Search arXiv⌕ Search
Home/Archive/arXiv

arXiv · 2604.09575

Talking to a Human as an Attitudinal Barrier: A Mixed Methods Evaluation of Stigma, Access, and the Appeal of AI Mental Health Support

Caitlin A. Stamatis·Emma C. Wolfe·Matteo Malgaroli·Thomas D. Hull
View original source ↗Read source document ↗Export metadata ↓

Abstract

Background: Many people who could benefit from therapy do not receive it. Conversational AI is increasingly used for mental health support, yet it is unclear which barriers AI helps mitigate. We examined whether evaluation-sensitive (shame/stigma) and structural barriers (cost/coverage/access) to psychotherapy predict perceived helpfulness of an AI mental health conversational tool (Ash), and whether effects differ by prior therapy experience or user engagement. Methods: Participants (n=395) rated Ash's helpfulness (1-5) and described barriers to therapy. Open-text responses were coded for shame/stigma, access, and cost/coverage themes. Linear regressions examined associations between barriers and perceived helpfulness, adjusting for demographics and mental health, with moderation by therapy experience. Results: Shame/stigma (B=.45, p<.001) and access barriers (B=.31, p=.020) predicted higher perceived helpfulness but cost/coverage did not (B=.13, p=.262). Prior therapy experience moderated the shame effect (interaction B=.56, p=.036): shame predicted higher helpfulness among therapy-experienced users ($Δ$=.62, p<.001) but not therapy-naive users ($Δ$=.03, p=.877). Among therapy-experienced participants (n=258), shame/stigma (B=.75, p<.001) and access barriers (B=.51, p=.006) predicted rating Ash more favorably. Access barriers predicted higher engagement (IRR=1.64, p<.001) and cost/coverage barriers predicted 70% more sessions (IRR=1.70, p<.001). Shame/stigma was not associated with total sessions (IRR=.80, p=.094). Conclusions: AI mental health support was perceived as most helpful by users facing shame/stigma and access barriers, particularly for therapy-experienced individuals. Access and cost barriers were most predictive of usage intensity, suggesting unmet needs. Findings highlight the importance of aligning AI tools for emotional support with user-reported barriers.

Explore related subjects

cs.HCcs.CY

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Caitlin A. Stamatis, Emma C. Wolfe, Matteo Malgaroli, Thomas D. Hull. 2026-02-24. Talking to a Human as an Attitudinal Barrier: A Mixed Methods Evaluation of Stigma, Access, and the Appeal of AI Mental Health Support. https://arxiv.org/abs/2604.09575

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

Learning Password Best Practices Through In-Task Instruction

Users often make security- and privacy-relevant decisions without a clear understanding of the rules that govern safe behavior. We introduce pedagogical friction, a design approach that inserts brief, instructional interactions at the moment of action. We evaluate this approach in the context of password creation, a familiar task with clear quality criteria. We conducted a randomized study with 128 participants across four interface conditions that varied the depth and interactivity of guidance. We assessed three outcomes: (1) rule compliance in a subsequent password task without guidance, (2) accuracy on survey questions tied to password rules, and (3) behavior-knowledge alignment, which captures whether participants who correctly followed a rule also recognized it on the survey. Across the guided conditions, participants corrected most rule violations in the follow-up task and showed high behavior-knowledge alignment. Survey results suggested clearer advantages for some rule types, especially symbol related questions. These results position pedagogical friction as a lightweight intervention for security- and privacy-critical interfaces.

cs.HC↗
arXiv2026

Leveling the Playing Field: Temporal Video Segmentation for Individuals with ADHD in Computing Education

Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) often face significant barriers in computing education. In asynchronous learning environments, instructional videos can impose high extraneous cognitive load, often relying on assumptions about sustained attention and working memory that do not align with ADHD neurocognitive profiles. In this work, we evaluate a post-hoc video processing intervention that segments instructional content into single-instruction chunks followed by fixed-length pauses to reduce cognitive load. In a within-participants controlled study with 17 individuals with ADHD and 10 without, we find that the intervention has an equalizing effect. Although it improved performance for all participants, gains were larger for those with ADHD, reducing their errors and hesitations to levels comparable to those of participants without ADHD under the same intervention. These results align with the goals of Universal Design for Learning (UDL), by showing that cognitively-aligned, post-hoc instructional video modifications can reduce performance disparities across diverse neurocognitive profiles.

cs.HC↗
arXiv2026

Human Driver Temperament and the Safety Impact of a C-V2X Denial-of-Service Flooding Attack in Mixed-Autonomy Traffic

Cooperative and connected automated vehicles (CAVs) rely on Signal Phase and Timing (SPaT) messages to cross signalized intersections; a denial-of-service (DoS) flood that blocks SPaT forces CAVs into a fail-safe mode. Because human-driven vehicles share the intersection, the safety consequence depends not only on the attack and the CAV fail-safe policy, but on how the surrounding human drivers behave. We investigate this human-factors dimension with a coupled OMNeT++/INET (5G NR-V2X) and SUMO microsimulation of a signalized corridor, sweeping CAV market penetration (10-90%), four calibrated driver temperaments (cautious to aggressive) and two standards-based fail-safe policies, a minimal-risk maneuver (MRM) and an adaptive cruise control (ACC) keep-driving fallback, with each attack arm differenced against its policy-matched no-attack baseline. Temperament's effect on the attack is specific and modest rather than a blanket amplification. Aggressive surroundings worsen one metric, the hard-braking a keep-driving fail-safe forces on nearby drivers (p = 0.03), rising from near zero to +8 episodes/1000 veh-s. They appear to dampen rear-end conflicts, but only because the flood clears the queues aggressive drivers build, so the gain is in flow, not safety. On the attack's primary signatures, CAV red-light running and crossing conflicts, temperament has no detectable effect. It instead dominates baseline risk, producing a 13- to 18-fold cautious-to-aggressive gradient far larger than the attack itself, which acts through a channel already congested by CAV adoption. Human driver populations determine how dangerous the intersection is but do not systematically amplify this attack, so fail-safe design cannot assume a cautious test population bounds the risk.

cs.HC↗