This is absurdly dangerous, and I"m continually astounded by the lack of push-back, especially in this community. This community understands what LLMs are much better than the general public.
Same thing with the post a while back of a ycombinator startup that used AI to generate survey data. It's plain what it is, but there's shockingly little push-back.
Do you think Google Search suggestion for any medical-related are all true? But, people still search for their problems and self-diagnose. How many of them suffered for that?
https://www.euronews.com/next/2023/03/31/man-ends-his-life-a...
It is profoundly irresponsible to basically encourage people to self-diagnose. It's going to kill a number of them too. That's no joke.
LLM mental health treatment can’t come soon enough.
The thing is bad actors are essentially forcing arguably unethical tools onto people in need.
Our current Healthcare struggle is completely unnecessary.
A good percentage of our economic struggles are equally unnecessary.
The only reason we are even having these discussions is too many people with means are not employing those means in ways that make it worth allowing said means at all.
Greed, psychopaths, ignorance and more are the problem.
People are saying:
Basic health care can't come soon enough.
Drug price reform can't...
Mental health
You get the idea.
I get it. Lots of us are desperate.
I lost a home over this health care shit. Basically traded more time with my wife for our home. Brutal as fuck. I currently pay close to $2k in premiums and have difficulty finding options because I fall into what Franken called the "doughnut hole."
Have considered some sort of crime, or leaving the country many times too.
Like I said, ugly.
If you think LLMs perform at a level that they can help resolve the mental health crisis in the US, you are very much a part of that problem. They can’t even always produce functional code without heavy steering, let alone negotiate the fraught domain of psychological and psychiatric health.
Foisting people in crisis off on unpredictable text generation engines is IMO a textbook example of the fundamentally anti-social character of American society that produces so many of the mental health problems that this country faces.
Bogus. How do you know an LLM isn’t better than human led treatment because the patient can be honest and have privacy, free to discuss anything without data leaving their premises.
Alternatively, how do you know that a high level of care is needed for all patients? There are waiting rooms filled with people trying to get a chance to talk to someone about their problems who will listen, and others who don’t come in at all because they have no insurance.
This has the evidentiary burden entirely backwards. We have evidence for the efficacy of various forms of psychological and psychiatric interventions and none for that produced by LLMs. I’m not even sure if it’s possible or ethical to test them for this purpose, as it would require OpenAI levels of RLHF training to get them to adhere to current guidelines and standards of care.
For ethics, how is this more dangerous than trials for a new heart medication that might kill patients? In fact, the only way to know for sure, is to try and see.
In terms of early results, these kinds of toy projects will be the frontline since any lawyer would tell you to not touch this with a 10ft pole. But I doubt a Github project would face that scrutiny since it takes technical skills to setup which requires knowledge and intent on the part of the user.
Clinical trials happen through an established regulatory framework to minimize harm to participants, for starters…
Knowing that hundreds of people end their lives /after/ seeking care in our current mental health system, I’m not afraid of exploring other options.
I do believe, however, that developers in this space must not over-represent the capability of their systems and have a duty to strongly warn users that the system can act unpredictably and give harmful advice. Resources to contact health professionals and warnings to contact 911 if there is a life-threatening emergency are also obligatory.
With those disclosures, I don’t see how a self-directed discussion with a language model could be overly harmful.
> They can’t even always produce functional code without heavy steering
Right, but you and I both can appreciate that it can produce functional code a lot of the time, sometimes with only light steering.
> let alone negotiate the fraught domain of psychological and psychiatric health.
I agree with you to a large extent. This is a sensitive area to operate in and introducing an unpredictable, unemotional, unwieldy language model into the loop has the potential for disastrous results.
>Foisting people in crisis off on unpredictable text generation engines...
I do not want this. I just want an additional option.
I personally have found relief through GPT-4. Despite its limitations, the LLM offers (the illusion of?) empathy, understanding, and clarity at a level that most mental health professionals simply do not. It helps me, and for that reason I know it can help others. An LLM isn't a substitute for healthcare, but it's absolutely a supplement.
I hope you'll reconsider your view and tone down the rhetoric.
But it could! You may feel it makes sense. And for some of us it may make sense too.
What happens when it doesn't and you do not know?
Talking about something with no expectation of it being fixed is doing nothing, and people are still dying. If some people die due to bad advice from a machine, but some people survive, is that better then everyone dying due to inaction of any sort?
We won’t get getting universal health care in the US. Maybe there’s something to a democratization of subpar, but at least available, medical advice and care?
And there is this: The change, if there is to be one, will have to come from us. A whole lot of us.
Most great things do.
This idea of using an LLM in some meaningful way is as laughable as watching the world burn while people squabble over baubles and trinkets is maddening.
I take it you’re on the “LLM can’t do anything but hallucinate.” However an awful lot of folks use LLM for quite a lot successfully already. I’ve found in the space of medical advice GPT4 is already fairly sophisticated. I wouldn’t use it without double checking it’s output, but I can ask it fairly complex questions about physiology, biochemistry, medicines, and many other subjects and it almost always provides a concise, detailed, and insightful answer. I’ve not yet found it hallucinating so long as I don’t ask it questions that are essentially information retrieval questions (who wrote the paper about blah will often induce a wrong answer, while, say, what medicines shouldn’t be mixed with ibuprofen will not). I personally believe LLM’s are not the answer as well, but I believe LLMs are a major missing piece in the assembly of partial answers we’ve built to date. I think LLM’s combined with information retrieval, optimizers, constraints systems, goal based agents, and other classical AI and information techniques forms a powerful combination greater than the sum of its parts. And I definitely think the way to scale medical care is for most medical questions that don’t need an expert to be serviced by a machine. The vast majority of our medical systems time is taken up by people with colds, GERD, and other questions and conditions that can be handled without a human.
Anyway, people will try this, others will get hurt or killed, and I along with others will get our "I told you so" moment, which will get added to the "when the fuck do we make health care a priority" advocacy library and the fight goes on.
Fact is, far too many people ignore health care.
When that changes, we will see progress.
https://pnhp.org/a-brief-history-universal-health-care-effor...
There have been meaningful efforts that keep reverting to insurance schemes since the late 1800s, with the first real legislative passage in 1915.
Universal healthcare has actually been pretty popular and enjoyed broad support. Most people are acutely aware of health care and the lack of it. In fact it typically ranks near the top in the concerns for most Americans:
https://www.pewresearch.org/politics/2023/06/21/inflation-he...
The issue is more the business lobby against expansion of health care and the insurance lobby against expansion of universal solutions like single payer and Medicare / VA expansion to everyone. In fact the concerns aren’t false - insurance and the billing industry are huge employers of relatively low skilled but well paid workers.
I agree with what you said.
Changes to this state of affairs will only come from us.
Otherwise, they have position and are fat 'n happy.
This means we need to speak in more basic terms. Expensive terms.
Are you sure the desperate don't deserve this attempt to help them? I can't imagine what it must be like to have such issues and have zero professional options to turn to, and you know what the solution for many is.
It took me far too long to realize that the first psychiatrist I saw was pushing me in the opposite direction that I wanted my life to go. I had no context and blindly trusted her as an expert. Other therapists have since told me that what I was told my first psychiatrist was unhelpful, unethical, and even malpractice. No person (other than myself) has harmed my life as much as that psychiatrist. And I got to pay a small fortune for the terrible experience.
In this instance, the solution isn't immature tech (that may [may!] one day be good tech), it's policy that enables healthcare access. You aren't going to fix that with LLMs. But, you know, that's what tech people keep doing. Poor tech solutions to people problems, and sometimes getting wealthy due to luck along the way.
[1] https://docs.acec.org/pub/18803059-a2fd-2d06-cc39-a6d1dd5752...