As hospitals work to integrate artificial intelligence into mental health care, some frontline clinicians say the technology is creating a troubling new barrier to treatment.
Instead of quickly reaching a licensed professional, patients in crisis can end up navigating apps, automated systems, and call centers first.
In California, the debate has moved beyond internal worker complaints and is increasingly drawing attention from both unions and state lawmakers.
Here's what to know
More than a dozen therapists, clinicians, academic experts, and advocates in California and Wisconsin — including mental health workers at Kaiser Permanente in Northern California and Rogers Behavioral Health in Wisconsin — told Capital & Main that AI-supported triage and intake systems are contributing to delays, inappropriate placements, and missed warning signs for patients with serious conditions.
Harimandir Khalsa, a Kaiser Permanente triage clinician in Walnut Creek, said staffing in her department has declined while automated and algorithmic systems have taken on a larger share of the work.
"What has increased is frustration. Sometimes people are like, 'I've been sent all over the place,'" Khalsa said, per Capital & Main.
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Other clinicians described similar experiences. Melissa Stevens, a clinical psychologist at Kaiser in Northern California, said some patients in need of psychiatric care were never contacted or were steered into lower-level group programs.
"It's getting dismissed by whatever their filtering system is until I actually pick up a phone and call a human," she said, per Capital & Main.
Kaiser and Rogers disputed the idea that AI is replacing clinicians. According to Capital & Main, Kathleen Chambers, a Kaiser spokesperson, said, "Clinical assessments, triage, and treatment decisions are made by licensed clinicians, and any technology we use is designed to support — not replace — clinical judgment."
More background
Workers say the stakes can be especially high in mental health care, where even short delays may quickly turn into emergencies.
Khalsa said she has seen a "delay of sometimes weeks with this new triage system or where self-harming or a prior suicide attempt has been missed."
Ilana Marcucci-Morris, a Kaiser therapist in Oakland, said intake systems that rely heavily on technology can be especially difficult for people with depression, who may already struggle with motivation and follow-through.
"Now the onus is on the patients to be their own care coordinators," she said, per Capital & Main.
What's being done?
Labor and government officials are pushing for safeguards.
In California, Assembly Bill 2575 would protect health care workers who overrule AI suggestions, require more transparency about AI use, and place liability on developers and facilities when patients are harmed. Another proposal, AB 1979, would prohibit clinical decisions based solely on AI output.
Unions are also trying to make AI oversight and limits part of contract negotiations.
The National Union of Healthcare Workers said Kaiser has refused contract language stating that AI "is not to replace but to assist" employees in providing safe care.
In Wisconsin, Rogers workers voted 54-4 to join the same union, with transparency around AI among the concerns raised.
Some experts say AI can still play a useful role if humans remain firmly in control. Leanna Fortunato, a clinical psychologist and the American Psychological Association's director of digital health and innovation, said, "Ultimately, AI tools are just that: They're tools," per Capital & Main.
"Therapy works because you build a relationship with your therapist," said Kate Zolandz, a former Rogers therapist, per Capital & Main. "AI can't build that connection in the same way that an actual human being can."
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