Ep 27: Tiered Care, Technology, and the Future of Mental Health

EPISODE INTRODUCTION:

In this solo episode, Rachel  steps back from guest conversations to share her own observations and questions about one of the most pressing topics in the field: where does technology fit in mental health care, and where does it fall short? Drawing from six recent research articles and peer-reviewed publications, Rachel explores an emerging tiered model of care that blends technology, human connection, and escalation across levels of need — and invites listeners to consider what it means for their corner of the mental health ecosystem.

KEY TOPICS DISCUSSED:

The technology debate in mental health — full replacement vs. full avoidance vs. integration Overview of six key articles framing the episode's discussion The five stages of mental health care where AI and digital tools are being applied: pretreatment and screening, active treatment, post-treatment monitoring, general support and prevention, and clinical education The emerging tiered or stepped care model — from wellness apps to inpatient care Implications for clients, clinicians, and businesses/systems within the mental health ecosystem

MAIN TAKEAWAYS:

Technology is most useful at the edges of care — pretreatment screening, post-treatment monitoring, and general wellness support — where it can expand access without replacing the clinical relationship.

A tiered stepped care model is already emerging in research and practice, where clients might first engage with low-intensity tools (sleep apps, meditation, mood tracking) before escalating to coaching, group therapy, individual therapy, and higher levels of care as needed.

Clinician oversight remains non-negotiable. Rachel emphasizes that AI-assisted notes, treatment plans, and clinical decision support tools are only as safe as the licensed clinician who reviews and edits them.

Safety access must be built into any technology that touches mental health. Any tool that asks someone about their mental health must have a clear, reliable pathway to a live person in the event of a crisis.

This shift raises important identity questions for clinicians — particularly generalists — about where their expertise fits in a system where technology may address lower-level needs.

NOTABLE QUOTES:

"I'm not predicting the future. I'm not taking a hard stance, but exploring a model that is already emerging. It's right out there in the research." — Rachel Harrison

"If we ever lose the part where a clinician reviews the notes, reviews the treatment plan, reviews the diagnoses, reviews the suggestions — I think we're going to see a lot of problems." — Rachel Harrison

"Anytime we are asking technology to ask someone questions about their mental health, that safety planning piece, I believe, absolutely needs to be in place. That is one of the biggest gaps that I see currently." — Rachel Harrison

RESOURCES MENTIONED:

of them are linked in the show notes.

ARTICLE 1: The Evolving Field of Digital Mental Health
This peer-reviewed review outlines how AI and digital tools are currently being used across multiple stages of mental health care, from prevention to post-treatment monitoring.
Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC12110772/

ARTICLE 2: Health Advisory on AI Chatbots and Wellness Apps (American Psychological Association)
This article discusses where AI-based tools may be helpful — and where limitations, risks, and ethical concerns remain.
Link: https://www.apa.org/topics/artificial-intelligence-machine-learning/health-advisory-chatbots-wellness-apps

ARTICLE 3: First Therapy Chatbot Trial Yields Mental Health Benefits (Dartmouth)
This study looks at outcomes from one of the first controlled trials of a therapy chatbot and what it suggests about early-stage support.
Link: https://home.dartmouth.edu/news/2025/03/first-therapy-chatbot-trial-yields-mental-health-benefits

ARTICLE 4: AI Is Providing Emotional Support for Employees — But Is It a Valuable Tool or a Privacy Threat?
Explores workplace use of AI support tools and the tension between access, effectiveness, and privacy.
Link: https://theconversation.com/ai-is-providing-emotional-support-for-employees-but-is-it-a-valuable-tool-or-privacy-threat-266570

ARTICLE 5: AI Mental Health Tools: Breakthrough or Band-Aid?
Examines whether digital tools meaningfully expand access or risk becoming substitutes for care when systems are under strain.
Link: https://hrzone.com/ai-mental-health-tools-breakthrough-or-band-aid-for-employee-wellbeing/

ARTICLE 6: From Clinical Judgment to Machine Learning
Looks at how AI is beginning to influence clinical decision-making and what that may mean for professional roles.
Link: https://societyforpsychotherapy.org/from-clinical-judgment-to-machine-learning-rethinking-psychotherapeutic-decision-making-with-artificial-intelligence/
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Music Credit: Music by Zach Harrison