Use and Perceptions of AI Chatbots for Mental Health Support Among Adults with Lived Experience

Importance: AI chatbots are increasingly used for mental health support, but little is known about how adults with lived experience of mental health condition use and perceive these tools. Objective: To characterize the use and perception of AI chatbots, including for mental health purposes, among adults connected to a large US mental health organization. Design: Cross-sectional online survey conducted from March to May 2026. Setting: Adults recruited through email newsletters from the National Alliance on Mental Illness (NAMI), the largest grassroots mental health organization in the US. Participants: Adults aged 18 years older with English proficiency. Affiliation with NAMI or a diagnosis of mental health disorder was not required. Results: Of 454 participants, 316 (69.6%) reported having used an AI chatbot. Use was more common among younger participants and those with a current mental health diagnosis. Among AI users, 133 (42.1%) reported using a chatbot for mental health purposes. Mental health-related use was typically brief and focused on information gathering and in-the-moment emotion regulation. Most users rated chatbots as helpful for their mental health. Among the 95 participants with a mental health provider, only 14 (14.7%) had openly discussed their AI use with their provider. Higher frequency of AI use was associated with greater odds of disclosure (OR, 1.67; 95% CI, 1.20-2.38; P = .003). Conclusion and Relevance: In this survey of adults connected to a large mental health organization, AI chatbots were widely used but engagement for mental health purposes was typically brief and focused. Most use occurred without clinician awareness, suggesting a need for proactive conversations about AI use in routine mental health care.