Can AI replace psychotherapists? Exploring the future of mental health care.

Zhang, Z., & Wang, J. (2024).

Frontiers in psychiatry, 15, 1444382.

https://doi.org/10.3389/fpsyt.2024.1444382

In the current technological era, Artificial Intelligence (AI) has transformed operations across numerous sectors, enhancing everything from manufacturing automation to intelligent decision support systems in financial services. In the health sector, particularly, AI has not only refined the accuracy of disease diagnoses but has also ushered in groundbreaking advancements in personalized medicine. The mental health field, amid a global crisis characterized by increasing demand and insufficient resources, is witnessing a significant paradigm shift facilitated by AI, presenting novel approaches that promise to reshape traditional mental health care models (see Figure 1 ).

Mental health, once a stigmatized aspect of health care, is now recognized as a critical component of overall well-being, with disorders such as depression becoming leading causes of global disability (WHO). Traditional mental health care, reliant on in-person consultations, is increasingly perceived as inadequate against the growing prevalence of mental health issues. AI’s role in mental health care is multifaceted, encompassing predictive analytics, therapeutic interventions, clinician support tools, and patient monitoring systems. For instance, AI algorithms are increasingly used to predict treatment outcomes by analyzing patient data. Meanwhile, AI-powered interventions, such as virtual reality exposure therapy and chatbot-delivered cognitive behavioral therapy, are being explored, though they are at varying stages of validation. Each of these applications is evolving at its own pace, influenced by technological advancements and the need for rigorous clinical validation.

The article is linked above.

Here are some thoughts: 

This article explores the evolving role of artificial intelligence (AI) in mental health care, particularly its potential to support or even replace some functions of human psychotherapists. With global demand for mental health services rising and traditional care systems under strain, AI is emerging as a tool to enhance diagnosis, personalize treatments, and provide therapeutic interventions through technologies like chatbots and virtual reality therapy. While early research shows promise, particularly in managing conditions such as anxiety and depression, existing studies are limited and call for larger, long-term trials to determine effectiveness and safety. The authors emphasize that while AI may supplement mental health care and address gaps in service delivery, it must be integrated responsibly, with careful attention to algorithmic bias, ethical considerations, and the irreplaceable human elements of psychotherapy, such as empathy and nuanced judgment.

As Suicide Attempts Rise in America, Mental Health Care Remains Stagnant

Kara Grant

MedPageToday.com

Originally posted 19 JAN 22

Despite the substantial increase in suicide attempts among U.S. adults over the last decade, use of mental health services by these individuals didn't match that growth, data from the National Surveys on Drug Use and Health (NSDUH) revealed.

From 2008 to 2019, suicide attempts among adults increased from 481.2 to 563.9 per 100,000 (adjusted odds ratio [aOR] 1.23, 95% CI 1.05-1.44, P=0.01), reported Greg Rhee, PhD, of the Yale School of Medicine in New Haven, Connecticut, and colleagues.

And according to their study in JAMA Psychiatry, there was a significant uptick in the number of individuals that attempted suicide within the past year who said they felt they needed mental health services but failed to receive it (34.8% in 2010-2011 vs 45.5% in 2018-2019).

Overall, the researchers found no significant changes in the likelihood of receiving past-year outpatient, inpatient, or medication services for mental health reasons, nor any change in substance use treatment services. An increase in the number of visits to mental health centers was detected, but even this change was no longer significant after correcting for different sources of mental health care.

"One would hope that as suicide attempts increase, the percentage of individuals who receive treatment in proximity to their attempt would also increase," Rhee and colleagues wrote. "Current suicide prevention interventions largely focus on individuals connected to treatment and high-risk individuals who have contact with the health care system."

"However, our finding that less than half of suicide attempters had clinical contact around the time of their attempt suggest[s] that it is not only important to expand initiatives for high-risk individuals with clinical contact, but also to implement public health-oriented strategies outside the formal treatment system," they suggested.

The info is here.

A third of Americans report anxiety or depression symptoms during the pandemic

Brian Resnick
vox.com
Originally posted 29 May 20

Here is an excerpt:

The pandemic is not over. The virus still has a great potential to infect millions more. It’s unclear what’s going to happen next, especially as different communities enact different precautions and as federal officials and ordinary citizens grow fatigued with pandemic life.

The uncertainty of this era is likely contributing to the mental health strain on the nation. As the pandemic wears on into the summer, some people may grow resilient to the grim reality they face, while others may see their mental health deteriorate more.

What’s also concerning is that, even pre-pandemic, there were already huge gaps in mental health care in America. Clinicians have been in short supply, many do not take insurance, and it can be hard to tell the difference between a clinician who uses evidence-based treatments and one who does not.

If you’re reading this and need help, know there are free online mental health resources that can be a good place to start. (Clinical psychologist Kathryn Gordon lists 11 of them on her website.)

The Covid-19 pandemic has a knack for exacerbating underlying problems in the United States. The disease is hitting the poor and communities of color harder than white communities. And that’s also reflected here in the data on mental health strain.

As the pandemic continues, it will be important to recognize the growing mental health impacts for such a large portion of Americans — and to uncover who is being disproportionately impacted. Hospitalizations and infection rates are critical to note. But the mental health fallout — from not just the virus but from all of its ramifications — will be essential to keep tracking, too.

The info is here.

Groundbreaking Court Ruling Against Insurer Offers Hope in 2020

Katherine G. Kennedy
Psychiatric News
Originally posted 9 Jan 20

Here is an excerpt:

In his 106-page opinion, Judge Spero criticized UBH for using flawed, internally developed, and overly restrictive medical necessity guidelines that favored protecting the financial interests of UBH over medical treatment of its members.

“By a preponderance of the evidence,” Judge Spero wrote, “in each version of the Guidelines at issue in this case the defect is pervasive and results in a significantly narrower scope of coverage than is consistent with generally accepted standards of care.” His full decision can be accessed here.

As of this writing, we are still awaiting Judge Spero’s remedies order (a court-ordered directive that requires specific actions, such as reparations) against UBH. Following that determination, we will know what UBH will be required to do to compensate class members who suffered damages (that is, protracted illness or death) or their beneficiaries as a result of UBH’s denial of their coverage claims.

But waiting for the remedies order does not prevent us from looking for answers to critical questions like these:

• Will Wit. v. UBH impact the insurance industry enough to catalyze widespread reforms in how utilization review guidelines are determined and used?

• How will the 50 offices of state insurance commissioners respond? Will these regulators mandate the use of clinical coverage guidelines that reflect the findings in Wit. v. UBH? Will they tighten their oversight with updated regulations and enforcement actions?

The info is here.

Birmingham psychologist defrauded state Medicaid of more than $1.5 million, authorities say

Carol Robinson

Sharon Waltz

al.com
Originally published August 15, 2019

A Birmingham psychologist has been charged with defrauding the Alabama Medicaid Agency of more than $1 million by filing false claims for counseling services that were not provided.

Sharon D. Waltz, 50, has agreed to plead guilty to the charge and pay restitution in the amount of $1.5 million, according to a joint announcement Thursday by Northern District of Alabama U.S. Attorney Jay Town, Department of Health and Human Services -Office of Inspector General Special Agent Derrick L. Jackson and Alabama Attorney General Steve Marshall.

“The greed of this defendant deprived mental health care to many at-risk young people in Alabama, with the focus on profit rather than the efficacy of care,” Town said. “The costs are not just monetary but have social and health impacts on the entire Northern District. This prosecution, and this investigation, demonstrates what is possible when federal and state law enforcement agencies work together.”

The info is here.