FOR MANY, the nearest therapist these days isn’t someone sitting across from them in a room but a friendly face on the other side of a Zoom, or even a chat thread on a smartphone. In a quantum leap beyond those types of virtual encounters, increasingly, the entity offering mental health advice may not even be a human.
Chat-based mental health services boomed during the pandemic, several of them using generative artificial intelligence chatbots to converse about mental health and offer virtual companionship. If that technology starts to make its way into professionally licensed mental health areas, Rep. Josh Cutler has filed legislation to make sure the usage is regulated and disclosed. And he had an unusual collaborator in that mission – his bill was co-written by the generative app ChatGPT.
The Pembroke Democrat knows it’s a little gimmicky. Coverage of the bill’s introduction understandably focused on the irony of asking an artificial intelligence to help regulate itself.
“The ChatGPT writing of the bill is a part of it that I think was kind of a ‘gee whiz shiny object’ kind of thing,” Cutler said. “I think the bill itself, what it’s trying to do, is more substantive, and I think necessary. I chose behavioral health, but what I hope will happen is that we’ll advance this and really take a look at AI in all facets of policy.”
State Sen. Barry Finegold also put forth a ChatGPT-authored bill with a broader brief, but Cutler sees AI mental health services as a creeping concern that has not yet broken into the wider medical field.
“I think it’s all the more reason to do it now,” he said. “Take a look at it proactively, prescriptively, and make sure we have some basic guardrails in place.”
The bill, now before the Committee on Mental Health, Substance Use and Recovery, isn’t a mandate against using AI, he notes. Rather, it sets up some basic approval processes for introducing artificial intelligence into mental health services and rules to make sure that patient privacy and choice are protected.
Other states are beginning to mull similar legislation. Texas legislators were considering a bill that would regulate offering mental health care using artificial intelligence earlier this year.
Artificial intelligence in medical fields is still an emerging subject. Researchers recently laid out possible chatbot applications for medical use in the New England Journal of Medicine. The authors, who are affiliated with the creators of ChatGPT’s most recent version, GPT-4, concluded that even with information only provided through internet databases as opposed to privately restricted health data, the chatbot systems showed “varying degrees of competence” in scenario-based tests.
The three tests targeted using AI in assisting with medical note-taking, the kind of innate medical knowledge a practitioner would need to pass the United States Medical Licensing Examination, and a basic level of patient consultation.
“Although we have found GPT-4 to be extremely powerful, it also has important limitations,” they wrote. It can catch human errors but also introduce new errors through mistakes known as “hallucinations,” and “such errors can be particularly dangerous in medical scenarios because the errors or falsehoods can be subtle and are often stated by the chatbot in such a convincing manner that the person making the query may be convinced of its veracity.”
AI is already being used in places to analyze medical images, flag possible adverse drug interactions, identify high-risk patients, and code medical notes. But mental health care is a delicate subject, and some go to GPT as a potential source of emotional support even though it is explicitly not recommended for that use.
Cutler’s bill requires informing patients if they are being treated by AI, a timely concern as individuals seeking mental health services increasingly turn to telehealth and chat services for support amid a counselor shortage. Earlier this year, the emotional support chat service Koko drew the ire of academics and legal experts when its founder announced about 4,000 people got responses from the app that were at least partially written by a GPT chatbot without disclosing the full role of the AI.
“I consider myself a technology guy, and I’m open minded about these things,” Cutler said. “But I’m also concerned about making sure that we have proper guardrails for this kind of technology. If we look at some of the things in the past with the internet, we haven’t always been ahead of the curve with them. And so I think it’s important that we do try to be as much as we can ahead of the curve with AI.”
JENNIFER SMITH
FROM COMMONWEALTH
All aboard: The House got on board with Gov. Maura Healey and the Senate in supporting a market-rate housing program, voting nearly unanimously to provide additional tax credits in a supplemental spending bill.
– The House vote means Healey, the House, and the Senate are now on the same page in regard to the Housing Development Incentive Program, but they are using different legislative vehicles. The Senate included an expansion of the program in its tax plan, as did Healey, while the House chose not to include tax credits in its tax plan, opting instead on Thursday to include the tax credits in the spending bill. The move by the House means the Legislature can now bolster the Housing Development Incentive Program through the spending bill or the tax plan.
– The House lifted the annual cap on the program from $10 million to $30 million and authorized up to $57 million in one-time credits to address a backlog of projects. Read more.
OPINION
Millionaire tax: Colin Jones of the left-leaning Massachusetts Budget and Policy Center calls a technical foul on NBA player Grant Williams for becoming a pawn in the fight over the millionaire tax. Williams is moving from the Boston Celtics to the Dallas Mavericks, receiving $54 million over four years, and indicated the millionaire tax in Massachusetts was a factor in his thinking. Read more.
FROM AROUND THE WEB
BEACON HILL
A State House rally pushed for bills that would raise salaries and benefits for child care workers and educators while also providing a stable funding source for grants and other incentives and supports for providers. (Worcester Telegram)
MUNICIPAL MATTERS
Boston Mayor Michelle Wu’s office has shared with Boston police a list of the mayor’s most vocal critics, citing security concerns raised by those who have dogged Wu repeatedly at public events. (Boston Herald)
Embattled Boston City Councilor Kendra Lara, already facing a slew of charges related to crashing into a Jamaica Plain house while driving without a license, is now also the subject of a residency challenge questioning where she lives. (Boston Herald)
WASHINGTON/NATIONAL/INTERNATIONAL
Vice President Kamala Harris will deliver the keynote address at the upcoming national NAACP convention in Boston. (Boston Herald)
ELECTIONS
Salem is exploring the use of ranked choice voting in its elections. (Salem News)
BUSINESS/ECONOMY
Owners of a Springfield learning center are frustrated that their application for ARPA funds was denied with no explanation while millions went to outdoor dining programs. (MassLive)
TRANSPORTATION
Another day of woes for MBTA riders, as the undercarriage of a Red Line car caught fire at Charles/MGH Station. (Boston Globe)
Massachusetts driver’s licenses issued to undocumented residents will be valid in Florida despite a new Florida law suggesting otherwise. (State House News Service)
A $1.4 billion transportation improvement plan for the Cape has drawn minimal public participation, despite major proposed changes to bridges and roadways. (Cape Cod Times)
ENERGY/ENVIRONMENT
Glass containers are not always recycled the way you think. (WBUR)
CRIMINAL JUSTICE/COURTS
A 12-year-old boy was shot to death yesterday afternoon inside a Mattapan apartment, and a 22-year-old man was later arrested on charges related to improper storage of a firearm. (Boston Globe)