The general tools do too, and John Torous, the Beth Israel psychiatrist I referred to earlier, thinks the ones those models are putting in place are just as good.

There's some evidence that these bigger models have become so big, they've learnt so much, they've read so much, they can reason better that they may be able to offer the same level if not better level of help.

Given that the larger companies have been under a lot of lawsuits and challenges for prior harms, I think there's a lot of changes that have been made.

He says there's lots of data now that show that AI tools both intended for mental health and not are getting pretty good at addressing type one harms.

Type two harm i- is different.

It's where you develop a relationship with the chatbot.

It grows over time.

It's more insidious.

Okay, but they are called prescription, so does someone actually need a prescription from a doctor to utilize one of these? Because, for example, you don't need a prescription from a doctor to buy tampons or novelty contacts.

Yeah.

In some ways it's like, it's just interesting to say can you even-- if you go ask a physician, "Can you prescribe me one of these apps?" It's not even clear how you actually prescribe them.

It's like w- we haven't actually built the infrastructure of how to prescribe them, and my sense is every major insurer, I'm usually not pro-insurance per se, but, like, I don't think they cover them because what they said is they don't seem to have evidence that they actually work.

A- and again, you say, "Well, they're FDA cleared.

How could that be?" When you're a class two medical device, you have to have a very low bar of evidence.

When you-- we called a prescription digital therapeutic, we're kind of inflating it with these kind of high-quality, double-blinded, multiple drug studies that you have to do.

Their website again is ADAA.org. That's ADAA.org. [upbeat music] And we're back with Dr. John Torous and Dr. Michelle Patrick Win.

Mi pregunta para ti, que podría resultar provocadora, es la siguiente: ¿llegará la IA en un futuro próximo a sustituir tanto a psiquiatras y psicólogos como también a los líderes espirituales? [risas]

Creo que cuando estaba haciendo mi formación en informática clínica en el Beth Israel, había un doctor médico muy famoso llamado Warner Slack.

Desafortunadamente, ya falleció.

Pero Warner Slack fue uno de los primeros médicos del Beth Israel en trabajar con historias clínicas electrónicas en los años setenta y ochenta, y tenía una cita muy famosa.

Él dijo: «Cualquier médico que pueda ser sustituido por una computadora debería de serlo».

Y por supuesto, ningún médico que yo haya conocido ha sido sustituido por una computadora.

Pero creo que lo que nos quería decir era que vamos a tener que evolucionar lo que es la práctica de la medicina, la psiquiatría y la espiritualidad.

Creo que John colabora con la FDA.

It also could be their therapist or psychiatrist.

I think...

The key to all health, physical and mental health, is good relationships.

There's been, I think it's the Harvard Happiness Study that's kind of followed people for almost 50 years.

It was like, what makes people happy and have fulfilling lives? It's relationships.

That's what it comes down to.

It's not money.

Anything else that you're working on right now or kind of looking at to focus on in the coming year or years?

It also could be their therapist or psychiatrist.

I think...

The key to all health, physical and mental health, is good relationships.

There's been, I think it's the Harvard Happiness Study that's kind of followed people for almost 50 years.

It was like, what makes people happy and have fulfilling lives? It's relationships.

That's what it comes down to.

It's not money.

Anything else that you're working on right now or kind of looking at to focus on in the coming year or years?

So my question to you, which could be a provocative one, will AI sometime in the near future replace both psychiatrist, psychologists, and spiritual leaders? [laughing] So this is the question.

I think when I was doing my clinical informatics training at Beth Israel, there was a very famous doctor called Dr. Warner Slack.

He unfortunately passed away.

But Warner Slack was one of the first physicians at Beth Israel to be working on electronic medical records in the seventies and eighties, and he had a very famous quote.

He said, "Any doctor who can be replaced by a computer should be." A-a-and of course, no doctor I've ever known has been replaced by a computer.

But I, I think what he was telling us with that is we're going to have to evolve what the practice of medicine, psychiatry, spirituality is.

We're, we're going to figure out ways to hopefully, in a good sense, reach more people, improve the quality of care.

[laughing]

How do you, how do you reconcile their, their disconnect? And, and can both things be true at the same time?

I, I think they both can be true, 'cause what Holly said was, again, users need to know what they're using.

So i- if you're making a medical claim versus a wellness claim, there's a very clear line in the sand, and there's nothing wrong with giving everyone access to a wellness tool.

If everyone wants to try meditation or mindfulness and finds it's helpful, that is terrific, and, and we can celebrate that.

But there's a big difference if you now claim your wellness tool is a medical tool.

And, and as you heard, there's no clear...

I- it's unclear what you're actually getting.

But if you have some familiarity with a therapy bot, but you don't have a therapist, and then you e- experience an extreme mental health crisis or something that needs that crossover, do you know not to use something you've been accustomed to using? Do you know what I mean? I, I, I just wonder that people don't necessarily know how to make that distinction when they're going through a, a crisis themselves.

But I want to sort of bring it back to, uh, diagnostics.

So the diagnostic side is still improving and, and learning as well.

What it really will be able to do is give us a more holistic picture of how our sleep, our exercise, our physiology, our diet, our environments impact our mental health.

So it's not only that we'll, say, have a diagnosis of what condition may be happening in the brain, but we understand what are the triggers and what are the risk factors that we wanna target in care to make people better quicker.

But what's interesting is in the summer and fall, both Apple and Google, again, not usually considered health companies, put out blog posts or pre-print papers, so they, they weren't peer reviewed.

But it's interesting, so what are Apple and kind of Google both doing, talking about? And what they said is, "Look, we have access to all of this rich sensor data.

People are wearing our wearables.

... an analysis on, on one patient, you know?