AI Overdiagnoses Mental Health Conditions
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What is the main topic discussed in this episode?
The Last Show with David Cooper. Procrastinate your life away with us. A lot of people type to AI chatbots if they're depressed, anxious, feeling broken, using them for mental health, for therapy. But be careful. It turns out these bots are a little over-eager when it comes to diagnosing you. They're likely to tell you you have a disorder that you don't. So what happens when these machines play therapist? Well, that's what we're about to discuss with AI and mental health researcher at the University of California, San Francisco, Dr. Karthik V. Sarma. Karthik, welcome to the show. Thanks so much for having me, David.
What is the main concern with AI chatbots in mental health?
I have reported on and I've heard read articles and heard stories of people using things like ChatGPT as therapists. At first, it's a little concerning and then it's a little uplifting knowing that people who wouldn't normally have access to therapists are using it. I don't really know what to make of it. Let's start here. How often are people using these tools to get mental health advice?
It depends a little bit on who you ask. There have been a number of different studies that have tried to evaluate that. OpenAI actually recently released a blog post where they talk about the subject a little bit. I would say, though, in my experience as a psychiatrist, a pretty high proportion of my patients have consulted Chachapiti or something like it about the mental health. If I had to peg it, I'd say probably 60, 70% of the patients who I've seen have at least once consulted Chachapiti about what's going on.
That is wild. What kind of questions are people asking? Are they mundane? Just sort of like, what's your opinion on this? Or are they really heavy things?
I think all of the above. I have patients who've told me they've talked to Chachapiti about their medications. Like, oh, I'm not feeling well. Could this be a side effect? They asked Chachapiti. I've had patients who... are really worried about their health, something specific about their health, and they ask Chachapiti, hey, I'm having this, is it okay? Perhaps more concerningly, I have patients who have this concern and they ask Chachapiti the same question five, six, eight times a day. Every time Chachapiti says, no, no, it's going to be okay, and they feel reassured, which in the moment is great, but I think as a long-term solution, I worry about. And I do know people who have really deep, in-depth conversations with Chachapiti, patients who
We'll bare their souls. We'll talk about what's going on. And maybe more concerning, some people who will essentially treat it like a therapist.
I have had this problem in therapy where I sort of over-pathologize myself. I have a distracted day. Then I think I have ADHD. I have a normal day where I'm a little sad. Maybe I cry. I therefore have major depression. I think we all can fall victim to over-pathologizing, to taking normal everyday things that happen in our lives and then assuming we have this like diagnosable disorder. Yeah. Let's talk about what happens when chatbots do that. If I describe some symptoms, intermittent ones, temporary ones, to ChatGPT, do you find that it's likely to tell me I have clinical depression when I may not?
It's a good question. And I think at least there's a risk of that. Now, I should say what ChatGPT does changes every time they change the model. It changes everything. So every big generation, like the Track 55, Track 54, it changes. But even within one generation, they do constantly make refinements. And OpenAI has said that they're really working hard to try to make sure the way that interacts with these subjects is safe. But in my experience, I do worry about this possibility that... If what you're doing is you're having some symptoms, you're telling ChatGPT about it, that there's a risk that ChatGPT is going to tell you either, hey, nothing's wrong when something is wrong, or hey, something is wrong when, in fact, actually this is a normal aspect of life.
What are some examples of that?
How prevalent is the use of AI chatbots for mental health advice?
Like, for example, if someone in my family passes and I cry for a few days, that doesn't mean I have major depression.
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