Evaluating an automated mental health care system: making meaning of human–computer interaction

Objectives:To qualitatively evaluate the response of patients with unipolar depression who used a computer telephony system designed to monitor their disease severity and support self-care, principally adherence to medication regimen and clinical office visit attendance.Methods:Weekly in-depth interviews were conducted with 15 patients who used the computer telephony system for 4 weeks. Users had a diagnosis of unipolar depression and took at least one antidepressant. All interviews were audio-taped and immediately transcribed. The transcripts of the interviews were subsequently coded and analyzed thematically by two qualitative researchers.Results:The patients spoke about the automated system as if it was a social actor. They did not, however, have an illusion that there was a health professional communicating through the system. Instead, they felt that it was designed to appear human-like. The majority offered suggestions intended to make the system behave and sound more like a “human professional” and less like a “machine”. They believed that the system would be more usable, acceptable and effective if these changes were made.Conclusions:These results do not support the “anthropomorphism” construct which posits that users of computer-mediated systems who attribute human qualities to the system are under an illusion that the system is human.