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> 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 y

> 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.

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.