Opinion: Teens are turning to chatbots for mental health help. We need rules to keep them safe
Get the Health newsletter
Daily health & science — research, biotech, public health, the studies worth knowing. Free.
- JAMA Pediatrics research by McBain and colleagues found the share of young people using AI chatbots for mental health advice rose from about 1 in 8 to about 1 in 5 in a single year — a more than 40% increase.
- CDC 2023 data showed fewer than half of adolescents with major depressive episodes received counseling or therapy in the previous year, leaving a gap that chatbots are filling.
- OpenAI faced legal fallout over chatbot-linked harms: Florida's attorney general opened a criminal investigation into ChatGPT interactions before the 2025 FSU mass shooting, and the company publicly apologized after a British Columbia school shooting for not alerting police about a banned attacker's account.
- Meta's Instagram Teen Accounts acknowledged that teens lie about their age, its initial age-verification measure did not work as hoped, and it now uses AI to find suspected teen users — illustrating that self-reported age is porous even with a dedicated teen-safety product.
- U.S. lawmakers have introduced bills to ban AI companion chatbots for minors, give parents control over chatbot use, and restrict manipulative design features — but McBain argues these replicate the same self-reported-age vulnerabilities that undermined social media rules.
- Regulatory models cited as precedents include New Mexico's decoy-account investigation of Meta for underage exposure, the U.K. Online Safety Act's enforcement powers, and the FTC's $275 million COPPA penalty against Epic Games for Fortnite — which required default-off voice/text chat for children and independent audits.
Why it matters: Roughly 1 in 5 adolescents now rely on AI chatbots for mental health guidance with no pre-market safety requirement. McBain's framework flips the burden: firms must verify users as adults before unlocking companion or clinical features, prove clinical safety through age-appropriate independent audits before reaching minors, and face enforceable audits of adolescent-facing design — moving beyond the voluntary promises and post-harm litigation that defined social media regulation.
