3 ms·

How about the opportunity cost of people dying because they don’t have access to any treatment? It can be very challenging to find a qualified professional, eve

How about the opportunity cost of people dying because they don’t have access to any treatment? It can be very challenging to find a qualified professional, even if you have the necessary funds, insurance, and determination. LLM mental health treatment can’t come soon enough.

ddingus 3y ago
Yes, it is ugly! The thing is bad actors are essentially forcing arguably unethical tools onto people in need. Our current Healthcare struggle is completely unnecessary. A good percentage of our economic struggles are equally unnecessary. The only reason we are even having these discussions is too many people with means are not employing those means in ways that make it worth allowing said means at all. Greed, psychopaths, ignorance and more are the problem. People are saying: Basic health care can't come soon enough. Drug price reform can't... Mental health You get the idea. I get it. Lots of us are desperate. I lost a home over this health care shit. Basically traded more time with my wife for our home. Brutal as fuck. I currently pay close to $2k in premiums and have difficulty finding options because I fall into what Franken called the "doughnut hole." Have considered some sort of crime, or leaving the country many times too. Like I said, ugly.
bugglebeetle 3y ago
> LLM mental health treatment can’t come soon enough. If you think LLMs perform at a level that they can help resolve the mental health crisis in the US, you are very much a part of that problem. They can’t even always produce functional code without heavy steering, let alone negotiate the fraught domain of psychological and psychiatric health. Foisting people in crisis off on unpredictable text generation engines is IMO a textbook example of the fundamentally anti-social character of American society that produces so many of the mental health problems that this country faces.
- xigency 3y ago
  > If you think LLMs perform at a level that they can help resolve the mental health crisis in the US, you are very much a part of that problem. Bogus. How do you know an LLM isn’t better than human led treatment because the patient can be honest and have privacy, free to discuss anything without data leaving their premises. Alternatively, how do you know that a high level of care is needed for all patients? There are waiting rooms filled with people trying to get a chance to talk to someone about their problems who will listen, and others who don’t come in at all because they have no insurance.
  - bugglebeetle 3y ago
    > Bogus. How do you know an LLM isn’t better than human led treatment because the patient can be honest and have privacy, free to discuss anything without data leaving their premises. This has the evidentiary burden entirely backwards. We have evidence for the efficacy of various forms of psychological and psychiatric interventions and none for that produced by LLMs. I’m not even sure if it’s possible or ethical to test them for this purpose, as it would require OpenAI levels of RLHF training to get them to adhere to current guidelines and standards of care.
    - xigency 3y ago
      I agree that this is unknown. In terms of finding the answer, I guess you’ll have to wait and see what optimistic or curious scientists, engineers, and doctors build and what they find. For ethics, how is this more dangerous than trials for a new heart medication that might kill patients? In fact, the only way to know for sure, is to try and see. In terms of early results, these kinds of toy projects will be the frontline since any lawyer would tell you to not touch this with a 10ft pole. But I doubt a Github project would face that scrutiny since it takes technical skills to setup which requires knowledge and intent on the part of the user.
      - bugglebeetle 3y ago
        > how is this more dangerous than trials for a new heart medication that might kill patients? Clinical trials happen through an established regulatory framework to minimize harm to participants, for starters…
        xigency 3y ago
        Sure, but one of those harms is death and that risk cannot be fully eliminated. Not to mention the ethical concerns of experimenting on animals for the riskiest testing. Knowing that hundreds of people end their lives /after/ seeking care in our current mental health system, I’m not afraid of exploring other options. I do believe, however, that developers in this space must not over-represent the capability of their systems and have a duty to strongly warn users that the system can act unpredictably and give harmful advice. Resources to contact health professionals and warnings to contact 911 if there is a life-threatening emergency are also obligatory. With those disclosures, I don’t see how a self-directed discussion with a language model could be overly harmful.
- bigyikes 3y ago
  Hey, I'm responding to this a week later on the off chance you'll see it. "You are very much a part of that problem" doesn't sit well with me. > They can’t even always produce functional code without heavy steering Right, but you and I both can appreciate that it can produce functional code a lot of the time, sometimes with only light steering. > let alone negotiate the fraught domain of psychological and psychiatric health. I agree with you to a large extent. This is a sensitive area to operate in and introducing an unpredictable, unemotional, unwieldy language model into the loop has the potential for disastrous results. >Foisting people in crisis off on unpredictable text generation engines... I do not want this. I just want an additional option. I personally have found relief through GPT-4. Despite its limitations, the LLM offers (the illusion of?) empathy, understanding, and clarity at a level that most mental health professionals simply do not. It helps me, and for that reason I know it can help others. An LLM isn't a substitute for healthcare, but it's absolutely a supplement. I hope you'll reconsider your view and tone down the rhetoric.

ddingus 3y ago

Yes, it is ugly! The thing is bad actors are essentially forcing arguably unethical tools onto people in need. Our current Healthcare struggle is completely unnecessary. A good percentage of our economic struggles are equally unnecessary. The only reason we are even having these discussions is too many people with means are not employing those means in ways that make it worth allowing said means at all. Greed, psychopaths, ignorance and more are the problem. People are saying: Basic health care can't come soon enough. Drug price reform can't... Mental health You get the idea. I get it. Lots of us are desperate. I lost a home over this health care shit. Basically traded more time with my wife for our home. Brutal as fuck. I currently pay close to $2k in premiums and have difficulty finding options because I fall into what Franken called the "doughnut hole." Have considered some sort of crime, or leaving the country many times too. Like I said, ugly.

bugglebeetle 3y ago

> LLM mental health treatment can’t come soon enough. If you think LLMs perform at a level that they can help resolve the mental health crisis in the US, you are very much a part of that problem. They can’t even always produce functional code without heavy steering, let alone negotiate the fraught domain of psychological and psychiatric health. Foisting people in crisis off on unpredictable text generation engines is IMO a textbook example of the fundamentally anti-social character of American society that produces so many of the mental health problems that this country faces.

xigency 3y ago
> If you think LLMs perform at a level that they can help resolve the mental health crisis in the US, you are very much a part of that problem. Bogus. How do you know an LLM isn’t better than human led treatment because the patient can be honest and have privacy, free to discuss anything without data leaving their premises. Alternatively, how do you know that a high level of care is needed for all patients? There are waiting rooms filled with people trying to get a chance to talk to someone about their problems who will listen, and others who don’t come in at all because they have no insurance.
- bugglebeetle 3y ago
  > Bogus. How do you know an LLM isn’t better than human led treatment because the patient can be honest and have privacy, free to discuss anything without data leaving their premises. This has the evidentiary burden entirely backwards. We have evidence for the efficacy of various forms of psychological and psychiatric interventions and none for that produced by LLMs. I’m not even sure if it’s possible or ethical to test them for this purpose, as it would require OpenAI levels of RLHF training to get them to adhere to current guidelines and standards of care.
  - xigency 3y ago
    I agree that this is unknown. In terms of finding the answer, I guess you’ll have to wait and see what optimistic or curious scientists, engineers, and doctors build and what they find. For ethics, how is this more dangerous than trials for a new heart medication that might kill patients? In fact, the only way to know for sure, is to try and see. In terms of early results, these kinds of toy projects will be the frontline since any lawyer would tell you to not touch this with a 10ft pole. But I doubt a Github project would face that scrutiny since it takes technical skills to setup which requires knowledge and intent on the part of the user.
    - bugglebeetle 3y ago
      > how is this more dangerous than trials for a new heart medication that might kill patients? Clinical trials happen through an established regulatory framework to minimize harm to participants, for starters…
      - xigency 3y ago
        Sure, but one of those harms is death and that risk cannot be fully eliminated. Not to mention the ethical concerns of experimenting on animals for the riskiest testing. Knowing that hundreds of people end their lives /after/ seeking care in our current mental health system, I’m not afraid of exploring other options. I do believe, however, that developers in this space must not over-represent the capability of their systems and have a duty to strongly warn users that the system can act unpredictably and give harmful advice. Resources to contact health professionals and warnings to contact 911 if there is a life-threatening emergency are also obligatory. With those disclosures, I don’t see how a self-directed discussion with a language model could be overly harmful.
bigyikes 3y ago
Hey, I'm responding to this a week later on the off chance you'll see it. "You are very much a part of that problem" doesn't sit well with me. > They can’t even always produce functional code without heavy steering Right, but you and I both can appreciate that it can produce functional code a lot of the time, sometimes with only light steering. > let alone negotiate the fraught domain of psychological and psychiatric health. I agree with you to a large extent. This is a sensitive area to operate in and introducing an unpredictable, unemotional, unwieldy language model into the loop has the potential for disastrous results. >Foisting people in crisis off on unpredictable text generation engines... I do not want this. I just want an additional option. I personally have found relief through GPT-4. Despite its limitations, the LLM offers (the illusion of?) empathy, understanding, and clarity at a level that most mental health professionals simply do not. It helps me, and for that reason I know it can help others. An LLM isn't a substitute for healthcare, but it's absolutely a supplement. I hope you'll reconsider your view and tone down the rhetoric.