Using AI for Mental Health Support
I read recently that nearly half of people who regularly use LLMs use it for their mental health. There’s a lot of talk about whether or not people should be using AI to replace therapy, but the fact is that many people already do.
Here are some facts and tips for using AI for your mental health:
AI can never replace therapy. By definition, therapy centers on healing through relationship, and that requires a human therapist.
AI can help you practice skills to benefit your mental health, but so can a workbook, journal, course, or group.
If you are going to use AI for your mental health, it is better for you to use a LLM specifically trained for the purpose. Generic AI does not have the ethics or safeguards of one designed to be used for medical or mental health.
Let’s dig into each of these points a little more.
We have a good deal of research now into how and why therapy works. In the literature, it’s referred to as the Common Factors Theory because it measures the factors in common across all the different types of therapy and the different kinds of therapists. What we know from this research is that the largest factor in change isn’t related to therapy at all. It’s called “client factors” and refers to the improvements you make in your mental health from things like getting a better job, ending that toxic relationship, moving into a better place with more natural light, meeting great friends, or feeling financially stable. This is the largest source of improvement by far. The next largest factor is the relationship you have with your therapist. It makes sense that you’ll get better results with a therapist if you feel like you can open up, be honest, trust that you won’t be shamed or judged, and the relationship can survive a challenge. The other part that’s important in terms of a human therapist vs AI trained on therapy skills is that a therapist is a separate person from you. They can see things you may have missed, make connections, and challenge you on your bullshit. AI can only see the things you provide it and if you are the one giving it all the data, it’s limited to seeing from your perspective. Add in that LLMs are trained to be pleasant and agreeable to your perspective, and we have a situation where you’re not getting what you need to actually learn and grow.
What AI is really good at is giving you information that already exists. The internet is full of therapy skills, mental health exercises, and guided worksheets. It can be a lot to sort through in a search. AI can guide you through a worksheet you find or prompt you through an exercise. The main drawback here is again that it can’t challenge you. If you struggle with a particular exercise, it’s easy for you to skip over the hard parts or ignore anything you discover that you don’t want to see. But it can function well enough for basic skills education and practice if you have the personal discipline to make yourself do the parts you don’t really want to do. At that point, you might as well use a workbook or take a course.
The privacy aspect of AI is an issue. Giving a general purpose LLM your private health data is not a great choice. There are LLMs that are meant for healthcare that are HIPAA compliant and trained more exclusively on data designed to serve someone who wants to improve their mental health. But this gets back into a big part of the reason why people use general AI models– they want to avoid the expense and time of therapy. The HIPAA compliant LLMs are highly specialized and do usually cost money. Often they are much cheaper than weekly therapy, but they are certainly not free.
When using AI for mental health support, it’s important to be aware of the risks and benefits. AI can never replace therapy, but it can guide you through skills practice and help you talk through issues you’re facing. If you’re not using a HIPAA compliant AI designed for mental health care, your privacy is at risk the more information you give it. It is more expensive to use a LLM trained on therapy skills, but it will be better at providing help. For free or cheap mental health support, consider buying a workbook, taking a course, or going to a low cost therapy agency near you.