The following is a guest article by Lindsay Oberleitner, Ph.D., LP, Head of Clinical Strategy at SimplePractice
Nearly 50% of individuals in the United States with a mental health diagnosis did not receive treatment in 2024. The barriers are familiar: prohibitive costs, confusion about where to turn, and a fragmented system that’s difficult to navigate. But AI is beginning to change the equation. From therapy chatbots offering immediate support to algorithms that help connect people with appropriate care, technology is creating new pathways to mental health services – and people are responding. Millions are already turning to tools like ChatGPT for validation, advice, or simply a judgment-free space to process difficult emotions.
However, this rapid pace of adoption brings to mind the wisdom of The Tortoise and the Hare. Innovation in mental healthcare, particularly with the introduction of AI therapy chatbots, is moving faster than healthcare traditionally has, outpacing safety standards and oversight. This swift innovation can be compared to the hare in this analogy. While it may sprint ahead in the beginning, it’s the tools grounded in safety and clinician oversight – the tortoise – that will see long-term success, ultimately “winning the race” in effectively addressing the mental health needs of patients.
AI Therapy Chatbots as a Gateway to Care
The rise of AI therapy chatbots – often used by teens as unsanctioned companions as well as by adults 65+ to combat loneliness – has sparked important conversations about their place within the broader continuum of mental healthcare. And while these tools may be sufficient for individuals exclusively seeking emotional wellness support, it’s important to note that they should never be seen as a replacement to clinicians. When used responsibly, they can serve as a valuable (re)entry point into therapy, expanding access for individuals who are exploring therapy options for the first time, or those who are in between stages of their mental health care journey.
Where these tools can become misleading is when AI therapy chatbots re-route users to an incomplete, unguided, or non-therapeutic solution, or if individuals who need clinical intervention believe the treatment is sufficient, discouraging patients from seeking help further. The strength of AI therapy chatbots, therefore, is not in the standalone idea of these tools as a solution for mental health, but how they encourage individuals to engage with clinicians, complementing existing treatment plans and models of care.
Innovation Racing Ahead of Safety
While AI therapy chatbots offer exciting opportunities for patients to engage in therapy, they must be integrated responsibly into the broader healthcare ecosystem. Without proper oversight, AI therapy chatbots illustrate how innovation in this space is outpacing safety and regulation, just like the hare, racing off at the start while caution lags behind. In the absence of clear standards, there is little pressure for these tools to adhere to safeguards.
Federal oversight remains fragmented, leaving a regulatory patchwork and confusion in its wake. However, some states are introducing regulations. In August, Illinois introduced The Wellness and Oversight for Psychological Resources Act, prohibiting the use of AI in providing mental health decisions. More recently, in October, California’s governor signed a bill prohibiting chatbots from representing themselves as health care professionals. Growing state-level efforts highlight how quickly AI-powered mental health solutions and subsequent regulatory responses are evolving, and how urgently proper guardrails are needed.
Incorporating Clinician Voices
Equally as concerning as this regulatory patchwork is that much of AI chatbot innovation is unfolding without the clear voice of mental health professionals – the experts who are best equipped to evaluate safety and clinical integrity.
Clinician perspectives must be taken into consideration and incorporated into regulations and platform design to ensure appropriate oversight. This includes tool development and design, ensuring clinical reasoning is at the forefront to better protect patients and provide a better experience. Without that input, safety checks can only go so far. Clinician voices shift these tools away from the hare (speeding ahead of safety regulations and clinical impact) to the tortoise (moving carefully and wisely). This insight is the key missing piece to winning the race for responsible innovation.
Steady and Safe Wins the Race
While innovation is exciting, AI tools are being developed faster than regulations can provide oversight. Rather than waiting for these regulations to be introduced, it is the platforms that look and build toward the future through thoughtful integration of safety and clinician-in-the-loop input that will effectively help patients and be viewed as the “winners” long-term.
AI therapy chatbots can help close the mental health care gap by providing an approachable entry point for patients beginning their therapeutic journey and connecting those seeking non-clinical wellness support with appropriate resources. Clinicians, industry leaders, and policymakers must collaborate to establish rigorous standards and oversight frameworks. With proper guardrails and clinical integration, these tools can serve as the triaging system our fragmented mental healthcare ecosystem desperately needs, helping to guide patients to appropriate care, support them throughout treatment, and ultimately reach the millions who might otherwise go without help.
About Lindsay Oberleitner
Lindsay Oberleitner, Ph.D., LP, is a licensed clinical psychologist and Head of Clinical Strategy at SimplePractice, where she applies evidence-based practices to drive strategic clinical decision-making and advocate for mental health providers. Throughout her career, she has worked at the intersection of addiction, chronic health conditions, and the criminal justice system, underscoring her passion for advancing interdisciplinary training and collaboration. Her academic background includes a Ph.D. from Wayne State University, a postdoctoral fellowship and faculty role at Yale University School of Medicine, ongoing leadership positions on the American Psychological Association’s Continuing Education Committee, and publishing over 40 peer-reviewed articles. For more deep dives into topics related to mental health and AI, visit SimplePractice’s livestream hub, featuring Dr. Oberleitner’s session, “Navigating AI in the Therapy Room: Supporting Clients’ Healthy Engagement with AI Tools.”
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