#64: Teaching AI to Care

Hi friends,

Imagine this. It’s 2035, and the two of us are sitting down for a chat.

The conversation turns to what it was like working in mental health back in 2025. The topic of AI comes up. What do our 2035 selves say about it?

Will we look back and see 2025 as a time when we got carried away with the hype of a new technology? Will we rue that we ever allowed it to come into existence? Or will we see it as the dawn of something that changed healthcare forever?

Answering that question is hard. But I think about it a lot. We should not be passive about the role technology plays in our lives. We should gather evidence and insight, form viewpoints based on strong ethical grounds, and act on those views

One way I get insight into this question is by talking to smart people.

Ross Harper is perhaps one of the smartest people in this space. He holds a Ph.D. in Computational Neuroscience and a Master's in Mathematical Modelling from UCL. He also holds a Master’s in Natural Sciences from the University of Cambridge.

For the last seven years, Ross has been running Limbic, one of the hottest AI mental healthcare businesses. He’s at the coalface of AI in mental health, with deep insights into the technology, how it’s changing care and how the ecosystem is adopting (and paying for) it all.

Ross recently wrote a post sharing his thesis on the opportunity of AI in mental health. He’s optimistic, and I really enjoyed the post - it’s highly logical and supported by data.

But I also had questions. So I caught up with him for a conversation about all things Limbic and AI in mental healthcare. We chat about clinical-grade LLMs, AI commercialisation, how the therapist’s role may change, the importance of trust, and even discuss if AI can actually care. It’s a fascinating conversation.

So let’s get into it.

Lessons from Ross (summary:

1. Clinical AI agents could finally unlock scalable care. After scribes and non-clinical AI agents, Ross sees the third wave of AI adoption as AI agents capable of performing clinical services. Clinical services account for 70% of all healthcare services and are massively under-resourced. Cracking this problem is what could truly scale mental healthcare.

2. The role of the therapist may be changing. If therapy services are unbundled and clinical AI agents are adopted at scale, the role of the therapist may change substantially. Ross sees a world where therapists may act as clinical supervisors to specialised AI agents. In this world, the therapist would focus on the most complex cases, treatment planning, managing quality and maintaining the therapeutic relationship.

3. LLMs must be paired with clinical reasoning AI systems. For AI to deliver quality care, LLMs must be paired with a more structured AI system with clinical reasoning. This way, you get the conversational benefits of LLMs but with clinical certainty and, importantly, transparency into how clinical decisions are made.

4. Trust must be a priority. Building trust takes time and relentless effort. It requires peer-reviewed evidence, regulatory approvals, accreditations and real-world impact. That trust is the only way to give stakeholders the confidence to adopt new technologies in this space. Over time, high trust will be a major asset.

Steve: Hey Ross, in your recent post, you described healthcare as a massive services market. Clinical services account for about 70% of that market.

One hypothesis I hold is that AI will lead to the unbundling of therapy services - in fact, I think it already is. Most people agree that AI will replace at least some of the jobs done by a therapist. The real question is what proportion of a therapist’s role it will replace. What’s your take on where that line should be?

Ross: I think you and I agree. For a therapist to scale from a panel of 30 patients to 300, AI will need to take on around 90% of the jobs they currently do.