Every day, clinical social worker Ilana Marcucci-Morris hears her patients’ most private struggles. She has no interest in letting AI software listen in—or take over—her role.
A self-proclaimed millennial and tech enthusiast, Marcucci-Morris accepts that artificial intelligence is becoming a fixture in healthcare. But for therapy, she wants it to be optional and supportive—a tool that enhances human connection rather than replacing it.
Her union, the National Union of Healthcare Workers, proposed contract language last summer that AI would “assist” mental health clinicians but not “replace” them. They expected no resistance: a similar clause had recently been approved for their sister union in Southern California.
Kaiser, however, removed the language in its counterproposal.
“We have asked them point-blank about language to prevent replacing therapists with artificial intelligence, and they have been very clear that they want the ‘flexibility’ to increase AI and reduce their need for us,” Marcucci-Morris said.
The debate reflects a broader concern among American workers: when will AI threaten my job? Health systems are adopting AI to save time and costs, while patients increasingly consult AI chatbots for mental health support. For Kaiser therapists, the abstract question has become real.
“AI is not inherently good or bad. It holds promise, but it isn’t without serious risks,” said Maya Sandalow, associate director for health programs at the Bipartisan Policy Center. “We need to ask, ‘how might this solution improve upon the status quo?’ And the status quo is that we are in a mental health crisis.”
Depression and anxiety rates surged 25% worldwide in 2022, and nearly two-thirds of American youth report regular mental health distress, though fewer than half seek professional help. Access to therapists is limited due to workforce shortages and low reimbursement rates.
Kaiser has faced these pressures for over a decade. California regulators have fined the company twice for long wait times and mandated staffing improvements. Administrators are exploring AI to help therapists spend less time on paperwork and more with patients.
Kaiser declined multiple interview requests but said in a statement that AI tools do not make medical decisions or replace human care. Instead, they “support better diagnostics, enhance patient-clinician relationships, optimize clinicians’ time, and address individual needs.”
Managers told the union they do not “intend” to lay off therapists because of AI, but they refused to commit to this in the contract, citing the need for “flexibility” and leaving options open.
How Kaiser Uses AI in Mental Health Care
Kaiser has piloted AI note-taking technology in exam rooms. These digital scribes record doctor-patient interactions and generate summaries for medical records. Many clinicians welcome the reduction in paperwork, which can take two and a half hours per day.
“It’s called pajama time,” said Jodi Halpern, a UC Berkeley psychiatrist. “Replacing that so human care can grow—I love that idea.”
Yet some clinicians are wary. Concerns include privacy breaches, ethical questions about using therapy transcripts to train AI, and potential patient self-censorship. Marcucci-Morris has declined to use the software, estimating only one in ten patients would consent.
Therapists have asked for a contract clause making digital scribes optional, but Kaiser refused. They also worry about electronic mental health triaging, where patients are routed to care based on online questionnaires. While some patients prefer this, others resent the lack of human interaction.
Brittany Beard, a therapist in Vallejo, was reassigned after Kaiser outsourced triage calls to an e-visit system. “They sell it as accessing care faster, but I’ve seen the opposite,” she said.
Is AI Coming for Your Therapist?
The extent of AI in mental health care will depend partly on patient acceptance. Experts note a “trust gap” between administrators’ enthusiasm and patient concerns. Patients generally support AI that aids diagnosis and treatment but resist full replacement of human interaction.
Use of commercial AI chatbots for mental health has risen sharply. One study found nearly half of users with mental health conditions turn to chatbots for support, with 63% finding the advice helpful. However, professionals question their effectiveness, and lawsuits allege that some chatbots encouraged harmful behaviors.
Evidence-based therapeutic chatbots, like TheraBot, are under development. The FDA is considering how such apps might be regulated, including requiring professional oversight.
Kaiser therapists remain uncertain about their job security. In a recent webinar, AI experts offered mixed reassurances: some said therapists would not be replaced in their lifetimes, while others warned of potential reductions in human interaction, especially among youth who prefer chatbots.
“Ultimately, patients should have choices,” said Merage Ghane, a clinical psychologist. In rural areas or for those with conditions making human interaction difficult, AI could provide valuable options. “The answer is they can be replaced at some point,” she said.
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