Artificial Intelligence and Psychiatry One Year Later

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

The first prediction I made a year ago, on March 20, 2023, was in the column “Artificial Psychiatry: Social Psychiatric Prediction #1.” At that time, the use of artificial intelligence (AI) was exploding in society. Chat GPT caught the attention of the public and some psychiatrists like our own former editor, Ronald W. Pies, MD, as is evident in his piece for Psychiatric Times on June 12, 2023, “Conversations with Artificial Intelligence: Mental Health vs Machine.” So, it was not hard or risky to put AI at the top of my list of future predictions.

Back then, I concluded that AI would influence psychiatry as such:

“ . . .those psychiatrists who will flourish the most will be those who are both adept enough at the technology and radiate what is irreplaceable in our caring and healing humanity.”

Last month, my Rabbi son confirmed the importance of AI and psychiatry by recommending to me:

“You need to start writing about AI. It is going to transform the world, in the same way the internet did. Huge mental health implications.”

Those changes are just emerging. One colleague related how it is beginning to influence education. An AI-generated humanoid can be the instructor, and a company named Synthesis offers over 100 avatar images that can be chosen as the instructor. Robots are becoming available for all types of relationships with humans. The artist Laurie Anderson has even used AI to help with her grieving of her late husband, the rock icon Lou Reed, by conflating his work so that Laurie could then ask the algorithmic version of Reed questions.

AI would seem to have great psychiatric potential in understanding and diagnosing due to its pattern recognition ability. However, it can also be inaccurate and biased like humans, in large part because it uses our available knowledge, and that knowledge can also be slanted in certain directions by programmers. For instance, it can be biased in its coding, such as its image-generation, as discussed in the February 27, 2024, Washington Post article, “Female popes? Google’s amusing AI bias underscores a serious problem.”¹ On the one hand, that image cultural biasing can look like the diverse casting of the popular musical “Hamilton,” but it has a different implication when the AI product refuses to create images of any all-White groups, even in response to the direction of “draw a picture of Nazis.” Hallucinations can also occur, though AI hallucinations are different than psychiatric ones. They are confabulated outputs which can have disastrous consequences in medicine.

For sure, my IT knowledge is very limited, but I felt like I was going into an Alice in Wonderland rabbit hole of information as I explored the benefits and adverse effects of our evolving AI. Because of its potential for both benefits and harms, there is both optimism and anxiety about AI. In the new movie “Dune: Part Two” that we have been discussing, for the presumed benefits of humans, AI and computers were eliminated in a war. Will we need to eventually do something like that? Can AI be harnessed to augment our intelligence without the risk of distorting the information or of taking over?

Perhaps fortunately, AI has seemed to be applied slowly in psychiatry.² That pace would seem to fit the Slow Thought manifest that Vincenzo Di Nicola has presented well before the recent explosion of AI.³

How about you? Have you used AI in your clinical practice, research, or administration? If so, I would love to hear about your experience.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.

References

1. McArdle M. Female popes? Google’s amusing AI bias underscores a serious problem. Washington Post. February 27, 2024. Accessed March 19, 2024. https://www.washingtonpost.com/opinions/2024/02/27/google-gemini-bias-race-politics/

2. Asbach M, Menon R, Long M. AI in psychiatry: changing the Landscape of mental health care. Psychiatric Times. 2024;41(3):15-17.

3. Di Nicola V. Slow Thought: a manifesto. Aeon. February 27, 2018. Accessed March 19, 2024. https://aeon.co/essays/take-your-time-the-seven-pillars-of-a-slow-thought-manifesto