Artificial intelligence may be the newest chapter in mental health care, but innovation in the field is nothing new. Dr. Jessica Watrous reflects on decades of progress and what responsible, evidence-based advancement should look like as AI enters the conversation.
Artificial intelligence may be the newest topic in mental health care, but the story of innovation it represents is one we’ve lived many times before.
From the outside, it can be easy to assume that progress in mental health care is slow. Even from within the field, I’ve sometimes felt that way myself. But, when I take a step back and look over the timeline of my own career, the transformation is unmistakable. The science, the practice, and even the conversation around mental health are all fundamentally different from when I began.
Every generation of clinicians has experienced a breakthrough that redefined how we think about and deliver care: new psychiatric medications in the 1950s, the rise of evidence-based therapy in the 1970s, the emergence of digital care in the 2000s, and the rapid expansion of telehealth during the pandemic.
Each shift was initially met with skepticism and uncertainty, which challenged the field to prove these innovations didn’t cause harm and actually helped those who needed them. We’ve pushed closer and closer to more humane, effective, and accessible care.
Undoubtedly, there’s still work to be done to improve mental health care, and innovation is one path we must follow to get there. Luckily, when it comes to AI, figuring out how it can transform mental health care isn’t uncharted territory for those of us who have devoted our careers to this work.
A century ago, “treatment” for mental health disorders often meant confinement in institutions. We didn’t have clear categories of clinical concerns, let alone a more expansive understanding of concerns like neurodivergence, trauma, and burnout. Over the decades, the field has evolved through seismic shifts. Today’s approach to mental health care includes a variety of interventions, many of which are data-backed, active, and focus on measurable improvement. Even within therapy itself, the most commonly thought of modern treatment, our methods have evolved dramatically.
There’s still a popular misconception—one I hear often—that therapy is just “talking.” But evidence-based treatments like Cognitive Behavioral Therapy or Acceptance and Commitment Therapy are anything but passive conversations. They’re structured, goal-focused, and often time-limited. Patients do active work in sessions, learning new skills and behaviors, often with the expectation of practicing them in their day-to-day lives.
Therapy has moved from exploration alone to active, measurable change. That shift didn’t happen by accident; it happened through decades of research, iteration, and a commitment to doing what actually helps people get better.
And innovation extends to how we use technology in care. When the COVID-19 pandemic forced millions into isolation, digital mental health solutions went from an alternative to a lifeline. Within months, therapy, coaching, and group care went online—and the field adapted. Licensure, privacy, and safety protocols followed. We proved that care could evolve responsibly and continue to produce meaningful outcomes.
That abrupt shift showed that innovation and safety don’t have to be opposing forces. So many scientific, digital, and clinical breakthroughs have moved us closer to the goal of effective, equitable, and available care when people need it.
Now, we find ourselves on the edge of another transformation. AI represents the next wave of innovation in mental health care—one that brings both promise and responsibility, like advances in research and technology before it.
Some see AI as a disruption. I see it as the continuation of a long and steady evolution. Every significant advancement in mental health care has begun with uncertainty and debate, and the goal was to prove that progress and caution can coexist.
AI is no different. The technology’s potential to personalize support, enhance access, augment providers’ work, and optimize outcomes is enormous. But its impact will depend on how it’s built and who’s guiding its use.
Most large-language-model chatbots, like ChatGPT or Claude, were not developed for health care, and they shouldn’t be mistaken for it. They’re designed for engagement, not health improvement. Despite this, we know people are using these chatbots for health care purposes and that’s leading to risk and requiring adaptation.
By contrast, AI tools created specifically for health care should be held to a higher bar from the start: they must meet strict standards for safety, privacy, and clinical oversight before they’re used in care settings. The question isn’t whether AI can belong in mental health care—it’s how we ensure it earns that place responsibly.
That’s where Modern Health’s history gives us perspective. We’ve been here before.
I believe meaningful innovation requires more than new technology. It demands an ethical and safe system that works in the real world—not only in tightly controlled clinical trials. That’s what drew me and the rest of the Clinical Strategy & Research team to Modern Health: the opportunity to build something that translates rigorous care to the real world by thinking about an entire population’s needs and all of the modalities necessary to provide care that can adapt to people’s needs and preferences.
At Modern Health, we’ve designed a flexible, evidence-based framework that integrates therapy, coaching, group support, and digital programs into a cohesive care experience and can evolve with whatever the next care innovation is, including AI.
As clinicians and researchers, my team’s work is rooted in understanding what works, for whom, and under what conditions—this comes from the science, and it comes from our very real experiences of sitting in rooms with people who are at their most vulnerable and doing the active work of taking care of their mental health.
We’re also continuously measuring effectiveness and equity across our platform and members, ensuring innovation translates to real-world impact. Our extensive set of published, peer-reviewed research demonstrates that adaptive care improves more than mental health symptoms alone—it enhances physical activity, reduces loneliness, and increases overall well-being. As the only digital mental health platform with this comprehensive set of peer-reviewed research, that evidence base gives us confidence to thoughtfully evaluate new technologies, like AI, as they enter the field.
We approach AI through the same philosophy that built our adaptive care framework: optimism balanced by oversight, and innovation guided by evidence.
If there’s one lesson from the past century of mental health innovation, it’s that progress without responsibility doesn’t last. The same principles that guided our evolution before must guide us again now:
These aren’t constraints on innovation—they’re what make it trustworthy. They’re how we’ll ensure AI becomes a tool for progress, not a source of harm.
The history of mental health care is a story of transformation: from confinement to compassion, from stigma to science, from one-size-fits-all treatment to care that flexes and evolves.
AI is the next chapter in that story. Its promise lies not in novelty, but in integrity—the same mix of evidence, ethics, and empathy that, when deployed, has moved our field forward.
Because at the end of the day, innovation in health care is only as valuable as the impact it has on people’s lives.
Dr. Jessica Watrous is a Licensed Clinical Psychologist and the Chief Clinical Officer at Modern Health. Broadly, her clinical and research efforts have focused on the complex relationships between physical and mental health, including the emotional impact of illness and injury, health behavior change, substance use problems, and optimizing clinical prevention and intervention protocols for mental and physical health promotion and behavior change. She is passionate about mental health care innovation that leads to accessible, evidence-based, equitable care for all.
