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Comment by phkahler | Hacker News Reader

>> The real issue that needs to be solved is that we need to make health care accessible to everybody, regardless of wealth or income.

Good therapists are IMHO hard to come by. Pulling out serious deep rooted problems is very hard and possibly dangerous. Therapist burn out is a real problem. Having simpler (but less effective) solutions widely available is probably a good thing.

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> Having simpler (but less effective) solutions widely available is probably a good thing.

And those solutions are not LLMs. It's been shown elsewhere (and in the OP, it seems) that LLMs are very bad therapists, severe malpractice bad.

So you're saying that there are no professional therapists that can do the same bad? I think that the issue is more subtle, and as with everything, nothing is really black and white.

I have, for instance, used LLMs a couple of times to assess and reflect over the few situations I have been questioning myself about recently. And I thought it did really well, much better than what most of my well-thought friends would do. Some proper advice and reflection. I did this in 1hr of my spare time completely randomly (before I went to a sleep) and without extra time spent on finding the (right) therapist, waiting on the list, going physically into his/her office, spending that 1hr there, and finally paying some cash. So, for me in this particular case this was an obvious win.

Professional therapists have to have malpractice insurance for this reason. LLMs currently don't.

I don't think such liability is really exercised all around the world, perhaps in the States it is. But how do you prove that psychotherapist's advice is what caused you the (psychological) damage? Court?

Yes, and those simpler solutions don't have to involve LLMs. Support groups, fostering community through more local activities and places of belonging, funding social workers. I'm sure there's more.

Friends.

Sadly I hear LLMs are a solution to this as well.

https://www.axios.com/2025/05/02/meta-zuckerberg-ai-bots-fri...

this is what he's going to push on all of us... terrifying

Friends, like spouses, are good for somethings and not for others. Some friends are great when it comes to helping you move, but are effective, and often even harmful, for therapy type situations.[1]

There's a reason many have adopted the prayer "Dear Lord, spare me from those trying to help me!"

[1] Of course, some friends are also the converse - good for helping you in times of mini-crises, but will never be there for you when you need to move. Unfortunately, such friends are rare, and many don't have one.

My guess is that as long as they’re willing to listen patiently, they will provide much of the benefit of going to a therapist.

> Support groups, fostering community through more local activities and places of belonging, funding social workers. I'm sure there's more.

In a post-labor-centric economy (if that's where we are heading with AI/automation) those are also among the things we'll need to figure out how to pay more people to do anyways.

There's tremendous value for society in paying people to care for the wellness of others, their communities, and the local and global environment. So therapists, park builders, environmental remediators, and more.

Communities composed of the wealthy already do this quite successfully for themselves today, as anyone who has driven through prosperous areas full of wellness services has observed.

The problem is we have to come up with ways of quantifying that value monetarily so it "makes sense" to markets and the signals they follow, which will otherwise completely ignore universal wellness as an objective, or even actively move against it, under the belief that the non-wealthy do not deserve the wellness that the wealthy enjoy.

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