Researchers at the University of Southern California developed software that assessed 74 acoustic features, including pitch, volume, quality, shimmer, jitter, and prosody, to predict outcomes among patients receiving couples therapy. This software was able to predict marital discord at least as well as human therapists.23
Many mental health apps purport to implement specific components of psychotherapy. Many of these apps focus on cognitive-behavioral therapy worksheets, mindfulness exercises, and/or mood tracking. The features provided by such apps emulate the tasks and intended outcomes of traditional psychotherapy, but in an entirely decentralized venue.24
Some have expressed concern that an increased use of virtual therapists powered by AI might lead to a dehumanization of psychiatry (Box25,26).
Box
Will artificial intelligence dehumanize psychiatry?
Whether there are aspects of the psychiatric patient encounter that cannot be managed by a “virtual clinician” created by artificial intelligence (AI) remains to be determined. Some of the benefits of using AI in this manner may be difficult to anticipate, or may be specific to an individual’s relationship with his/her clinician.25
On the other hand, AI systems blur previously assumed boundaries between reality and fiction, and this could have complex effects on patients. Similar to therapeutic relationships with a human clinician, there is the risk of transference of emotions, thoughts, and feelings to a virtual therapist powered by AI. Unlike with a psychiatrist or therapist, however, there is no person on the other side of this transference. Whether virtual clinicians will be able to manage such transference remains to be seen.
In Deep Medicine,26 cardiologist Eric Topol, MD, emphasizes a crucial component of a patient encounter that AI will be unlikely able to provide: empathy. Virtual therapists powered by AI will inherit the tasks best done by machines, leaving humans more time to do what they do best—providing empathy and being “present” for patients.
Electronic health record reforms
Although many clinicians find EHRs to be onerous and time-consuming, EHR technology is constantly improving, and EHRs have revolutionized documentation and order implementation. Several potential advances could improve clinical practice. For example, EHRs could incorporate a clinical decision support system that uses AI-based algorithms to assist psychiatrists with diagnosis, monitoring, and treatment.27 In the future, EHRs might have the ability to monitor and learn from errors and adverse events, and automatically design an algorithm to avoid them.28 They should be designed to better manage analysis of pharmacogenetic test results, which is challenging due to the amount and complexity of the data.29 Future EHRs should eliminate the non-intuitive and multi-click interfaces and cumbersome data searches of today’s EHRs.30
Technology brings new ethical considerations
Mental health interventions based on AI typically work with algorithms, and algorithms bring ethical issues. Mental health devices or systems that use AI could contain biases that have the potential to harm in unintended ways, such as a data-driven sexist or racist bias.31 This may require investing additional time to explain to patients (and their families) what an algorithm is and how it works in relation to the therapy provided.
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