Can AI improve access to mental health care? Possibly, Stanford psychologist says

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“Hey Siri, am I depressed?” When I posed this question to my iPhone, Siri’s reply was “I can’t really say, Jennifer.” But someday, software programs like Siri or Alexa may be able to talk to patients about their mental health symptoms to assist human therapists.

To learn more, I spoke with Adam Miner, PsyD, an instructor and co-director of Stanford’s Virtual Reality-Immersive Technology Clinic, who is working to improve conversational AI to recognize and respond to health issues.

What do you do as an AI psychologist?

“AI psychology isn’t a new specialty yet, but I do see it as a growing interdisciplinary need. I work to improve mental health access and quality through safe and effective artificial intelligence. I use methods from social science and computer science to answer questions about AI and vulnerable groups who may benefit or be harmed.”

How did you become interested in this field?

“During my training as a clinical psychologist, I had patients who waited years to tell anyone about their problems for many different reasons. I believe the role of a clinician isn’t to blame people who don’t come into the hospital. Instead, we should look for opportunities to provide care when people are ready and willing to ask for it, even if that is through machines.

I was reading research from different fields like communication and computer science and I was struck by the idea that people may confide intimate feelings to computers and be impacted by how computers respond. I started testing different digital assistants, like Siri, to see how they responded to sensitive health questions. The potential for good outcomes — as well as bad — quickly came into focus.”

Why is technology needed to assess the mental health of patients?

“We have a mental health crisis and existing barriers to care — like social stigma, cost and treatment access. Technology, specifically AI, has been called on to help. The big hope is that AI-based systems, unlike human clinicians, would never get tired, be available wherever and whenever the patient needs and know more than any human could ever know.

However, we need to avoid inflated expectations. There are real risks around privacy, ineffective care and worsening disparities for vulnerable populations. There’s a lot of excitement, but also a gap in knowledge. We don’t yet fully understand all the complexities of human–AI interactions.

People may not feel judged when they talk to a machine the same way they do when they talk to a human — the conversation may feel more private. But it may in fact be more public because information could be shared in unexpected ways or with unintended parties, such as advertisers or insurance companies.”

What are you hoping to accomplish with AI?

“If successful, AI could help improve access in three key ways. First, it could reach people who aren’t accessing traditional, clinic-based care for financial, geographic or other reasons like social anxiety. Second, it could help create a ‘learning healthcare system’ in which patient data is used to improve evidence-based care and clinician training.

Lastly, I have an ethical duty to practice culturally sensitive care as a licensed clinical psychologist. But a patient might use a word to describe anxiety that I don’t know and I might miss the symptom. AI, if designed well, could recognize cultural idioms of distress or speak multiple languages better than I ever will. But AI isn’t magic. We’ll need to thoughtfully design and train AI to do well with different genders, ethnicities, races and ages to prevent further marginalizing vulnerable groups.

If AI could help with diagnostic assessments, it might allow people to access care who otherwise wouldn’t. This may help avoid downstream health emergencies like suicide.”

How long until AI is used in the clinic?

“I hesitate to give any timeline, as AI can mean so many different things. But a few key challenges need to be addressed before wide deployment, including the privacy issues, the impact of AI-mediated communications on clinician-patient relationships and the inclusion of cultural respect.

The clinician–patient relationship is often overlooked when imagining a future with AI. We know from research that people can feel an emotional connection to health-focused conversational AI. What we don’t know is whether this will strengthen or weaken the patient-clinician relationship, which is central to both patient care and a clinician’s sense of self. If patients lose trust in mental health providers, it will cause real and lasting harm.”

This is a reposting of my Scope blog story, courtesy of Stanford School of Medicine.

Awe, anxiety, joy: Researchers identify 27 categories for human emotions

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Scores of words describe the wide range of emotions we experience. And as we grasp for words to describe our feelings, scientists are similarly struggling to comprehend how our brain processes and connects these feelings.

Now, a new study from the University of California, Berkeley challenges the assumptions traditionally made in the science of emotion. It was published recently in the Proceedings of the National Academy of Sciences.

Past research has generally categorized all emotions into six to 12 groups, such as happiness, sadness, anger, fear, surprise and disgust. However, the Berkeley researchers identified 27 distinct categories of emotions.

They asked a diverse group of over 850 men and women to view a random sampling of 2185 short, silent videos that depicted a wide range of emotional situations — including births, endearing animals, natural beauty, vomit, warfare and natural disasters, to name just a few. The participants reported their emotional response after each video — using a variety of techniques, including independently naming their emotions or ranking the degree they felt 34 specific emotions. The researchers analyzed these responses using statistical modeling.

The results showed that participants generally had a similar emotional response to each of the videos, and these responses could be categorized into 27 distinct groups of emotions. The team also organized and mapped the emotional responses for all the videos, using a particular color for each of the 27 categories. They created an interactive map that includes links to the video clips and lists their emotional scores.

“We sought to shed light on the full palette of emotions that color our inner world,” said lead author Alan Cowen, a graduate student in neuroscience at the UC Berkeley, in a recent news release.

In addition, the new study refuted the traditional view that emotional categories were entirely distinct islands. Instead, they found many categories to be linked by fuzzy boundaries. For example, there are smooth gradients between emotions like awe and peacefulness, they said.

Cowen explained in the release:

“We don’t get finite clusters of emotions in the map because everything is interconnected. Emotional experiences are so much richer and more nuanced than previously thought.

Our hope is that our findings will help other scientists and engineers more precisely capture the emotional states that underlie moods, brain activity and expressive signals, leading to improved psychiatric treatments, an understanding of the brain basis of emotion and technology responsive to our emotional needs.”

The team hopes to expand their research to include other types of stimuli such as music, as well as participants from a wider range of cultures using languages other than English.

This is a reposting of my Scope blog story, courtesy of Stanford School of Medicine.

Mindset about personal activity correlated with lifespan, new Stanford research shows

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The mind is a powerful thing — a simple thought can have an immediate physiological effect. For instance, just thinking about something stressful can make you sweat or increase your heart rate.

Now, Stanford researchers have found that mindsets about exercise can influence health and longevity. Namely, people that think they are less active than their peers tend to have shorter life spans, even if their activity levels are similar.

“Our findings fall in line with a growing body of research suggesting that our mindsets — in this case, beliefs about how much exercise we are getting relative to others — can play a crucial role in our health,” said Alia Crum, PhD, an assistant professor of psychology at Stanford, in a recent Stanford news release.

As outlined in a paper in Health Psychology, the researchers analyzed surveys from more than 61,000 U.S. adults from three national databases, which documented participants’ health, physical activity levels and personal demographics. The research team focused on the question: “Would you say that you are physically more active, less active, or about as active as other persons your age?”

Using statistical models to control for factors like physical activity, age, body mass index and chronic illnesses, they then correlated the results with death records. The researchers found that people who thought they were less active than their peers were up to 71 percent more likely to die during the follow-up period (of up to 21 years) than those who perceived themselves as more active — even when both groups had similar activity levels.

A possible explanation suggested by the researchers is that perception can positively or negatively affect motivation. People who see themselves as unfit are more likely to remain inactive, which then increases their feelings of stress and depression to reinforce the negative cycle.

Although the research identifies a correlation between perceived amounts of exercise and health outcomes, it does not show that perceptions of inactivity cause an earlier death. However, it suggests that Americans should feel good about the healthy activities that they do every day — such as taking the stairs, walking or biking to work, or cleaning the house — instead of only valuing vigorous exercise at a gym, the authors said.

“It’s time that we start taking the role of mindset in health more seriously,” Crum said in the release. “In the pursuit of health and longevity, it is important to adopt not only healthy behaviors, but also healthy thoughts.”

This is a reposting of my Scope blog story, courtesy of Stanford School of Medicine.