On AI and Mental Health: It's Already Here. Are We Ready?
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What are the main promises and perils of AI in mental health care?
Welcome to On the Mind, the official podcast of the Weil Cornell Medicine Department of Psychiatry. I'm your host, Dr. Daniel Knuffelmacher. In each episode, I speak with experts in various aspects of psychiatry, psychotherapy, research, and other important topics on the mind. Today's episode focuses on artificial intelligence and mental health care. A topic I'll admit is not entirely abstract for me. I periodically turn to AI myself, including a specialized chatbot that draws from peer-reviewed literature and finds primary sources that have helped me prepare for this podcast in the past. Not today, I'll admit, but I have used it before to back up the data that I present. That kind of tool represents just one corner of a rapidly expanding landscape.
АІ і з наубінюс та стрімлай клініко документацію. Assist with diagnostic reasoning. And even deliver CBT interventions directly to patients. There's tremendous energy. And tremendous money. Flowing into this space. And with it comes a real tension between two competing impulses. The genuine promise of expanding access to care during a mental health crisis. And entrepreneurial hype. That doesn't always put patience first. Can medicine's oldest obligation First, do no harm, survive contact with an industry that champions rapid change and disruption as virtues. Those who need help are already voting with their thumbs. An article published last week in JAMA Pediatrics found that a fifth of adolescents and young adults in the US now use chatbots for mental health advice.
That's a 50% increase from the year before. Most of them are turning to tools like ChatGPT that are built to help make profits for their companies. На то проводи. evidence based treatment. This is a complex, rapidly evolving topic that demands our attention. I'm very excited to welcome Dr. Drev Coolar to explore AI's promise and peril with me today. doctor Coolar is a hospitalist here at Wild Cornell, where he is an associate professor of population health policy and economics and directs the Center for the Study of Physician, Practice and Leadership. He is also a contributing writer for The New Yorker, where he has written with remarkable clarity and depth about AI's potential impact on medicine and mental health care.
He is simply put one of the best physician writers out there today. Nice to have you on the podcast, Drew.
It's great to be here. Thank you for having me.
So you wear multiple hats, and these are just a few, but you're a clinician, you're a researcher, you're obviously a journalist. How did your career develop into what it is today? And I'm curious what parts were intentional? Were they, you know, maybe filling aspirations that were long held for you or part of plans? Or were some of these things accidental or unexpected.
Well, my dad is a doctor and so as we all know, that's a risk factor for going into medicine yourself. And so I always kind of had the sense that I wanted to go into medicine. I saw the way that he cared for patients, the way that he was able to enter people's lives and the impact that he could have. And I knew very early on that I wanted to do something similar. I wanted to be someone who could be there for people in those moments when they really needed you. But I also had this sense, particularly during college and afterwards, that I wanted to understand the system around healthcare in more detail. You know, I was in medical school when the Affordable Care Act was being debated and passed, and it became very clear both that the healthcare system was troubled in a lot of ways, it was expensive, is inaccessible, it was inconvenient,
But also that it was going to change pretty dramatically, whether because of that legislation or other economic and social forces. And so I ended up taking a year and a half away from medical school. I did three years of medical school. I went to the Kennedy School, which is a public policy school at Harvard, and then came back and finished up my medical school.
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Chapters
8 chapters
1
What are the main promises and perils of AI in mental health care?
0:04–5:09
2
How did Dr. Khullar’s career path shape his view on AI and health policy?
5:09–10:53
3
What did the early New Yorker pieces reveal about AI’s diagnostic potential?
10:53–16:55
4
How might AI‑driven chatbots affect therapeutic relationships and patient attachment?
16:55–24:11
5
What are the risks of cognitive de‑skilling and sycophantic AI in psychiatry?
24:11–30:03
6
How can clinicians use AI as a second‑opinion tool without losing critical reasoning?
30:03–35:16
7
What regulatory and research frameworks are needed to ensure safe AI deployment?
35:16–41:08
8
Which low‑hanging AI applications could reduce waste and improve mental health access right now?
41:08–44:43