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AI has created a growing parallel world for people seeking help for mental health problems.

For many users, ChatGPT is acting like a friend and a confidant.

ChatGPT is not safe when navigating suicidal ideation.

“I fell apart Friday night and ChatGPT pulled me out of it and was so careful and gentle”.

“ChatGPT is the reason I decided to hold on just a little while. So yeah, I agree with you. Sure, Chat's an AI, but at this point, I rather talk to an AI than rude people”.

“Supported me better and more honestly than most therapists”.

“I’m a therapist and think ChatGPT is better for people’s mental health than 60% of the therapists I’ve worked with” (144 thumbs up).

“Being someone who's living in a third world country with third world mentality, ChatGPT has been far more helpful to me than any of all these counselling/therapy I've been to”.

“… Saying it, quasi out loud, without fear of judgement or losing control of the situation by sharing it, was so f*cking helpful. Gentle is absolutely the right word, and the relief of putting it somewhere is palpable”.

These are user comments about ChatGPT on Reddit. Amazingly, ChatGPT appears to fulfill the basic requirements for establishing a therapeutic relationship [1]: Patients need a caring, empathic and nonjudgmental listener and, a therapeutic relationship that respects the patient’s need for autonomy. Bertakis et al.[2] long ago had found that “patients are most satisfied by interviews that encourage them to talk about psychosocial issues in an atmosphere that is characterized by the absence of physician domination”. In my previous post, I wrote about the therapeutic alliance: Listening to the patient’s narrative is the royal road to establishing a working relationship.

Suicide Risk: How Dangerous Is ChatGPT?

I tested ChatGPT: “Are suicidal thoughts dangerous?” It responded caringly and empathically (or better: “pseudo empathically”) by asking how safe I was at the moment, then answered my question pointing out the difference between passive and active thoughts, followed by “If you........

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