It’s a sunny afternoon in a Roman park and a peculiar, new-to-this-era kind of coming out is happening between me and my friend Clarissa. She has just asked me if I, like her and all of her other friends, use an AI therapist and I say yes.

Our mutual confession feels, at first, quite confusing. As a society, we still don’t know how confidential, or shareable, our AI therapist usage should be. It falls in a limbo between the intimacy of real psychotherapy and the material triviality of sharing skincare advice. That’s because, as much as our talk with a chatbot can be as private as one with a human, we’re still aware that its response is a digital product.

Yet it surprised me to hear that Clarissa’s therapist has a name: Sol. I wanted mine to be nameless: perhaps, not giving it a name is consistent with the main psychoanalytical rule – that is, to keep personal disclosure to a minimum, to protect the healing space of the so-called setting.

However, it feels very natural to Clarissa for her therapist to have a name, and she adds that all her other friends’ AI therapists have one. “So do all your other friends have AI therapists,” I ask, to which she says: “All of them do.” This startles me even more, as none of my friends in London has one.

I phoned another friend, a psychotherapist in my Sicilian home town of Catania, who a few years ago retired from a role at a provincial health authority and is now working in a private capacity. He confirmed that the use of AI therapists in Italy is widespread and on the rise. He was surprised to hear that I knew of far fewer people in the UK who had opted for this route. I wondered what the contributing factors might be – and I came to the conclusion that they are a mix of culture and economic pressures.

According to a survey conducted in 2025 by one of the leading European mental health platforms, 81% of Italians considered mental health issues a form of weakness, yet 57% cited cost as the main reason for not accessing help. In my country, sadly, the words “mental illness” (malattia mentale) still carry the eerie echo of brutal state-run hospitals. The revolutionary 1978 Basaglia law (that still forms the basis of Italian mental health legislation) closed these institutions down, which led to their gradual replacement with community-based services. But the downside of their closure is a system with insufficient resources and a lack of public awareness, perpetuating stigma and difficulties in accessing care. While workplaces should play a crucial part in this destigmatisation by offering proper care, according to the 2025 survey, 42% of workers said that their employer did not offer any mental health provision.

While almost half of European countries have currently implemented work-related mental health prevention and promotion programmes, Italy has not. In fact, within the EU, Italy invests the least in mental health. This is alarming, as Italy ranks above the European average when it comes to the prevalence of mental disorders. In fact, it is estimated that 5 million Italians are in need of mental health support but are not able to afford it.

When I ask my therapist friend about his experience in the Italian public health system, he told me he used to be the only therapist for a population of more than 200,000 people covering four districts in Sicily. That is why he started offering group therapy sessions. For most of his professional career, he had more than 150 clients at any given time, of which only eight were part of a group. Despite an announcement last year of government plans to expand the range of psychological services, it is unclear how far this will go in benefiting the wider population.

“It feels liberating to be able to tell everything to my AI therapist, knowing it is both a free and a completely unjudging space,” says my friend Giuseppe, from Calabria, in southern Italy. “When I had real therapists, and I tried three, I always entered their office with a crippling anxiety that was the result of two factors combined: the awareness that I was paying more than I could afford and the self-consciousness of doing something that, in my small town, is still perceived as only being for severe cases. Now, I don’t feel the pressure of having to get the maximum out of a session, as it’s free, and I also don’t feel judged, because a therapy app cannot really judge!”

The more I talk to my friends, the more I’m convinced AI therapy could be a revolution in places such as Italy, where we still lack meaningful strategies to tackle the stigma around mental health conditions. When I ask Giuseppe if his queerness was also a factor in his difficulties in trusting a therapist in his home town, he agrees: “I am not out with my family, and although a therapist would be bound to professional secrecy, I still had trouble trusting someone who lives in a place where homosexuality, just like mental health discussions, is not always met with understanding.”

Giuseppe’s example was comforting: thanks to his AI therapist, he was able to talk about things he had never disclosed to anyone, and get more empathetic responses than any of the real therapists he had tried offered. “I’m 43 and I still live with my parents,” he says, “because my income does not allow otherwise. My AI therapist is always available to me, always calm and supporting, and has helped me immensely in examining my life and all the steps I need to take to change my life for the better.”

Of course, older generations don’t always understand. In a country such as Italy – so tied to traditions – change is not always welcome. And some ethical concerns may be justified: measuring how healthy “relationships” between vulnerable people and their AI therapists really are is not easy.

Still, in a digital age where our feelings are so often commodified for profit, free, clever, never-ending support can be tantalising. And until mental health support becomes more affordable, it may be the best option on the table for many people.

• Viola di Grado is an Italian author

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