Minding the AI: Ethical Challenges and Practice for AI Mental Health Care Tools

Abstract

The use of artificial intelligence (AI) for mental health raises ethical challenges regarding bias, privacy, and potential impact on fiduciary obligations in the therapeutic relationship. Health tools utilizing AI present particular challenges for regulation, both in terms of the technical aspects of evaluating the algorithms and because many of the applications may be used outside of healthcare settings, and thus are outside of the traditional frameworks for regulation of health issues. Bias can enter into AI tools at different stages, such as the data collection and preparation stages, as well as into the way that issues are framed and presented for AI. Addressing bias and fairness in mental health applications of AI is important to avoid results that reflect and reinforce existing social problems and inequality in mental health care. At the same time, AI can present opportunities for addressing existing inequities in mental health care. Protection of patients and other users of mental health AI tools from potential misuse of their health information and potential negative repercussions from sharing their data is another critical area of concern. Finally, AI tools present challenges for the fiduciary obligations generally expected in the therapeutic relationship. It will be necessary to carefully consider likely areas of concern in order to formulate processes for integrating these tools appropriately into mental health care.