This commentary is by Narain Batra of Hartford, who will give a lecture next month through the Osher Institute at Dartmouth, “Our Freedoms and The Age of Artificial Intelligence.” He is affiliated with the graduate college at Norwich University.
If you are feeling lonely, depressed or anxious, who you gonna call? Certainly not Ghostbusters. Nor would Elvis Presley’s romantic “Tell me, dear, are you lonesome tonight” help you to get out of a funk, a shade-of-gray mood characterized by feelings of emptiness, lack of motivation, grouchiness, some kind of diffused malaise.
Most of us know how our bodies twist and turn, ache and break, and we readily seek medical help, but very few of us understand our cognitive health, how and why our minds become dysfunctional. We spend billions and billions on our physical health but not much on our mental health.
According to Statista’s projection, the U.S. health expenditure in 2023 would be approximately $4.67 trillion. Of this massive amount, it is estimated that the United States would spend over $200 billion on mental health, about 4.3 % of the total health outlay. This includes spending by the federal, state and local governments, and private insurance.
A 2023 study by the RAND Corp. reported that spending on mental health services among Americans with private health insurance has surged since the beginning of the Covid-19 pandemic, due to a rise in “anxiety disorders, major depressive disorder, bipolar disorder, schizophrenia, and PTSD.”
Notable research findings included an interesting fact: “During the acute phase of the pandemic (March 2020 to December 2020), in-person mental health services declined by 40 percent while tele-mental health services increased roughly 10-fold as compared to the year prior.” Tele-mental health and AI-mental health may open new doors.
This was before the era of Generative Artificial Intelligence, which since its inception in November 2022 has been permeating all our activities, including business, national security, entertainment, education and health care, especially the challenges of mental health disorders, which are widespread in the United States.
There’s no gainsaying the fact that mental health issues can have a profound impact on individuals’ lives, affecting their emotional well-being, relationships, work or school performance, and overall quality of life. Mental health problems have substantial economic costs, including health care expenses, lost productivity, and the burden on the criminal justice system and social services — estimated to be $206.6 billion each year, according to the National Alliance on Mental Illness.
Disparities in access to mental health care are a serious concern. Many individuals, especially in underserved communities, face barriers such as lack of insurance, shortage of mental health professionals, and inadequate mental health services. Mental health problems are often intertwined with substance abuse issues, creating a dual diagnosis situation. Substance abuse can worsen mental health conditions and vice versa.
Suicide rates are a serious concern in the U.S. and are often linked to mental health issues. Suicide is one of the leading causes of death in the country. The stigma surrounding mental health issues can discourage individuals from seeking help, leading to untreated or undertreated conditions. This can exacerbate the problem and result in terrible outcomes.
There is a shortage of mental health professionals, including psychiatrists, psychologists, social workers and counselors, in the United States, and the shortage is a serious issue. The severity of the shortage can vary by region and population. Rural areas often experience more acute shortages of mental health professionals compared to urban areas. This geographic disparity can limit access to care, particularly for those in remote or underserved regions.
As mentioned earlier, the Rand Corp. reported that tele-mental health services jumped tenfold during the Covid-19 pandemic. If mental health patients feel comfortable with tele-health therapy, it is possible that Generative Artificial Intelligence-based mental therapy would open another door, especially for people living in remote areas and those who are hesitant to lie on the psychiatrist’s couch.
Generative AI can be used to develop new and innovative therapy methods, including personalized treatment plans for individual patients. Generative AI-created virtual assistants can provide companionship, comfort and support to mental patients. This can be especially helpful for patients who feel isolated or lonely.
For example, Woebot is a chatbot that provides cognitive behavior therapy to users. It has been shown to be effective in reducing symptoms of depression and anxiety.
Ellie is a virtual therapist that was developed by the University of Southern California. It is designed to help patients with a variety of mental health conditions, including anxiety, depression, and post-traumatic stress disorder.
Dreamcatcher is an app that uses AI to analyze users’ dreams and provide insights into their mental health. It is designed to help users identify and understand their emotions, and to develop coping mechanisms.
One of the most promising and worth exploring AI therapists is Wysa, which claims that its “clinically validated AI gives immediate support as the first step of care, and human coaching for those who need more. … Wysa’s AI is clinically proven to create a therapeutic alliance equivalent to a human therapist within the first week.”
The field of AI therapy is new and holds great promise, and it “can provide access to interventions that a lot of people wouldn’t otherwise be able to access, particularly in a short amount of time,” argued Nicholas C. Jacobson, a Dartmouth Geisel School of Medicine College assistant professor of biomedical data science and psychiatry, and director of the AI and Mental Health Lab.
However, many experts, including the World Health Organization, have cautioned that the technology needs rigorous oversight to ensure that the therapeutic counseling and products are effective and first do no harm.
But individual AI therapy can go so far. California’s mental health problem coupled with homelessness — more than 170,000 street people, 25% of whom have serious mental illness — is so humongous that Gov. Gavin Newsom has pursued a controversial solution that would cost billions.
The CARE Court plan will bring mental health care into the courtroom. Newsom told “60 Minutes” Cecelia Vega that “a person referred to CARE Court for a severe mental illness is evaluated. If they have an untreated psychotic disorder, like schizophrenia, a judge can order a mental health treatment plan including medication, therapy and a place to live.”
The governor believes that “the new civil court system will help thousands get off the streets — and make everyone safer by helping people before they become a danger to themselves or others.”
Could our judicial system solve our mental problems? One might wonder if this is the only way to solve California’s critical mental health-homelessness-drug addiction problem. A high-level Generative Artificial Intelligence system, trained to solve complex public health and socioeconomic problems, under the guidance of experts, could offer strategies far more effective and less expensive to mitigate the problem.
One out of five of us has a mental health condition. Let’s try something new and more creative.
