The Role of Perceived Emotional Support in AI Mental Health Chatbots among Generation Z
Keywords:
Mental Health, Perceived Emotional Support, Perceived Empathy, AI Companionship, Emotional Well-BeingAbstract
Artificial Intelligence (AI) mental health chatbots are increasingly used by Generation Z as a source of emotional support and digital companionship. The growing interaction between users and AI systems has raised questions regarding the ability of AI chatbots to provide empathetic communication and contribute to users’ emotional well-being. This study aims to examine the role of perceived emotional support and perceived empathy in AI mental health chatbots on AI companionship and emotional well-being among Generation Z users. This study employed a quantitative approach using survey data collected from 160 Generation Z respondents who had experience using AI mental health chatbots. Data were analyzed using Structural Equation Modeling Partial Least Squares (SEM-PLS) to evaluate the relationships among variables. The findings indicate that perceived emotional support and perceived empathy positively influence AI companionship. Furthermore, AI companionship significantly contributes to emotional well-being. The results also show that perceived emotional support and perceived empathy have direct positive effects on emotional well-being among Generation Z users. AI mental health chatbots have the potential to provide emotionally supportive and empathetic interactions that enhance users’ emotional well-being. The study highlights the importance of integrating human-centered and empathetic features into AI systems to support psychological well-being in digital healthcare environments.
Downloads
References
[1] M. Zaki, U. Rusilowati, D. Apriliasari, and J. Parker, “Artificial intelligence empathy and patient satisfaction in digital healthcare services,” Health, Empathy, and AI Learning (HEAL), vol. 1, no. 1, pp. 26–33, 2025.
[2] Y. AbdulRaheem, “Unveiling the significance and challenges of integrating prevention levels in healthcare practice,” Journal of primary care & community health, vol. 14, p. 21501319231186500, 2023.
[3] A. H. Aditiya, H. Hamdan, S. N. W. Putra, S. Visiana, and R. Thakkar, “Transforming education with genai: Case study on chatgpt, midjourney, and policy changes,” Sundara Advanced Research on Artificial Intelligence, vol. 1, no. 1, pp. 20–27, 2025.
[4] S. Aguilar-Gaxiola, S. M. Ahmed, A. Anise, A. Azzahir, K. E. Baker, A. Cupito, M. Eder, T. D. Everette, K. Erwin, M. Felzien et al., “Assessing meaningful community engagement: a conceptual model to advance health equity through transformed systems for health: organizing committee for assessing meaningful community engagement in health & health care programs & policies,” NAM perspectives, vol. 2022, pp. 10–31 478, 2022.
[5] M. M. Ahmad, I. A. Khan, and N. Priyanka, “The crucial role of community medicine in improving public health,” Digital Journal of Clinical Medicine, vol. 6, no. 3, p. 3, 2024.
[6] M. Migunani, A. Setiawan, and I. Sembiring, “Optimizing automated machine learning for ensemble performance and overfitting mitigation,” Aptisi Transactions on Technopreneurship (ATT), vol. 7, no. 3, pp. 808–822, 2025.
[7] B. S. T. Alharbi, A. S. Alrehili, I. M. Alalawi, A. Z. Alharbi, A. S. A. Altarjami, A. A. Aljohani, and M. A. A. Alharbi, “The impact of preventive health program management on raising awareness and improving community health,” Journal of International Crisis and Risk Communication Research, vol. 7, no. S7, p. 165, 2024.
[8] F. Ameri, M. Dastani, A. Sabahi, F. Hooshangi, M. Rahimkarimi, E. Rajabi, and P. Yaghooby, “The role of e-health literacy in preventive behaviors for covid-19: a systematic review,” Journal of Health Literacy, vol. 6, no. 4, pp. 88–97, 2022.
[9] J. Chevinsky, S. Chirumamilla, S. Caswell, L. M. Nyoni, and K. Studer, “Clinical preventive medicine, integrative medicine, and lifestyle medicine: current state and future opportunities in the development of emerging clinical areas,” AJPM focus, vol. 3, no. 1, 2024.
[10] V. Devrani, A. S. Bist, N. Chawla, C. B. L. Thapliyal, P. Thapliyal, K. Kukreti, O. P. M. Daeli, and A. Fitriani, “Integrating ai and psychology for enhancing human health and development,” in 2025 4th International Conference on Creative Communication and Innovative Technology (ICCIT). IEEE, 2025, pp. 1–7.
[11] F. J. Ferreira-Alfaya, M. J. Zarzuelo-Romero, and Y. Cura, “Advancing pharmaceutical practice: Promoting organizational health literacy to improve medication use through an intersectoral model based on the preventive medicine framework,” Research in Social and Administrative Pharmacy, 2025.
[12] K. Hacker, J. Auerbach, R. Ikeda, C. Philip, and D. Houry, “Social determinants of health—an approach taken at cdc,” Journal of public health management and practice, vol. 28, no. 6, pp. 589–594, 2022.
[13] J. J. Hess, N. A. Errett, G. McGregor, T. Busch Isaksen, Z. S. Wettstein, S. K. Wheat, and K. L. Ebi, “Public health preparedness for extreme heat events,” Annual Review of Public Health, vol. 44, no. 1, pp. 301–321, 2023.
[14] J. Holt-Lunstad, “Social connection as a public health issue: The evidence and a systemic framework for prioritizing the “social” in social determinants of health,” Annual Review of Public Health, vol. 43, no. 2022, pp. 193–213, 2022.
[15] N. Azizah, P. A. Sunarya, U. Rahardja, A. B. Mutiara, P. Prihandoko, and C. Pasha, “Improving smear-negative tuberculosis detection using data augmentation and faster r-cnn,” International Journal of Cyber and IT Service Management (IJCITSM), vol. 6, no. 1, pp. 65–77, 2026.
[16] F. Hu, H. Yang, L. Qiu, X. Wang, Z. Ren, S. Wei, H. Zhou, Y. Chen, and H. Hu, “Innovation networks in the advanced medical equipment industry: supporting regional digital health systems from a local–national perspective,” Frontiers in public health, vol. 13, p. 1635475, 2025.
[17] R. F. Hunter, M. Nieuwenhuijsen, C. Fabian, N. Murphy, K. O’Hara, E. Rappe, J. F. Sallis, E. V. Lambert, O. L. S. Duenas, T. Sugiyama et al., “Advancing urban green and blue space contributions to public health,” The lancet public health, vol. 8, no. 9, pp. e735–e742, 2023.
[18] C. M. Jones, D. Houry, B. Han, G. Baldwin, A. Vivolo-Kantor, and W. M. Compton, “Methamphetamine use in the united states: epidemiological update and implications for prevention, treatment, and harm reduction,” Annals of the New York Academy of Sciences, vol. 1508, no. 1, pp. 3–22, 2022.
[19] H. T. Khan, K. M. Addo, and H. Findlay, “Public health challenges and responses to the growing ageing populations,” Public health challenges, vol. 3, no. 3, p. e213, 2024.
[20] M. Knowles, A. P. Crowley, A. Vasan, and S. Kangovi, “Community health worker integration with and effectiveness in health care and public health in the united states,” Annual Review of Public Health, vol. 44, no. 1, pp. 363–381, 2023.
[21] J. V. Lazarus, H. E. Mark, Q. M. Anstee, J. P. Arab, R. L. Batterham, L. Castera, H. Cortez-Pinto, J. Crespo, K. Cusi, M. A. Dirac et al., “Advancing the global public health agenda for nafld: a consensus statement,” Nature Reviews Gastroenterology & Hepatology, vol. 19, no. 1, pp. 60–78, 2022.
[22] W. L. Macias-Konstantopoulos, K. A. Collins, R. Diaz, H. C. Duber, C. D. Edwards, A. P. Hsu, M. L. Ranney, R. J. Riviello, Z. S. Wettstein, and C. J. Sachs, “Race, healthcare, and health disparities: a critical review and recommendations for advancing health equity,” Western journal of emergency medicine, vol. 24, no. 5, p. 906, 2023.
[23] A. O. Mbata, O. S. Soyege, C. N. Nwokedi, B. O. Tomoh, A. Y. Mustapha, O. D. Balogun, A. Y. Forkuo, and D. R. Iguma, “Preventative medicine and chronic disease management: reducing healthcare costs and improving long-term public health,” International Journal of Multidisciplinary Research and Growth Evaluation, vol. 5, no. 06, pp. 1584–1600, 2024.
[24] A. Mody, A. H. Sohn, C. Iwuji, R. K. Tan, F. Venter, and E. H. Geng, “Hiv epidemiology, prevention, treatment, and implementation strategies for public health,” The Lancet, vol. 403, no. 10425, pp. 471–492, 2024.
[25] M. Mulyati, S. Zebua, D. Apriani, F. P. Oganda, A. Fitriani, S. V. Sihotang, and N. A. Santoso, “Optimization of community entrepreneurship through diversification and digitalization of locally based chocolate beverages,” ADI Journal on Recent Innovation, vol. 7, no. 1, pp. 88–99, 2025.
[26] C. N. Ugwu, O. P.-C. Ugwu, E. U. Alum, V. H. U. Eze, M. Basajja, J. N. Ugwu, F. C. Ogenyi, R. I. Ejemot-Nwadiaro, M. B. Okon, S. I. Egba et al., “Sustainable development goals (sdgs) and resilient healthcare systems: Addressing medicine and public health challenges in conflict zones,” Medicine, vol. 104, no. 7, p. e41535, 2025.
[27] F. Syafariani, M. S. Lola, S. S. S. Abd Mutalib, W. N. F. W. Nasir, A. A. K. A. Hamid, and N. H. Zainuddin, “Leveraging a hybrid machine learning model for enhanced cyberbullying detection,” Aptisi Transactions on Technopreneurship (ATT), vol. 7, no. 2, pp. 371–386, 2025.
[28] K. Thapliyal, M. Thapliyal, and D. Thapliyal, “Social media and health communication: A review of advantages, challenges, and best practices,” Emerging technologies for health literacy and medical practice, pp. 364–384, 2024.
[29] M. Murod, S. Anhar, D. Andayani, A. Fitriani, and G. Khanna, “Blockchain based intellectual property management enhancing security and transparency in digital entrepreneurship,” Aptisi Transactions on Technopreneurship (ATT), vol. 7, no. 1, pp. 240–251, 2025.
[30] N. T. Nwosu, S. O. Babatunde, and T. Ijomah, “Enhancing customer experience and market penetration through advanced data analytics in the health industry,” World Journal of Advanced Research and Reviews, vol. 22, no. 3, pp. 1157–1170, 2024.
[31] A. Ruangkanjanases, A. Khan, O. Sivarak, U. Rahardja, and S.-C. Chen, “Modeling the consumers’ flow experience in e-commerce: The integration of ecm and tam with the antecedents of flow experience,” Sage Open, vol. 14, no. 2, p. 21582440241258595, 2024.
[32] N. I. Susanthi, M. F. Djamaly, A. Fitriani, M. Mardiana, and C. T. Hua, “Design and evaluation of emotionally adaptive chatbots to promote positive mental well-being in young adults,” Journal of Orange Technology, vol. 1, no. 2, pp. 51–62, 2025.
[33] M. U. Tariq, “Advanced wearable medical devices and their role in transformative remote health monitoring,” in Transformative approaches to patient literacy and healthcare innovation. IGI Global Scientific Publishing, 2024, pp. 308–326.
[34] J. Zinsstag, A. Kaiser-Grolimund, K. Heitz-Tokpa, R. Sreedharan, J. Lubroth, F. Caya, M. Stone, H. Brown, B. Bonfoh, E. Dobell et al., “Advancing one human–animal–environment health for global health security: what does the evidence say?” The Lancet, vol. 401, no. 10376, pp. 591–604, 2023.
[35] V. Agarwal, M. Lohani, Q. Aini, and N. A. Santoso, “A novel deep learning technique for medical image analysis using improved optimizer,” Health, Empathy, and AI Learning (HEAL), vol. 1, no. 1, pp. 7–16, 2025.
[36] S. A. Thomas, C. J. Browning, F. J. Charchar, B. Klein, M. G. Ory, H. Bowden-Jones, and S. R. Chamberlain, “Transforming global approaches to chronic disease prevention and management across the lifespan: integrating genomics, behavior change, and digital health solutions,” Frontiers in public health, vol. 11, p. 1248254, 2023.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Mardiana, Ossi Ferli, Henderi, Evelyn Anderson, Alni Cahyani

This work is licensed under a Creative Commons Attribution 4.0 International License.




