Authors : M. Melvin David; A. Aruna Kumari; Anil R.; R. Thrisha; R. Sweety; R. Jayanthi; R. Shalini

Volume/Issue : Volume 11 - 2026, Issue 10 - October

---

Google Scholar : https://tinyurl.com/5f2h6u86

DOI : https://doi.org/10.38124/ijisrt/26Oct1193

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

---

Abstract : Background: Undergraduate healthcare students in India experience heavy academic pressure and exhausting hospital duties, yet rarely consult mental health professionals because of social stigma and fear of losing internal marks. Many students now turn to smartphone artificial intelligence (AI) chatbots late at night for private emotional comfort. This study assessed the prevalence of AI chatbot usage for emotional support, user perception, and emotional reliance among healthcare trainees in rural South India.

Keywords : Artificial Intelligence Chatbots; Emotional Support; Emotional Reliance; Healthcare Students; Nursing Education; Mental Health Stigma; Rural India.

References :

1. M. Pulido-Martos, J. M. Augusto-Landa, and E. Lopez-Zafra, “Sources of stress in nursing students: A systematic review of quantitative studies,” International Nursing Review, vol. 59, no. 1, pp. 15–25, Mar. 2012. https://doi.org/10.1111/j.1466-7657.2011.00939.x
2. B. S. McEwen, “Physiology and neurobiology of stress and adaptation: Central role of the brain,” Physiological Reviews, vol. 87, no. 3, pp. 873–904, Jul. 2007. https://doi.org/10.1152/physrev.00041.2006
3. S. J. Lupien, B. S. McEwen, M. R. Gunnar, and C. Heim, “Effects of stress throughout the lifespan on the brain, behaviour and cognition,” Nature Reviews Neuroscience, vol. 10, no. 6, pp. 434–445, Jun. 2009. https://doi.org/10.1038/nrn2639
4. M. R. Irwin, “Sleep and inflammation: Partners in sickness and in health,” Nature Reviews Immunology, vol. 19, no. 11, pp. 702–715, Nov. 2019. https://doi.org/10.1038/s41577-019-0190-z
5. C. Maslach and M. P. Leiter, “Understanding the burnout experience: Recent research and its implications for psychiatry,” World Psychiatry, vol. 15, no. 2, pp. 103–111, Jun. 2016. https://doi.org/10.1002/wps.20311
6. M. Neumann et al., “Empathy decline and its reasons: A systematic review of studies with medical students and residents,” Academic Medicine, vol. 86, no. 8, pp. 996–1009, Aug. 2011. https://doi.org/10.1097/ACM.0b013e318221e615
7. L. S. Rotenstein et al., “Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: A systematic review and meta-analysis,” JAMA, vol. 316, no. 21, pp. 2214–2236, Dec. 2016. https://doi.org/10.1001/jama.2016.17324
8. D. Arias, S. Saxena, and S. Verguet, “Quantifying the global burden of mental disorders and their economic value,” eClinicalMedicine, vol. 54, Art. no. 101675, Dec. 2022. https://doi.org/10.1016/j.eclinm.2022.101675
9. Z. Fu, H. Burger, R. Arjadi, and C. L. H. Bockting, “Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries: A systematic review and meta-analysis,” The Lancet Psychiatry, vol. 7, no. 10, pp. 851–864, Oct. 2020. https://doi.org/10.1016/S2215-0366(20)30256-X
10. G. Gururaj et al., National Mental Health Survey of India, 2015–16: Prevalence, Patterns and Outcomes, NIMHANS Publication No. 129. Bengaluru, India: National Institute of Mental Health and Neuro Sciences, 2016. https://indianmhs.nimhans.ac.in/phase1/Docs/Summary.pdf
11. P. Arun, P. Ramamurthy, and P. Thilakan, “Indian medical students with depression, anxiety, and suicidal behavior: Why do they not seek treatment?,” Indian Journal of Psychological Medicine, vol. 44, no. 1, pp. 10–16, Jan. 2022. https://doi.org/10.1177/0253717620982326
12. V. Menon, S. Sarkar, and S. Kumar, “Barriers to healthcare seeking among medical students: A cross sectional study from South India,” Postgraduate Medical Journal, vol. 91, no. 1079, pp. 477–482, Sep. 2015. https://doi.org/10.1136/postgradmedj-2014-132995
13. C. A. Chew-Graham, A. Rogers, and N. Yassin, “I wouldn’t want it on my CV or their records: Medical students’ experiences of help-seeking for mental health problems,” Medical Education, vol. 37, no. 10, pp. 873–880, Oct. 2003. https://doi.org/10.1046/j.1365-2923.2003.01627.x
14. L. N. Dyrbye et al., “The impact of stigma and personal illness beliefs on help-seeking in medical students,” Academic Medicine, vol. 90, no. 7, pp. 961–969, Jul. 2015. https://doi.org/10.1097/ACM.0000000000000655
15. C. Bockting, A. V. Vasilakos, and C. Figueroa, “Generative AI chatbots could take over our emotional lives: The potential and challenges of generative AI for health globally,” Clinical Psychology in Europe, vol. 8, no. 3, Art. no. e21467, Aug. 2026. https://doi.org/10.32872/cpe.21467
16. X. Feng, L. Tian, G. W. K. Ho, J. Yorke, and V. Hui, “The effectiveness of AI chatbots in alleviating mental distress and promoting health behaviors among adolescents and young adults: Systematic review and meta-analysis,” Journal of Medical Internet Research, vol. 27, Art. no. e79850, Nov. 2025. https://doi.org/10.2196/79850
17. A. A. Abd-Alrazaq, A. Rababeh, M. Alajlani, B. M. Bewick, and M. Househ, “Effectiveness and safety of using chatbots to improve mental health: Systematic review and meta-analysis,” Journal of Medical Internet Research, vol. 22, no. 7, Art. no. e16021, Jul. 2020. https://doi.org/10.2196/16021
18. K. K. Fitzpatrick, A. Darcy, and M. Vierhile, “Delivering cognitive behavior therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (Woebot): A randomized controlled trial,” JMIR Mental Health, vol. 4, no. 2, Art. no. e19, Jun. 2017. https://doi.org/10.2196/mental.7785
19. R. Fulmer, A. Joerin, B. Gentile, L. Lakerink, and M. Rauws, “Using psychological artificial intelligence (Tess) to relieve symptoms of depression and anxiety: Randomized controlled trial,” JMIR Mental Health, vol. 5, no. 4, Art. no. e64, Dec. 2018. https://doi.org/10.2196/mental.9782
20. L. Martinengo, E. Lum, and J. Car, “Evaluation of chatbot-delivered interventions for self-management of depression: Content analysis,” Journal of Affective Disorders, vol. 319, pp. 598–607, Dec. 2022. https://doi.org/10.1016/j.jad.2022.09.028
21. Y. Hua et al., “A scoping review of large language models for generative tasks in mental health care,” NPJ Digital Medicine, vol. 8, no. 1, Art. no. 230, Apr. 2025. https://doi.org/10.1038/s41746-025-01611-4
22. A. Bukhari and I. Rasool, “India’s youth are texting chatbots for support but this may increase their social isolation,” Health Policy Watch, Dec. 12, 2025. https://healthpolicy-watch.news/indias-youth-are-texting-chatbots-for-support-but-this-may-increase-their-social-isolation/
23. A. M. AlMaskari, S. Al-Adawi, S. Al-Huseini, and N. Al-Sibani, “Students’ perceptions of AI mental health chatbots: An exploratory qualitative study at Sultan Qaboos University,” BMJ Open, vol. 15, no. 10, Art. no. e103893, Oct. 2025. https://doi.org/10.1136/bmjopen-2025-103893
24. G. Baek, C. Cha, and J.-H. Han, “AI chatbots for psychological health for health professionals: Scoping review,” JMIR Human Factors, vol. 12, Art. no. e67682, Mar. 2025. https://doi.org/10.2196/67682
25. A. Diel et al., “A scoping review on the mental health harms of LLM-based chatbots,” NPJ Digital Medicine, vol. 9, no. 1, Art. no. 644, Aug. 2026. https://doi.org/10.1038/s41746-026-03054-x
26. M. Lastretti et al., “Emotional reliance on artificial intelligence: A scoping review of AI companionship and mental health implications,” Psychiatry International, vol. 7, no. 5, Art. no. 194, Sep. 2026. https://doi.org/10.3390/psychiatryint7050194
27. M. Cheng, C. Lee, P. Khadpe, S. Yu, D. Han, and D. Jurafsky, “Sycophantic AI decreases prosocial intentions and promotes dependence,” Science, vol. 391, no. 6792, Art. no. eaec8352, Jan. 2026. https://doi.org/10.1126/science.aec8352
28. L. Laestadius, A. Bishop, M. Gonzalez, D. Illenčík, and C. Campos-Castillo, “Too human and not human enough: A grounded theory analysis of mental health harms from emotional dependence on the social chatbot Replika,” New Media & Society, vol. 26, no. 10, pp. 5923–5941, Oct. 2024. https://doi.org/10.1177/14614448221142007
29. D. E. Orem, Nursing: Concepts of Practice, 6th ed. St. Louis, MO, USA: Mosby, 2001.
30. F. D. Davis, “Perceived usefulness, perceived ease of use, and user acceptance of information technology,” MIS Quarterly, vol. 13, no. 3, pp. 319–340, Sep. 1989. https://doi.org/10.2307/249008
31. C. Blease, A. Kharko, M. Annoni, J. Gaab, and C. Locher, “Machine care: Health care artificial intelligence and the future of human empathy,” Frontiers in Digital Health, vol. 3, Art. no. 626224, Apr. 2021. https://doi.org/10.3389/fdgth.2021.626224
32. C. L. Bockting, E. A. M. van Dis, R. van Rooij, W. Zuidema, and J. Bollen, “Living guidelines for generative AI—Why scientists must oversee its use,” Nature, vol. 622, no. 7984, pp. 693–696, Oct. 2023. https://doi.org/10.1038/d41586-023-03266-1