Mental Health Meets AI
Scott Wallace, PHDWhere clinical judgment and AI systems collide, and decisions have consequences.
| Platform |  | Pricing | Only free issues | Publishes | Daily |
|---|---|---|---|---|---|
| Issues | 44 | Founded | 7 months ago | Last Issue | 44 hours ago |
| Active | |||||
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drscottwallace.substack.comLatest Issues
If Your Therapist Acted Like a Chatbot
The Appearance of Care Without Its Obligations
General-purpose chatbots have become the most-used mental health “tool” on Earth without ever being designed, validated, or regulated as care.
A March 2026 KFF poll found that 16%...
The Mental Health AI Stack Needs a Triage Layer, Not Another Chatbot
In early 2026, Chat & Ask AI exposed roughly 300 million private messages tied to 25 million users through a Firebase misconfiguration, including conversations from people asking how to end their lives. In practice, the database was left wi...
The Attention Engine in Therapeutic Clothing
Mental health AI is an attention engine in therapeutic clothing. It inherits its instincts from the attention economy, not from clinical care: optimize for time spent, positive affect, and return visits, then wrap those instincts in...
Build a Mental Health AI Company That Can Afford Recovery
I have spent more than 35 years building mental health technology inside clinical and commercial systems. The central business problem has never disappeared. A mental health AI company that earns more when distressed users return more often...
Inside the Black Box of Mental Health AI
Mental health AI has a black box problem.
In AI, a black box is a system that produces an output without showing how it arrived there. Information goes in. A result comes out. The reasoning in between remains difficult to examine, explain,...
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Authors
The writers behind this newsletter.
35+ years building digital mental health. Through my writing and advising, I help founders, developers, and product teams navigate AI in mental health — content, UX, evidence, ethics, governance, and safety.
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