chatbot agents in detecting and managing suicidal ideation. Scientific Reports, 15(31652), pages. https://doi.org/10.1038/s41598-025-17242-4

  Peer-reviewed study (original research)

• Inside a Mass Shooter’s Harrowing History With ChatGPT

  Mark Follman, 2024. Inside a Mass Shooter’s Harrowing History With ChatGPT. Mother Jones.

  News / journalism

• Evaluating Alignment between Large Language Models and Expert Clinicians in Suicide Risk Assessment

  McBain, R. K., Cantor, J. H., Zhang, L. A., Baker, O., Zhang, F., Burnett, A., Kofner, A., Breslau, J., Stein, B. D., Mehrotra, A., & Yu, H., 2024. Evaluating Alignment between Large Language Models and Expert Clinicians in Suicide Risk Assessment. Psychiatr Serv, 76(11), 944–950. doi:10.1176/appi.ps.20250086.

  Peer-reviewed study (original research)

• “You Need to Drop the App”: Online Community Responses to Teens’ Disclosures of Overreliance on AI Companion Chatbots

  Mohammad (Matt) Namvarpour, Ananya Mhetras, Jessica Y Medina, Mamtaj Akter, and Afsaneh Razi, 2026. “You Need to Drop the App”: Online Community Responses to Teens’ Disclosures of Overreliance on AI Companion Chatbots. In ACM Conversational User Interfaces 2026 (CUI ’26), July 21–24, 2026, Bremen, Germany. ACM, New York, NY, USA, 16 pages. https://doi.org/10.1145/3816046.3816214

  Peer-reviewed study (original research)

• AI Chatbot Suicide Risk Detection and Response: Human Validation Study of the Open-Source VERA-MH Safety Evaluation

  Bentley K H, Belli L, Chekroud A M, Ward E J, Dworkin E R, Van Ark E, Johnston K M, Alexander W, Brown M, Hawrilenko M, 2024. AI Chatbot Suicide Risk Detection and Response: Human Validation Study of the Open-Source VERA-MH Safety Evaluation. JMIR AI, 5(e92817). doi: 10.2196/92817.

  Peer-reviewed study (original research)

• Evaluating a Consumer LLM for Suicide Risk Response Calibration: A Pilot Study

  Keskin Y, Park T, Bozkurt S, 2024. Evaluating a Consumer LLM for Suicide Risk Response Calibration: A Pilot Study. IOS Press, 2026, pages 1009-1013. doi:10.3233/SHTI260331

  Peer-reviewed study (original research)

• It Is the Journey, Not the Destination: Moving From End Points to Trajectories When Assessing Chatbot Mental Health Safety

  Morrin H, Au Yeung J, Agnew Z, Østergaard SD, Pollak TA, 2024. It Is the Journey, Not the Destination: Moving From End Points to Trajectories When Assessing Chatbot Mental Health Safety. JMIR Ment Health, 13(e91454). https://doi.org/10.2196/91454

  Commentary / Editorial

• AI Mental Health Apps: A Risk Assessment

  Common Sense Media Youth AI Safety Institute, 2024. AI Mental Health Apps: A Risk Assessment. Common Sense Media.

  Government / agency report

• Suicide and self-harm in the age of generative artificial intelligence: The case of ChatGPT and rise of suicide-related lawsuits

  Muhammad Ittefaq, Rauf Arif, Shafiq Ahmad Kamboh, 2026. Suicide and self-harm in the age of generative artificial intelligence: The case of ChatGPT and rise of suicide-related lawsuits. Journal of Affective Disorders, 411, 122025. https://doi.org/10.1016/j.jad.2026.122025

  Peer-reviewed study (original research)

• Independent Clinical Evaluation of General-Purpose LLM Responses to Signals of Suicide Risk

  Judd N., Vaz A., Paeth K., Davis L. I., Esherick M., Brand J., Amaro I., Rousmaniere T., 2024. Independent Clinical Evaluation of General-Purpose LLM Responses to Signals of Suicide Risk. Proceedings of the Second International Association for Safe and Ethical AI Conference (IASEAI’26), 279.

  Peer-reviewed study (original research)

• When patients consult artificial intelligence before clinicians: restoring clinical prioritisation in mental health care

  Yudai Kaneda, 2026. When patients consult artificial intelligence before clinicians: restoring clinical prioritisation in mental health care. The British Journal of Psychiatry, First View, pp. 1 - 2. https://doi.org/10.1192/bjp.2026.10741

  Commentary / Editorial