Weighing Costs and Benefits of Delay and the Acceptance of Two Decision Support Tools in Mental Health Care: Scoping...

Mental disorders are the leading cause of disability in young people (aged 12-30 years), and their incidence constitutes a major health crisis. Primary youth mental health services are struggling to keep up due to overwhelming demand, the complexity and severity of young people presenting for care, and a shortage of qualified mental health professionals (MHPs). Artificial intelligence (AI) tools have the potential to facilitate necessary improvements to diagnosis, triage, and care planning for young people with emerging mental disorders.

The objective of the present scoping research was to examine beliefs and attitudes underlying MHP acceptance of AI tools in youth mental health services.

In total, 57 MHPs (mean age 35.35, SD = 9.50 years, 72% female (n = 39)) with experience working with youth populations (age 12-30) took part in study 1 that involved completing a web-based survey about the acceptability of using AI in early intervention services. During study 2, 15 MHPs also participated in 1-hour semistructured Zoom interviews. Attitudes toward the use of 2 novel AI prototypes (both of which provide recommendations for care coordination based on previously published data analyses) in youth mental health were explored. Quantitative data were interpreted using descriptive statistics, and qualitative analysis followed the thematic analysis approach.

MHPs were more likely to agree than disagree that AI will improve youth mental health care overall (eg, n=37, 64% participants somewhat or strongly agree that the field of mental health will improve with AI). Despite voicing concerns regarding data security and privacy, MHPs also acknowledged a need for AI to improve the "signal-to-noise ratio" in services and address delays to care for those with severe and complex problems. Such problems were seen as pervasive across the youth mental health system and emphasize the serious costs of delaying the development and implementation of novel tools. All participating MHPs discussed the potential negative impacts of not adopting novel tools.

MHP acceptance and uptake of novel AI tools in youth mental health services will be driven by a more complex cost-benefit analysis of both adopting and not adopting, rather than solely on their design. The costs of delay are clear, and so researchers and MHPs have a shared imperative to develop useful and meaningful clinical tools and to work jointly on integrating them into practice. Limitations of our sample (including low sample size limiting generalizability) notwithstanding, these findings should inform the future design and implementation of such tools.