Use of Artificial Intelligence in Adolescents' Mental Health Care: Systematic Scoping Review of Current Applications and Future Directions

Background: Given the increasing prevalence of mental health problems among adolescents, early intervention and appropriate management are needed to decrease mortality and morbidity. Artificial intelligence's (AI) potential contributions, although significant in the field of medicine, have not been adequately studied in the context of adolescents' mental health. Objective: This review aimed to identify AI interventions that have been tested, implemented, or both, for use in adolescents' mental health care. Methods: We used the Arksey and O'Malley framework, further refined by Levac et al, along with the Joanna Briggs Institute methodology, to guide this scoping review. We searched 5 electronic databases from the inception date through July 2024 (inclusive). Four independent reviewers screened the titles and abstracts, read the full texts, and extracted data using a validated data extraction form. Disagreements were resolved by consensus, and if this was not possible, the opinion of a fifth reviewer was sought. We evaluated the risk of bias (ROB) for prognosis and diagnosis-related studies using the Prediction Model Risk of Bias Assessment Tool. We followed the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist for reporting. Results: Of the papers screened, 88 papers relevant to our eligibility criteria were identified. Among the included papers, AI was most commonly used for diagnosis (n=78), followed by monitoring and evaluation (n=19), treatment (n=10), and prognosis (n=6). As some studies addressed multiple applications, categories are not mutually exclusive. For diagnosis, studies primarily addressed suicidal behaviors (n=11) and autism spectrum disorder (n=7). Machine learning was the most frequently reported AI method across all application areas. The overall ROB for diagnostic and prognostic models was predominantly unclear (58%), while 20% of studies had a high ROB and 22% were assessed as low risk. Conclusions: In our review, we found that AI is being applied across various areas of adolescent mental health care, spanning diagnosis, treatment planning, symptom monitoring, and prognosis. Interestingly, most studies to date have concentrated heavily on diagnostic tools, leaving other important aspects of care relatively underexplored. This presents a key opportunity for future research to broaden the scope of AI applications beyond diagnosis. Moreover, future studies should emphasize the meaningful and active involvement of end users in the design, development, and validation of AI interventions, alongside improved transparency in reporting AI models, data handling, and analytical processes to build trust and support safe clinical implementation.