‘What about you? What helps you to relax?’ Boon asks me. Boon is a chatbot designed to support mental health, created by Winnie Mak, a psychology professor at The Chinese University of Hong Kong. It’s open to everyone, but with a specific a focus on young people in Hong Kong.

I’ve messaged Boon because I’ve been supporting someone with a serious mental health condition and it’s had a big impact on me. I’ve realised I need quite a lot of support myself because of it. I’m seeing what Boon can offer.

With Gen Z being more receptive to getting help online, psychology professor Mak has developed AI mental health chatbots to support them.

TourHeart+ chatbot offers users mental health support

I respond to the bot about what I think helps me relax: ‘Swimming, meditation, sometimes TV,’ I tell it. ‘I see!’ comes the response. ‘So, do you relax using this method regularly? When we try our best to take care of others, it’s easy to neglect our own needs. So, we can plan our time for relaxing in advance! You can make your own self-care plan!’

Hong Kong Jockey Club Charities Trust Funding

Boon is right. I need regular reminders of what will help me and our conversation reinforces what might help, multiple times. While still learning and evolving, the bot has useful and insightful advice and support through our conversation: I do need to schedule in more of the things I love, I realise.

‘In Hong Kong there is a lot of stigma and discrimination around mental health’ – Professor Winnie Mak

In the following weeks I think about more things I find relaxing and joyful. I remember how great it was being in a choir some years ago. Not long after I sign up for a choir taster and since joining a month ago, my happiness levels have increased.

The chatbot is one of the features available through the non-profit mental health and wellbeing app and platform called TourHeart+, which has been solely funded by the Hong Kong Jockey Club Charities Trust, since it started development in 2017. AI therapy exists in other places with some good, and also a few bad results, and has been trialled by the NHS in the UK.

Combining AI mental health health with human support

A big package of support is available through TourHeart+, combing AI with real human help. There’s a virtual support community where users can share their stories – proven to be helpful in mental health recovery, according to research out earlier this year. There are the chatbots, and also psycho-educational materials, self-care practices, webinars and online psychological interventions for depression, anxiety and insomnia. Cognitive behavioural and mindfulness approaches are used, as well as face-to-face group therapies with clinical psychologists.

The various digital exercises promote self-awareness around mood, state of mind and mental health. ‘Lived experience of mental health is a very personal journey’, says Professor Mak.

Stigma around mental health issues in Hong Kong

Mak’s vision is for everyone to enjoy mental health as a basic human right; that all individuals should have the opportunity to thrive in a compassionate and understanding environment.

But she knows this is far from the case throughout most of the world. ‘In Hong Kong,’ she says, ‘there is a lot of stigma and discrimination around mental health. People don’t want to tell others they are struggling. It may be seen as shameful.’

According to an epidemiological study conducted in Hong Kong, only a quarter of people with common mental health conditions have sought professional help.

With public mental health services being limited (more than one year to see a clinical psychologist), and private services often being prohibitively expensive, she created her own solution with TourHeart+. She also co-founded social enterprise, StoryTaler, where people with lived experience use storytelling to destigmatise and advocate mental health for all. 

Online mental health support reduces depressive symptoms

I didn’t test the bot on any more serious or traumatic issues, so I’m not sure how it would fair. But the platform has more than 36,000 registered users of different ages. A randomised controlled trial (currently being written up) of the affect of chatbot support via TourHeart+ compared to a control group, showed that it was able to increase people’s self-care behaviours, reduce depressive symptoms, and improve overall wellbeing.

TourHeart+ feature encourages users to log their current mental health status

In the coming four years, the team intends to more specifically target those aged 18-29. This is the age when signs of mental health problems and conditions can commonly start to present in people. The aim is to support young people at a crucial time in their lives by fostering self-care and empowering them to take control of their wellbeing.

While young people are shown to be less likely to reach out to traditional public or private mental health services, according to the aforementioned research, there has been a noteworthy increase in awareness and openness regarding mental health issues among young people.

Mak thinks harnessing AI might be an important part of helping them further understand themselves and their mental health and recieve support.

Young people find community online

‘Technology has been instrumental in making mental health information and support more accessible and at giving people a voice,’ she says. ‘Young people have found a sense of community and solace in online support groups, which may mitigate feelings of loneliness and isolation.’

While her focus is on the positive sides of technology, she caveats that not all digital resources for mental health are scientifically validated. And notes concerns about adverse effects of excessive use of technology. But TourHeart+ is proving effective and taps into the digital native generation’s natural tendencies.

Social investment supporting youth mental health

With lived experience of mental health difficulties herself, Mak knows far more needs to be done across the world to support good mental health. And, She feels that social investment and philanthropy can play a pivotal role in advancing mental health initiatives such as TourHeart+ and accelerating policy and system changes.

‘I wonder if philanthropists can form a critical and vocal clout, together with grassroots organisations, social advocates, and citizens on pressing social issues such as mental health’ – Professor Winnie Mak

‘There is a pressing need for more tailored funding structures that specifically address the unique challenges of mental health-related projects, particularly those focusing on leveraging technology for service innovation, instead of traditional face-to-face interventions,’ she asserts.

Current social investment frameworks and grants often lack the necessary flexibility to support the iterative development and long-term sustainability required by mental health initiatives, according to Mak.

Technology projects require funding flexibility

‘For example, projects are typically required to propose long-term budgets for technology development. However, what was cutting-edge technology three years ago may become outdated today, yet the project may only have budgeted for the earlier technology.

‘Technology-focused projects require financial flexibility to adapt to such rapid advancements. Projects also require long-term cycles (not the traditional two to three years) to drive impact and sustainable changes,’ she states.

Professor Winnie Mak, founder of TourHeart+

The professor advocates for a multi-system approach, emphasising that mental health issues are pervasive across all domains of life. ‘Mental health promotion must transcend traditional mental health frameworks to address broader societal challenges, including financial security and stability (e.g., alleviate poverty) and social equality (e.g., respect diversity, no stigma and discrimination).

‘Given there are many philanthropies working on different areas and pockets of populations, I wonder if they can form a critical and vocal clout, together with grassroots organisations, social advocates, and citizens on pressing social issues such as mental health, so they can more effectively lobby for policy reform with the government and systemic changes in the community?’

Claudia Cahalane is Alliance‘s Investments Editor