Gabby is a “racially ambiguous female in her mid-forties.”1 A software program designed to help patients with chronic pain and depression, Gabby has many “siblings” that already converse directly with millions of patients in the United States and globally about their mental health. Advances in machine learning, digital assistants, and natural language processing support such personal health conversations between machines and patients. Conversational artificial intelligence is the term used to describe this new capability. Gabby is a conversational agent, a software program that uses conversational artificial intelligence to interact with users through voice or text. Conversational agents are different from other software programs because they converse directly with people, and some data suggest that people respond to them psychologically as though they are human.2 Clinicians have contemplated the use of conversational agents in mental health care for decades, especially to improve access for underserved populations.