Recently, there has been a rise in articles with headlines like “Gen Z is increasingly turning to ChatGPT for affordable on-demand therapy” [1]. The growing demand for a so-called ‘AI therapist’ highlights both the prevalence of mental health complaints among young people and the lack of suitable, low-barrier care within our current mental healthcare system. In the Netherlands, more than half of young people between 16 and 25 say they’re dealing with mental health issues [2]. However, they are less likely than any other age group to access mental health services. Why? Because many don’t know where to turn for help, aren’t sure what kind of help is out there, feel let down by the current system, or simply get stuck on long waiting lists [3].

My name is Fenna Hellegers, and before starting my PhD at Amsterdam UMC, I worked as a psychologist in a clinical setting, where I saw the barriers to receiving care firsthand. While managing the waiting list for a specialized intervention, I often had to tell individuals with serious mental health concerns that they would need to wait up to a year before receiving help. This led me to the conclusion that something needs to change within the system, and that I wanted to contribute to this.

However, using ChatGPT to fill the gap between demand and available care might not be the best solution. Even though AI holds promise for mental healthcare, studies also suggest that AI therapists can contribute to stigma and may produce harmful responses [4], in the most extreme cases potentially contributing to psychotic symptoms [5]. Therefore, I believe it’s crucial to offer young people a safe and effective digital alternative where they can access low-barrier support for their mental health complaints at any time.

The Moderated Online Social Therapy platform (MOST) could be a solution for this. This platform was first developed in Australia by Orygen Digital and consists of (1) interactive guided therapy journeys, (2) peer-to-peer online networking, (3) peer and clinical moderation, and (4) online expert support by mental health clinicians. Research shows that the platform is effective and cost-effective [6] in reducing psychological distress and improving social functioning in young people [7]. Moreover, young people have reported that the platform is well-adjusted for their specific age group [8].

I’m excited to have the opportunity to combine my interest in research and my experience within the clinical setting in the intervention 3 – MOST study, within the YOUTHreach consortium. Together with my colleagues, I am investigating the (cost-)effectiveness of the digital intervention ‘MOST’ among help-seeking young people (aged 16–25) in three countries: the Netherlands, Ireland, and Australia. In addition, Spain will implement the intervention and conduct an implementation study. For my dissertation, I will focus on the Dutch clinical trial, which assesses the (cost-)effectiveness of ‘MOST’ in young people currently on the waiting list for mental healthcare. Through my involvement in these studies, I hope to contribute to real-life improvements in mental healthcare for young people.

Are you a young person, or someone working in clinical practice and/or research, who has become excited about our research? Please feel free to contact YOUTHreach. We are always interested in feedback or co-creation, especially with young people. In our opinion, changing mental healthcare for young people is impossible without the input of young people themselves!

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References:

[1] Hepburn, S. (2025, June 1). The generative AI therapy chatbot will see you now. Fortune. https://fortune.com/2025/06/01/ai-therapy-chatgpt-characterai-psychology-psychiatry/

[2] Rijksinstituut voor Volksgezondheid en Milieu (RIVM). (2023, March 30). More than half of young adults reported experiencing mental health problems. https://www.rivm.nl/en/news/more-than-half-of-young-adults-reported-experiencing-mental-health-problems

[3] McGorry, P. D., Mei, C., Chanen, A., Hodges, C., Alvarez-Jimenez, M., & Killackey, E. (2022). Designing and scaling up integrated youth mental health care. World Psychiatry, 21(1), 61–76. https://doi.org/10.1002/wps.20938

[4] Moore, J., Grabb, D., Agnew, W., Klyman, K., Chancellor, S., Ong, D. C., & Haber, N. (2025). Expressing stigma and inappropriate responses prevents LLMs from safely replacing mental health providers [Preprint]. arXiv. https://doi.org/10.48550/arXiv.2504.18412

[5] Morrin, H., Nicholls, L., Levin, M., Yiend, J., Iyengar, U., DelGuidice, F., Bhattacharya, S., Tognin, S., MacCabe, J., Twumasi, R., Alderson-Day, B., & Pollak, T. A. (2025, July 11). Delusions by design? How everyday AIs might be fuelling psychosis (and what can be done about it) [Preprint]. PsyArXiv. https://doi.org/10.31234/osf.io/cmy7n

[6] Engel, L., Alvarez-Jimenez, M., Cagliarini, D., D’Alfonso, S., Faller, J., Valentine, L., Koval, P., Bendall, S., O’Sullivan, S., Rice, S., Miles, C., Penn, D. L., Phillips, J., Russon, P., Lederman, R., Killackey, E., Lal, S., Cotton, S. M., Gonzalez-Blanch, C., Herrman, H., McGorry, P. D., Gleeson, J. F. M., & Mihalopoulos, C. (2024). The cost-effectiveness of a novel online social therapy to maintain treatment effects from first-episode psychosis services: Results from the Horyzons randomized controlled trial. Schizophrenia Bulletin, 50(2), 427–436. https://doi.org/10.1093/schbul/sbad071

[7] Van Doorn, M., Monsanto, A., Wang, C. L., Verfaillie, S. C. J., van Amelsvoort, T. A. M. J., Popma, A., Jaspers, M. W. M., Öry, F., Alvarez-Jimenez, M., Gleeson, J. F., & Nieman, D. H. (2023a). The effects of a digital, transdiagnostic, clinically and peer-moderated treatment platform for young people with emerging mental health complaints: Repeated measures within-subjects study. JMIR mHealth and uHealth, 11, e50636. https://doi.org/10.2196/50636

[8] Van Doorn, M., Monsanto, A., Boeschoten, C. M., van Amelsvoort, T., Popma, A., Öry, F. G., Alvarez-Jimenez, M., Gleeson, J., Jaspers, M. W. M., & Nieman, D. H. (2023b). Moderated digital social therapy for young people with emerging mental health problems: A user-centered mixed-method design and usability study. Frontiers in Digital Health, 4. https://doi.org/10.3389/fdgth.2022.1020753