A Letter from the President of the American Ƶ
As a former college president in the rural area of Middlebury, Vermont, my experience of the precarious state of mental health for young people in our country is real. On the one hand, students often feel that they lack the skills and resources to make meaningful in-person connections. They frequently turn to AI-generated forms of connecting, which leads them further away from the actual in-person company of their peers. On the other hand, many students report that AI tools help them practice being in community and interacting with people in a way that lets them build an authentic self—a key task for young adults.
The mental health concerns of adults in the community are also real and include the daily pressures of childrearing, work, and eldercare. Adults also struggle in rural communities, where maintaining and staffing adequate mental health facilities are ongoing challenges. AI tools can provide a bridge when underfunded systems might falter.
From these communities, I have learned that AI-generated mental health tools cannot provide magic bullets for adaptation in a difficult world, nor can they substitute entirely for human connection. If they are solidly grounded in face-to-face realities, however, these tools can help people practice being resilient in an often inhumane world.
What I have also come to understand is that while mental health challenges may at times feel isolating, they cut across age, geography, and identity. Even with its unique New England flavor, Middlebury is no different than most places in America. Its challenges reflect a broader pattern in American cultural life that has resulted in an expanded and increasingly accessible public discourse around mental health.
The systems surrounding care, connection, and well-being, however, have not kept pace. This discrepancy invites a broader public responsibility: to bring forth our collective ingenuity and empathy and confront one of the defining challenges of our time. The AI and Mental Health Care project at the American Ƶ of Arts and Sciences responds to this calling with a commitment to inquiry and collaboration.
We find ourselves in a period of extraordinary technological advancement. Artificial intelligence and other digital tools are already redefining how we live, work, and connect with others. Some of these advances are poised to reshape how we seek care, particularly in the face of provider shortages and unequal access to care. Others raise pressing questions about equity, safety, and the limits of machine-driven empathy. What remains undetermined is not whether these tools will play a role in the future of mental health care; they already do. Rather, the question is whether they will do so in ethical, inclusive, and effective ways.
To interrogate these complexities is the work of scholarship and thus the work of the Ƶ. As we considered how best to engage in these efforts, we turned to one of our core values: Fostering Deliberative Discourse. Respectful discussion in the face of disagreement is a foundational principle of our democracy and of the Ƶ, one that shaped both our committee’s composition and this report’s format. Rather than seeking consensus or a singular vision, we invited a wide range of experts to respond to a shared set of questions. The result is not an argument about the utilization of AI in mental health care but a scholarly conversation that reflects the breadth of disciplines, experiences, and perspectives gathered around the table. We invite you, as you read this report, to join us in an active discussion examining this important issue at the intersection of care and technology.
The choice of the dialogical genre for this publication is intentional. Because no clear consensus or agreed paradigm has emerged concerning AI and the right approaches to AI and mental health, we felt it was more straightforward to use a genre that is often the beginning of scientific inquiry: question and debate, or the dialogue. Plato used dialogue in his philosophical teaching. Philosopher David Hume used dialogue in what he thought of as a scientific investigation into human experience. And beyond science, Samuel Taylor Coleridge’s “conversational poems” have a lasting fascination, as do many dialogical poems in literature around the world. What philosopher Mikhail Bakhtin called “dialogical reasoning” is an intellectually honest way of showing the vibrancy of the debate. Combined with the authors’ thoughts on future research in AI and mental health, such a conversational genre implicitly moves us toward the future.
This document does not aim to resolve every uncertainty. Instead, it offers the foundations of a scholarly agenda that can guide future researchers, policymakers, and practitioners as they navigate this emerging terrain. The most powerful ideas often come from relationships developed across boundaries, whether they be boundaries of field, institution, or lived experience. Through this shared inquiry, we can build the collaborative tools and understanding needed to meet the challenges ahead.
This process is at the heart of what makes the Ƶ unique. Our work seeks to advance the nation’s culture of science and discovery by bridging the social sciences and arts with the physical sciences. Among the Ƶ’s many contributions to the nation’s intellectual life is our history of facilitating scholarship and dialogue centered on emerging issues. For a century, the Ƶ discussed just how light traveled, assuming it required a medium—“luminiferous ether.” The Ƶ eventually backed Albert A. Michelson, awarding him the Rumford Prize in 1888 and funding his research. Though the Michelson–Morley experiment’s null results were initially seen as failures, Albert Einstein’s special relativity later revealed they were actually proof: light’s speed is constant. Nearly a century later, our AI and mental health care work is rooted in the same tradition of bringing together scholars in the social sciences, arts, and physical sciences to consider timely and complex issues from an array of perspectives.
I am deeply grateful to the members of this project for their wisdom, candor, and willingness to tolerate discomfort in order to foster important new connections. I thank the cochairs, Paul Dagum, Sherry Glied, and Alan Leshner, whose steady guidance and insight shaped every stage of this work. I also deeply appreciate the steering committee, whose diverse expertise and ongoing thoughtful contributions gave this project depth. And I thank the Ƶ staff, whose quiet diligence and care behind the scenes made this work possible.
Despite differences in expertise and approach, this group never lost sight of the simple truth that care is not just part of mental health care; it is the heart of it. This work reflects their thoughtfulness for ideas, for one another, and for those whose well-being depends on what comes next.
Sincerely,
Laurie L. Patton
Cambridge, MA