Dual Public Health and Regulatory Dilemmas of "Relational" Artificial Intelligence

AbstractRelational artificial intelligence (AI) - designed to simulate emotional support, companionship, or intimacy - is rapidly entering everyday life and has enormous potential to positively impact human society. Yet we should pause to consider the potential public health and regulatory dilemmas of this technology. Although relational AI has potential therapeutic benefits, recent studies and emerging cases suggest potential risks of emotional dependency, reinforced delusions, addictive behaviors, and encouragement of self-harm. Moreover, technology companies face mounting pressures to retain user engagement, which often involves resisting regulation, creating tension between public health and market incentives. We argue that clinicians, researchers, and policy makers must proactively respond by advancing epidemiological research on AI-based relational attachments, counseling patients on risks, establishing youth protections, leading public education, and advocating for regulatory and accountability mechanisms insulated from market forces. If we can anticipate harms while also engaging constructively with this technology, we can better ensure that relational AI will influence mental health and well-being in ways that are beneficial to society.