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The issue is that if we go down this path, what will happen is that the gap between access to real therapy and "LLM therapy" will widen, because the political l
by shafyy 1y ago
The issue is that if we go down this path, what will happen is that the gap between access to real therapy and "LLM therapy" will widen, because the political line will be "we have LLM therapy for almost free that's better than nothing, why do we need to reform health care to give equal access for everybody?".
The real issue that needs to be solved is that we need to make health care accessible to everybody, regardless of wealth or income. For example, in Germany, where I live, there are also long waitlists for therapists or specialists in general. But not if you have a high income, then you can get private insurance and get an appointment literally the next day.
So, we need to get rid of this two class insurance system, and then make sure we have enough supply of doctors and specialists so that the waits are not 3 months.
- spwa4 1y ago> So, we need to get rid of this two class insurance system, and then make sure we have enough supply of doctors and specialists so that the waits are not 3 months. Germany has reduced funding for training doctors. So clearly the opposite is true. > For example, in Germany, where I live, there are also long waitlists for therapists or specialists in general. But not if you have a high income, then you can get private insurance and get an appointment literally the next day. And the German government wants to (or is implementing policies to) achieve the opposite and further reduce access to medical specialists of any kind. Both by taking away funding and taking away spots for education. So they're BOTH taking away access to medical care now, and creating a situation where access to medical specialists will keep reducing for at least the next 7 years. Minimum.
- shafyy 1y agoYeah, I am not saying Germany is doing it right :D Just explained how it works here and what I think should be improved.
- spwa4 1y agoIt really looks that's how a lot of countries intend to solve the crisis they are causing by destroying medical care now: restrict it to fewer and fewer people, without lowering the taxes that pay for it, of course. Great medical care for the select few. No medical care for you and me. And with the traditional difference between socialists and rightists. Socialists will have their party pick who gets medical care, not you and me. Rightists will make it more expensive, which means you and me can't pay for it.
- Dumblydorr 1y agoThat’s nice sounding, in the USA currently we’re headed the opposite direction and those in power are throwing off millions from their insurance. So for now, the LLM therapist is actually more useful to us. Healthcare won’t be actually improved until the current party is out of power, which is seeming less likely over the years.
- jjmarr 1y agoI live in Canada and it's illegal to take private insurance if you also take public insurance. The private healthcare system is virtually nonexistent and is dominated by scammers. The public healthcare system still has months-long wait times. If you want to avoid waitlists you need surplus capacity, which public healthcare doesn't provide.
- pjc50 1y ago> it's illegal to take private insurance if you also take public insurance. This seems like an odd excluded middle. In the UK, you can have private health insurance if you want, but you can always fall back on the NHS; the one wrinkle is that you may not always be able to take a prescription from the private to the public system without getting re-evaluated. (e.g for ADHD) > which public healthcare doesn't provide == taxpayers aren't willing to pay for.
- neom 1y agoIt's a slippery slope and we really don't want a 2 class system. If you start allowing doctors to bill for things that public insurance covers, you're 30 seconds away from a losing the egalitarianism that Canadians value. You can pay out of pocket for whatever you want, you can tell the doctor not to bill any insurance, and in some clinics (in my experience not many) that will get you seen faster, but it's not really common and it's very expensive.
- jjmarr 1y agoDrugs aren't considered healthcare for whatever reason. If I got an ADHD pill in a hospital that's free, but if I wanted to get the same at an outpatient pharmacy it'll cost money in most cases. Ditto for dental. So while there isn't any overlap between public and private, there's still a gap. Though our drugs cost 10% of American prices.
- droopyEyelids 1y agoIn the USA we have huge waitlists for most all types of healthcare. Private healthcare doesn't provide surplus capacity either.
- sui762o 1y ago[dead]
- tjs8rj 1y agoWhy do we need to make mental healthcare available to everyone? For all of human history people have got along just fine, happily in fact, without “universal access to mental health care” This just sounds like a bandaid. The bigger problem is we’ve created a society so toxic to the human soul that we need universal access to drugs and talk therapy or risk having significant chunks of the population fall off the map
- quest88 1y agoJust fine? Happily? Surely many wars and deaths would have been prevented with better mental strategies.
- ceejayoz 1y ago> For all of human history people have got along just fine, happily in fact, without “universal access to mental health care” Mixing up "some people survived" and "everyone was fine" is a common mistake. Some folks who're able to thrive today on drugs and therapy are the "tragically wandered off in a snowstorm" of past eras.
- wing-_-nuts 1y ago>Why do we need to make mental healthcare available to everyone? Why do we need to make physical healthcare available to everyone? For most all of human history, bones were set by family. Yeah, ok, often the patient was hobbled for life. I guess it makes sense to get treated by a professional...wait, perhaps we've stumbled upon something here...
- tayo42 1y agoNo one is stopping you from making society better... In the mean time it's best we all have
- wat10000 1y agoI suggest you put the terms "warfare," "genocide," and "slavery" into Wikipedia and then tell us how fine people got along.
- techjamie 1y ago
- phkahler 1y ago>> The real issue that needs to be solved is that we need to make health care accessible to everybody, regardless of wealth or income. Good therapists are IMHO hard to come by. Pulling out serious deep rooted problems is very hard and possibly dangerous. Therapist burn out is a real problem. Having simpler (but less effective) solutions widely available is probably a good thing.
- Apocryphon 1y agoYes, and those simpler solutions don't have to involve LLMs. Support groups, fostering community through more local activities and places of belonging, funding social workers. I'm sure there's more.
- jimbokun 1y agoFriends.
- hellisothers 1y agoSadly I hear LLMs are a solution to this as well. https://www.axios.com/2025/05/02/meta-zuckerberg-ai-bots-friends-companions https://www.axios.com/2025/05/02/meta-zuckerberg-ai-bots-fri...
- twelve40 1y agothis is what he's going to push on all of us... terrifying
- BeetleB 1y agoFriends, like spouses, are good for somethings and not for others. Some friends are great when it comes to helping you move, but are effective, and often even harmful, for therapy type situations.[1] There's a reason many have adopted the prayer "Dear Lord, spare me from those trying to help me!" [1] Of course, some friends are also the converse - good for helping you in times of mini-crises, but will never be there for you when you need to move. Unfortunately, such friends are rare, and many don't have one.
- martypitt 1y agoI agree with the principal here, and beleive that it's noble. However, it boils down to "Don't advance technology, wait 'till we fix society", which is futile - regardless of whether it's right.
- disgruntledphd2 1y agoCorrect, but the alternative of don't fix society, just use technology is equally destructive.
- nradov 1y agoI think it would be great to make mental healthcare accessible to everyone who could benefit from it, but have you actually run the numbers on that? How much would it cost and where would the money come from? Any sort of individual counseling or talk therapy is tremendously expensive due to the Baumol effect. And even if we somehow magically solve the funding problem, where will the workers come from? Only a tiny fraction of people are really cut out to be effective mental health practitioners. I'm pretty sure that I'd be terrible at it, and you couldn't pay me enough to try.
- b112 1y agoLet's solve that productivity issue! The classic view of one reclining on a couch, and the professional listening, seems to have a lot of downtime for the professional. The occasional sound of affirmation, 'go on', 'yes, yes' may be heard, but often a lot is the patient talking. We could easily move this to text or video, but let's choose text. Best would be some form of speech to text, but AI driven and with a shorthand for emoted quality. I suggest we assign primary emotions to primary colours, using three base emotions as primaries, and the professional would be able to read the emotions at play, and quantity, merely by the resulting colour of text. Larger print or bold or what not, could be used for more intense speech, eg yelling. This would allow one professional to allow multiples to speak, yet they could simply wait for the text to appear, consider it, and respond vocally. Any perceived delay in response, could be derided by the concept of "I needed time to think on your words". Thus the patient speaks, the professional's voice responds, the illusion of complete dedication to one patient is whole. Yet anywhere from 4 to 10 patients could be served in parallel with such a system, and remotely too! I'm fairly sure I could whip this entire platform up over a weekend. This solves the surmised shortages, for one could do the work of 10. It also helps the environment, with people not traveling to an office for their appointment. Hmm. Maybe I should pursue this, and be bought out by Amazon so it can be included in Prime Plus or whatever.
- anon_e-moose 1y ago/s... Right...?
- more_corn 1y agoLLM therapy lacks important safeguards. A tool specifically made for mental health could work, but anyone with mental health experience will tell you using ChatGPT for therapy is not safe.