Schools can't keep up with teen mental health issues by hiring more psychological counselors, so AI is stepping in as an amplifier.
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In today’s column, I examine the rapidly emerging strategy of employing generative AI and large language models (LLMs) that are customized mental health chatbots to serve as school psychology counselors for teens.
Here’s the deal. There is abundant evidence that teens are increasingly suffering from mental health challenges and well-being difficulties. The traditional avenue for dealing with this disconcerting situation would be to hire specialist counselors trained as therapists and psychologists and station them at the schools for ready access by students. This is a costly and labor-intensive way to contend with the problem at hand.
Given the vast number of teens who are nowadays encountering mental health issues, tossing specialized labor at the matter is simply not realistic. Worse still, spilling the teens over to non-specialists, such as school career and academic guidance counselors, is misguided and makes for double trouble to all parties involved. The question looms as to what can viably be undertaken?
One solution that schools are trying out consists of leveraging the latest LLMs that are tailored for mental health purposes. Students can access the specialized LLMs whenever they wish to do so. The LLMs easily scale to accommodate any number of students. It seems like an ideal way to proceed. To some extent, yes, the use of AI can be quite beneficial, but there are also serious gotchas and limitations that need to be dealt with.
Let’s talk about it.
This analysis of AI breakthroughs is part of my ongoing Forbes column coverage on the latest in AI, including identifying and explaining various impactful AI complexities (see the link here).
As a quick background, I’ve been extensively covering and analyzing a myriad of facets regarding the advent of modern-era AI that produces mental health advice and performs AI-driven therapy. This rising use of AI has principally been spurred by the evolving advances and widespread adoption of generative AI. For an extensive listing of my well over one hundred analyses and postings, see the link here and the link here.
There is little doubt that this is a rapidly developing field and that there are tremendous upsides to be had, but at the same time, regrettably, hidden risks and outright gotchas come into these endeavors, too. I frequently speak up about these pressing matters, including in an appearance on an episode of CBS’s 60 Minutes, see the link here.
I’d like to set the stage on how generative AI and large language models (LLMs) are typically used in an ad hoc way for mental health guidance. Millions upon millions of people are using generative AI as their ongoing advisor on mental health considerations (note that ChatGPT alone has over 900 million weekly active users, a notable proportion of which dip into mental health aspects, see my analysis at the link here). The top-ranked use of contemporary generative AI and LLMs is to consult with the AI on mental health facets; see my coverage at the link here.
This popular usage makes abundant sense. You can access most of the major generative AI systems for nearly free or at a super low cost, doing so anywhere and at any time. Thus, if you have any mental health qualms that you want to chat about, all you need to do is log in to AI and proceed forthwith on a 24/7 basis.
There are significant worries that AI can readily go off the rails or otherwise dispense unsuitable or even egregiously inappropriate mental health advice. Banner headlines in August of this year accompanied the lawsuit filed against OpenAI for their lack of AI safeguards when it came to providing cognitive advisement.
Despite claims by AI makers that they are gradually instituting AI safeguards, there are still a lot of downside risks of the AI doing untoward acts, such as insidiously helping users in co-creating delusions that can lead to self-harm. For my follow-on analysis of details about the OpenAI lawsuit and how AI can foster delusional thinking in humans, see my analysis at the link here. As noted, I have been earnestly predicting that eventually all of the major AI makers will be taken to the woodshed for their paucity of robust AI safeguards.
Today’s generic LLMs, such as ChatGPT, Claude, Gemini, Grok, and others, known as general-purpose AI (GPAI) are not at all akin to the robust capabilities of human therapists. Meanwhile, specialized LLMs are being built to presumably attain similar qualities, referred to as purpose-built AI (PBAI), but they are still primarily in the development and maturation stage. See my coverage at the link here.
Let’s shift gears and focus on the worrisome situation that teens in the U.S. are increasingly experiencing mental health difficulties. After covering that topic, I’ll bring AI back into the picture as a means of coping with the mental health aspects.
How bad is the situation involving teen mental health?
According to the CDC, as per an article entitled “Poor Mental Health Effects Adolescent Well-Being” (posted online November 29, 2024), these are key points to keep in mind (excerpts):
You can plainly see that not only are teens experiencing mental health challenges, but there are also macroscopic ramifications that have long-term adverse consequences. It isn’t just that they are momentarily having mental health issues. The mental health side of the equation can prod them toward drugs and risky behaviors. Furthermore, this might establish a shaky foundation for the rest of their lives.
What happens right now for teens can become a calamitous pattern for their actions as adults.
The place to do something about teen mental health is naturally in our public schools, since that’s where teens are for much of the day. It is akin to the old line about why a robber targets robbing banks; it’s because that’s where the money is. Dealing with mental health issues of teens can be opportunistically undertaken at schools and offers a ready means of access.
According to a 2024 report by the National Center for Education Statistics entitled “Prevalence of Mental Health Services Provided by Public Schools and Limitations in Schools’ Efforts to Provide Mental Health Services” by the U.S. Department of Education, Institute of Education Sciences, these key findings were noted (excerpts):
Observe that there are two primary stages of providing mental health assistance in the schools, consisting of: (1) diagnostic services, and (2) treatment services.
Diagnosis is great, but if there aren’t viable treatment options, the diagnosis doesn’t provide much aid. The hope would be to have a balance of both diagnosis and treatment services and do so to whatever level of need is required at a given school.
Schools might logically group up and try to share their respective mental health resources. This isn’t as straightforward as it seems. Each school gets into a potential tug of war with other schools. As noted by the stats, bigger schools tend to have more such resources in their midst. Smaller schools have less and end up on the low end of the pecking order of trying to lean into the mental health resources of the larger nearby schools.
It is altogether a vexing problem.
This brings us to the advent of modern-era generative AI that can perform a semblance of mental health guidance. Is this a potential solution? Can AI be used to serve as a mental health guidance tool for teens and do so under the auspices of public schools?
If so, it would be nearly a godsend. The cost of using AI is demonstrably lower than using human therapists and mental health professionals. The AI can be used with an almost unlimited number of students. It would be available 24/7. It responds in personalized ways. And so on. Schools would no longer need to cope with complex and unsustainable staffing issues, budgetary requirements would be lowered, and deployment could easily accommodate all school sizes.
Would teens use school-provided AI for this purpose?
First, we need to realize that many millions of teens are likely already tapping into generic generative AI such as ChatGPT, Grok, CoPilot, Gemini, and so on, for their ad hoc mental health advisement. This is usually done under the radar. Their parents don’t know about them doing so. The teachers and schools don’t know about them doing so. In any case, teens generally accept AI as a handy tool.
They are already AI-aware and ready.
Second, it is vital to realize that using generic generative AI for formalized mental health guidance is not a suitable way to proceed. Generic LLMs such as ChatGPT are not specifically set up for mental health advisement. It is merely a byproduct of generic facets, and half-baked at that. Plus, most of the major AI makers stipulate in their online licensing that users aren’t supposed to use the AI for therapy. Of course, very few users abide by the licensing or are completely unaware of the usage stipulations, but the licensing is there anyway.
The gist is that if schools are going to make use of AI for this purpose, it needs to use customized LLMs. Those are devised specifically for mental health usage. They provide features and functions associated with that type of usage. And they provide licensing stipulations that allow for this kind of tailored fitness.
The good news is that students will almost undoubtedly be open-minded to using AI and won’t balk at doing so. They are accustomed to making use of AI overall, such as for homework assistance, and some amount of informal mental health advisement. Getting them to lean into AI for this purpose should be somewhat easygoing.
As with most things in life, there isn’t a free lunch. I mean to say that though using specialized LLMs as school psychological counselors has its upsides, there are plenty of downsides to consider.
One aspect that would certainly be needed is the ability for the schools to have a means of tracking the usage of the specialized LLMs. They would want to know which students are using it. How much time are they making use of the AI? What types of mental health concerns are coming up? What is the AI advising the students to do? Various types of reporting and alerts need to be established.
This is where things start to face a rough patch. Who at the school would be privy to those reports and analyses? Why are they being allowed access? Would they keep it private? What escalation should be undertaken if needed? Would parents also have access to the reporting? It is a quagmire.
The problem will be that the more school access and parent access are permitted, the less likely the teens are to make use of the specialized LLMs. A rampant perception of the LLM as a mental health “snitch” will readily spread. Students will realize that the AI is a Trojan-horse portal into their personal thoughts and concerns. It is presumably a portal that will reveal all to those around them.
What would teens do?
Astutely, they would avoid using the specialized school-provided LLM and would go back to the underground use of generic AI. To make matters more confounding, if the school was dinging students for not avidly using the specialized LLM, the students would figure this out and trick the administrators. They would go into the LLM just to make it seem like they are using it. Everything entered would be apple pie and sunshine. Meanwhile, some other generic AI would be getting the true lowdown.
The aim then would be for schools to derive sensible strategies and implement those strategies when it comes to preserving privacy on the part of students, while still ensuring that the school is on top of what is taking place with the AI. Likewise, proper policies and practices would need to be undertaken for access to reports and alerts by parents and other stakeholders. A myriad of legal and ethical elements need to be worked o
This is not an impossible task. On the other hand, if it is a neglected task, the whole kit-and-kaboodle will be a boondoggle and a waste of school funds and an exasperating and dismal flop.
Let’s cover another twist.
Some vendors of mental health LLMs might claim that schools no longer need any human mental health professionals since the AI can handle everything. Go ahead and release those school psychologists and free up that part of the budget. Use the savings to cover the cost of the AI.
Nope, we aren’t there, not at least currently. Maybe the future could entail advanced AI or artificial general intelligence (AGI) that could fully do the job of a human, but not right now. The better way to think of this is as a mix-and-match of AI usage and human mental health professionals. They need to work hand-in-hand.
The beauty is that the school psychologist can multiply their efforts. AI is doing most of the day-to-day grunt work. The school psychologist steps in when predetermined thresholds are reached or particular adverse situations are detected by the AI. They would also be regularly staying on top of the reporting. There is an important role in discerning what aspects of the AI need to be tuned and what proactive actions can be taken by the school to get ahead of mental health adversities.
There are existing ratios of the recommended number of school psychologists per number of students. We don’t yet know what the ratio is for an AI-amplified school psychologist. Research on this vital nuance is greatly needed.
I’ve got a few more twists to mention and then will do a wrap-up for now.
Public schools are notorious for jumping on bandwagons that end up being a kerfuffle. They invest time and money into what seems practical and useful, but it turns out to be impractical and useless. This especially happens with tech investments. The splashiest way to adopt tech in education is to make a big show of the tech and then drop the ball on implementation and ongoing upkeep. It seems like a cure-all; everyone gets excited, and important people pat themselves on their backs. A few months later, the tech has fallen by the wayside.
Sometimes you can lay this at the feet of the vendor. They sold the school a bill of goods. Other times, you can place this squarely on the shoulders of the school. They wanted a shiny new toy but weren’t willing or cognizant of what it takes to make it work out. Plenty of blame can be handed around.
A crucial heads-up currently is that specialized LLMs that perform bona fide mental health and well-being, and do so on an evidence-based, tested, and reliable basis, are not plentiful. Schemers want in on this huge monetary bonanza and will pull together an LLM that looks pretty and seems stellar, yet it is hollow and endangering. Make sure to mindfully weed out the wheat from the chaff. Involve AI experts in the selection process. Include mental health experts, especially those who know about AI. It takes a village to pick the right AI and ensure that it gets prudently and properly adopted.
Please do not fall into the classic trap of being preoccupied by fancy demos and shiny brochures. The use of AI for the mental well-being of students requires a much more sensible and robust approach.
I am going to be doing a series of postings on the use of AI as a mental health tool for students and schools. I’ll be covering a wide range of topics, including handling of AI hallucinations, privacy of prompts and data contained in the LLM, hacking of the AI, adding of AI safeguards, and so on. Be on the lookout for that valuable coverage.
A final thought to wrap things
It is incontrovertible that we are now amid a grandiose worldwide experiment when it comes to societal mental health. The experiment is that AI is being made available nationally and globally, which is either overtly or insidiously acting to provide mental health guidance of one kind or another. Doing so either at no cost or at a minimal cost. It is available anywhere and at any time, 24/7. We are all the guinea pigs in this wanton experiment.
The reason this is especially tough to consider is that AI has a dual-use effect. Just as AI can be detrimental to mental health, it can also be a huge bolstering force for mental health. A delicate tradeoff must be mindfully managed. Prevent or mitigate the downsides, and meanwhile make the upsides as widely and readily available as possible.
Abraham Lincoln famously made this remark: “The most reliable way to predict the future is to create it.” We are faced with an enormous problem of teens increasingly experiencing mental health issues, undermining their efforts now and potentially dismally reshaping their future. There isn’t enough labor to fix this. AI can be a means of stemming the tide. Schools must consider creating a bright future for teens, rather than simply letting the future happen to them.
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