AI and Mental Health

[Andie Schwabe] 14:14:28
Artificial intelligence, or AI, is all around us now, embedded in our apps and programs and easy to engage with. Lots of folks turn to chatbots for mental health support, but when can that be useful and when can that be risky?

[Casey Smart] 14:14:49
All right. Hello and welcome to the Connecting Badgers podcast. We are licensed mental health providers at the University of Wisconsin–Madison. I am Casey Smart. I use she and hers pronouns.

[Andie Schwabe] 14:15:03
I’m Andy Schwabe. I also use she and hers.

[Kari K Treu] 14:15:07
And I’m Kari Troy. I use she/her pronouns as well.

[Casey Smart] 14:15:14
And while we are all mental health professionals here, we are not experts.

[Casey Smart] 14:15:19
Let’s do that again. That came out weird. While we are mental health professionals, we are not AI experts, and this conversation will center more around the intersection between the two.

[Casey Smart] 14:15:36
All right, I guess it jumps into me. All right, so let’s talk about…

[Casey Smart] 14:15:41
AI and therapy versus AI. Um, what does.

[Casey Smart] 14:15:47
therapy involve? And then what does AI support often involve?

[Andie Schwabe] 14:15:54
Yeah. In this conversation about AI and mental health and those options for AI support, we wanted to talk about when we might lean on one or the other, starting with therapy and understanding what therapy is. That is going to be a dedicated session with.

[Andie Schwabe] 14:16:10
an individual or you can do group counseling where you’re with other folks who are also there for the therapy. Typically scheduled in advance, although there are definitely options for in the moment crisis support or walk in support on campus or through public support lines.

[Andie Schwabe] 14:16:25
And you will have a professional supporting, so you’ll be scheduled with somebody or have that designated person assigned to you when you walk in. It’ll be with a professional. It’ll be focused on specific therapy topics and have some guidance from them, open to lots of different concerns. There’s lots of different groups that you can join, and obviously in individual counseling, you can talk about anything that’s relevant for you.

[Andie Schwabe] 14:16:49
AI will be slightly different. It is, of course, as of right now, mostly via chat. You’d be typing and it will type back to you. There are some that will be voice like as if it’s speaking to you. They do have immediate responses. So you can type anything you want into that chat and have an immediate response back.

[Andie Schwabe] 14:17:09
It is, of course, AI, so it’s artificial intelligence, it’s generated from patterns that it’s been trained on for mental health support, um, and it is beneficial to have that immediate support in that way.

[Andie Schwabe] 14:17:22
Both of them are tailored to what you put in. So in the same way that you type in whatever you want to get guidance from the AI chat, the same thing happens in individual therapy. Whatever you are willing and able to share with your provider, then they can offer some feedback on and shape the sessions based on what you’re sharing.

[Andie Schwabe] 14:17:39
AI will do the same. It’ll shape its responses based on what you are putting into that chat.

[Andie Schwabe] 14:17:45
Therapy typically is recommended more for longer form, lasting change. It can include like coping strategies, it can include processing, problem solving, lots of different avenues you can go down with that professional support.

[Andie Schwabe] 14:18:02
And AI will be dependent on the exact words you type in. It typically will offer more, like, problem solving and some validation, more of that short-term, like, in-the-moment support.

[Casey Smart] 14:18:17
was extremely well put and just… summarized those things really well So I appreciate that.

[Casey Smart] 14:18:27
What about, okay, we’ve talked some about what AI can do, but can you tell me more? And then also, when might therapy be more helpful?

[Kari K Treu] 14:18:40
Absolutely. Yeah. I think that.

[Kari K Treu] 14:18:42
With AI being available 24/7, like Andy said, like being able to get that immediate support can sometimes have its benefits in terms of like being able to get feedback on your thoughts. And it does really depend on kind of what your.

[Kari K Treu] 14:19:00
putting into it, um, and what you’re getting out of it. And oftentimes, AI does come from a more validating place, where it’s kind of going to use what you tell it to kind of.

[Kari K Treu] 14:19:12
tailor its responses in that way, which therapy can also be very validating and comforting at times. And I think one thing that therapy can offer that is less likely with AI is a space to challenge us directly and kind of assess the thought processes we’re having.

[Kari K Treu] 14:19:30
Where again, like that immediate support, kind of getting that validation, and maybe some immediate problem solving can be helpful, especially. In moments of yeah grief or depression, and. I think that there are also particularly ways that.

[Kari K Treu] 14:19:46
a relationship, a therapeutic relationship can build upon itself. And also you do kind of build that safety trust rapport in the therapeutic space that again just feels different in kind of a chat room. AI.

[Kari K Treu] 14:20:02
conversation. Um, and I think something else in terms of therapy, you can, like, practice coping skills with a profession…

[Kari K Treu] 14:20:14
You can be able to have space to kind of make a more thorough plan based on all of the context a therapist might have, where AI might not really have as much of the full picture. One thing that is also important to remember, even though, yeah, typically for more ongoing traditional individual therapy.

[Kari K Treu] 14:20:35
Usually 24/7 kind of immediate response is not likely, but there are a lot of crisis lines and resources available immediately. Particularly, there’s a lot of crisis lines that you can call that are available 24/7.

[Kari K Treu] 14:20:51
For example, UHS has a crisis line that you can call at any time and get immediate support from a therapist. And I think sometimes the idea of it being crisis support sometimes can bring up questions for students, understandably, of like.

[Kari K Treu] 14:21:05
yeah, I could benefit talking to a therapist. But do I meet criteria of being in crisis where you know, even if you’re not actively at risk or in crisis, you can always use our crisis line, even just as a starting place.

[Kari K Treu] 14:21:20
and to get that immediate support. And like, I said, there’s other crisis lines outside of the university that can be utilized if that’s what people’s preferences are, for whatever reason. So yeah, lots of resources available still to get immediate support.

[Kari K Treu] 14:21:39
I think another thing we wanted to kind of touch on with, you know.

[Kari K Treu] 14:21:46
AI versus seeing a mental health professional is, um, AI doesn’t really have the ability to assess for things like psychosis. So, like, if our thoughts.

[Kari K Treu] 14:22:00
are not… Yeah, I think in a lot of ways, our thoughts are not automatically factual. There can be a lot of different pieces and nuance with that, and AI is probably most likely going to kind of take…

[Kari K Treu] 14:22:12
our information at face value versus kind of thinking about it through that lens of like, okay, and is this kind of factual? And what’s happening in yeah, in someone’s experience with their mental health symptoms.

[Kari K Treu] 14:22:27
Another thing that we…

[Kari K Treu] 14:22:30
don’t know a lot about yet, but I think we will continue to get more information, but just like the general impact kind of using AI for immediate answers will have on our overall cognitive functioning and our critical thinking skills.

[Kari K Treu] 14:22:46
Um, we don’t know how fully how AI can impact those things, but I mean, in a lot of ways, and I don’t know if I’m biased as a therapist in terms of the work I do, but, like, I think that there’s a lot of parts that are important to getting feedback from our peers and from professionals who have studied and kind of worked.

[Kari K Treu] 14:23:06
towards different, yeah, professional titles. And I think also being able to read through different sources, getting differing perspectives, all of those things are really helpful in terms of our development and how we view the world. And again.

[Kari K Treu] 14:23:21
instead of having kind of immediate access to that affirming answer that usually is in that same lens. Lastly, last thing I’ll say is, we do also want to consider the concept of confidentiality. AI is often going to use your responses to train itself, and is not bound by hipaa or other kinds of laws around healthcare privacy.

[Kari K Treu] 14:23:45
where therapists and other mental health professionals are required to kind of abide by these these laws and regulations around your information.

[Casey Smart] 14:23:58
Yeah. Well, that sounds like there is a lot of nuance in choosing AI support or therapy. Are there times where you feel like there isn’t as much nuance situations with a more firm answer or guidance?

[Andie Schwabe] 14:24:14
Yeah, I think there’s a lot of considerations for making changes or having that immediate support that you can keep in mind. The situations where we would say we would definitely not recommend using AI and instead using whatever you’re.

[Andie Schwabe] 14:24:29
choice is for crisis support would be things like suicidal ideation, self-harm or urges, thoughts of hurting or killing another person. If we’re dealing with substance use, any of those types of emergent situations are more.

[Andie Schwabe] 14:24:45
more, you know, more urgent. If you do think or other people have been giving you feedback that you might have some thoughts that aren’t entirely grounded in reality, those are all times where we would recommend talking to a human being or walking in to see one at your.

[Andie Schwabe] 14:25:00
preferred location. Those are times where we don’t want something just giving us, like, pattern recognition answers or the practical problem solving, and we run some risk with AI leaning heavily on the warmth and validation. That is really nice if we’re waking up in the middle of the night dealing with grief.

[Andie Schwabe] 14:25:17
But if I’m dealing with safety concerns, I maybe don’t want something that is going to just reinforce whatever thoughts I’m already having. So, any type of self-harm, harm to others, risk of safety, substance use stuff, we would firmly recommend you talk to a human being who still can offer.

[Andie Schwabe] 14:25:34
warmth and validation, but do a little bit more assessing for what’s the safest recommendations. Crisis lines really are free sometimes, especially with AI chatbots. We run into a limit, and we would need to start paying for them. But crisis lines are free to you.

[Andie Schwabe] 14:25:50
There is the public 988 line and then UHS at UW Madison has the 24/7 line as well at the 608-265-5600 option nine. And then all services at UHS for students of UW Madison are free as well. So can walk in, can schedule mental health appointments.

[Andie Schwabe] 14:26:10
Whatever you might need.

[Casey Smart] 14:26:12
Thank you for Andy. Thank you for that. I think that is an important distinction. Also, therapists are held to certain ethical standards where AI is not. Could you speak more on that?

[Kari K Treu] 14:26:28
Yeah, I think that there is just the reality that AI is going to, yeah, not necessarily have those rules and regulations that licensed mental health professionals do. I think in terms of what maybe the goal of AI is versus the goal of therapy, I mean, I think that AI is.

[Kari K Treu] 14:26:51
in some ways trying to use your information to kind of train itself, get better and learn more. And sometimes they then can use that information in different ways. Like we said at the beginning, we’re not AI experts by any means, but like we do kind of know how.

[Kari K Treu] 14:27:07
That is something that oftentimes is a part of AI, and in terms of like also kind of the goals of therapy. I think that the the biggest goal is to help you to learn. How do you cope with these things independently when you’re not in therapy. And again.

[Kari K Treu] 14:27:25
Kind of thinking about those kind of self-reflective.

[Kari K Treu] 14:27:30
how we cope and how we deal with mental health, um, concerns in the moment in terms of, like, how do we…

[Kari K Treu] 14:27:37
cope with those things independently, or know things that might be helpful. And also, I mean, obviously to know times that we might need to reach out for more immediate support. And I think kind of having that immediate AI response can also in some ways.

[Kari K Treu] 14:27:54
Run the risk of kind of potential, like feeling more dependent on needing to ask something or someone for an answer versus like, yeah, kind of the goal of therapy, of building your toolkit in terms of the coping skills you have and being able to do that coping independently.

[Kari K Treu] 14:28:13
In addition to that, like we said, there’s the the consideration with confidentiality. There are also other ethical standards that therapists are bound by by law.

[Kari K Treu] 14:28:27
Therapists can also be reported, reviewed, and barred from practicing again. Um, there’s even times that therapists can take… can face legal charges for things that they are doing in the therapeutic space, and again, I mean, understandably, obviously, AI can’t face those same kinds of consequences, or.

[Kari K Treu] 14:28:46
really have the same kind of reporting systems in place. And again, kind of thinking about.

[Kari K Treu] 14:28:53
confidentiality, particularly just kind of like that uncertainty of what what happens with your information. And I mean, I think that there’s some AI platforms coming out that potentially do have.

[Kari K Treu] 14:29:09
things around some protection of information. But usually those cost money. Usually those aren’t completely accessible, and like there still is just like the not knowing of like what happens with your information where there’s just more.

[Kari K Treu] 14:29:24
Again, ethical standards that therapists are held to that, you know, in a lot of ways couldn’t really even be mimicked in, like, an artificial intelligence space.

[Casey Smart] 14:29:34
Yeah.

[Casey Smart] 14:29:35
And even those…

[Andie Schwabe] 14:29:35
Cool.

[Casey Smart] 14:29:37
you know, AI models that, you know, claim to use clinical, you know, information and experts, like, consider those sources. Like, where is that coming from? Like, we don’t always know those things, either. Can that be trusted?

[Andie Schwabe] 14:29:52
Mmhm.

[Andie Schwabe] 14:29:55
Yeah, I would say we’ve offered a lot of detail here. And like we mentioned, there’s a lot of nuance for most situations. Overall, it’s important to consider confidentiality. What type of need you have? What do you need help with?

[Andie Schwabe] 14:30:10
For safety concerns, for more complex help, for longer term help or change, therapy or crisis support is recommended. For short term solutions, helping build a schedule, other like practical in the moment support, AI.

[Andie Schwabe] 14:30:24
Or a resource like Let’s Talk at UHS if you want to talk to a person. Those could be helpful.

[Casey Smart] 14:30:33
All right. Well, thank you both. I really appreciated that discussion. I know we really only just scratched the surface on it. But thank you for those listening and subscribe to our podcast. And remember, this podcast is not a substitute for mental health treatment.

[Casey Smart] 14:30:49
If you are a UW–Madison student and are looking to start mental health treatment, you can call 608-265-5600, option 2 to schedule, and option 9 for 24-7 crisis support.