Evidence and Implications of AI-Enabled Chatbots for the Mental Health of Migrants: A Global Systematic Review

Abstract

Background: Migrants experience disproportionately higher rates of depression, anxiety, and psychological distress compared with native-born populations. However, access to mental health services remains limited due to structural, cultural, linguistic, financial, and stigma-related barriers. Artificial intelligence (AI)–enabled digital mental health chatbots have emerged as potentially accessible and scalable tools for psychological support, yet evidence regarding their role in improving mental healthcare access among migrant populations remains fragmented.

Objective: This systematic review aimed to synthesise existing evidence regarding AI-enabled digital mental health chatbots and explore their potential to improve access to mental health support among migrant populations globally. The review also examined the methodological quality of included studies and the capacity of chatbot technologies to address structural, cultural, linguistic, financial, and stigma related barriers to mental healthcare access.

Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Medline, PsycInfo, and Embase databases were searched for peer-reviewed studies published between 2021 and 2025. Eligible studies examined AI-enabled digital chatbots used in mental health support and interventions relevant to migrant mental healthcare contexts. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) checklist, and findings were synthesised narratively using reflexive thematic analysis.

Results: Ten studies involving 43,401 participants met the inclusion criteria. The findings demonstrated that AI-enabled mental health chatbots may improve access to mental health support through affordability, anonymity, continuous availability, scalability, multilingual accessibility, and personalised engagement. Chatbots were also associated with increased self-referral behaviours, reduced stigma, and improved accessibility across geographical and linguistic barriers. However, concerns relating to 2 privacy, ethical safeguards, technical reliability, data security, and limited emotional empathy were consistently identified across the included studies.

Conclusions: AI-enabled digital mental health chatbots demonstrate promising potential to improve access to mental health support among migrant populations globally. Their ability to provide accessible, scalable, and culturally adaptable support may help address persistent barriers to mental healthcare access. However, further migrant-specific research, culturally responsive implementation strategies, and stronger ethical and regulatory safeguards are required to support the safe and effective integration of AI-enabled mental health chatbots into mental healthcare systems.