Designing Mental-Health Chatbots for Indian Adolescents: Mixed-Methods Evidence, a Boundary-Object Lens, and a Design-Tensions Framework

Abstract: Mental health challenges among Indian adolescents are shaped by unique cultural and systemic barriers, including high social stigma and limited professional support. We report a mixed-methods study of Indian adolescents (survey n=362; interviews n=14) examining how they navigate mental-health challenges and engage with digital tools. Quantitative results highlight low self-stigma but significant social stigma, a preference for text over voice interactions, and low utilization of mental health apps but high smartphone access. Our qualitative findings reveal that while adolescents value privacy, emotional support, and localized content in mental health tools, existing chatbots lack personalization and cultural relevance. We contribute (1) a Design-Tensions framework; (2) an artifact-level probe; and (3) a boundary-objects account that specifies how chatbots mediate adolescents, peers, families, and services. This work advances culturally sensitive chatbot design by centering on underrepresented populations, addressing critical gaps in accessibility and support for adolescents in India.