We are training with horses to drive Teslas. It’s been a long time since people relied on Google just to find information, and now GPT models have evolved beyond merely providing answers—they’re performing tasks. This shift highlights how dramatically the landscape has changed. But what about universities and higher education institutions? Are they keeping pace with these changes? Let’s take a closer look at mental health professions—where is digital in their curricula? Have you ever wondered why some programs seem stuck in the past, even as the world moves forward?
People invest time and money in tuition, only to receive methodologies from the 20th century. But is this the best way to prepare future mental health professionals? The business model, based on pay-per-session, hasn’t changed much either. But is mental health really something that can be managed session by session? Or is it a life cycle that demands more continuous attention than any traditional provider can offer? It’s not just about how I learn according to the system—it’s about life itself. So, why aren’t our educational systems adapting?
The Evolution of Digital Mental Health: Waves of Change
When mental health workers discuss or attempt to use digital tools, do they really understand how deeply AI is changing the process? Are they prepared for what’s already here? The first wave of digital adoption, prior to the COVID-19 lockdown, was met with significant skepticism. Why were so many mental health professionals resistant to videoconferencing, even as millions of people had been using video calls through Messenger since the early 2000s?
Now, there’s an awareness that something must change, but what’s holding us back? Are regional and national professional associations too focused on maintaining control over who is authorized to work in their space? And what about ethics—how do we ensure that the rush to digital doesn’t compromise the ethical standards that are so crucial in mental health care?
The second wave brought platforms where mental health services were rated and reviewed—much like Tripadvisor or Booking.com. But is this really the best way to measure the effectiveness of mental health care? Should we be thinking about this more critically? Platforms became social hubs—Instagram and TikTok were flooded with mental health professionals sharing positive messages and images of themselves. But does this approach trivialize the seriousness of mental health care?
As discussions continue about digital innovations like the metaverse, AR, and VR, have we already missed the arrival of the third wave—chatbots, AI, and mental health apps? And now, with the fourth wave of GPT and large language models, how will AI’s ability to mimic human interaction change the landscape of mental health care? Are we ready for AI to ask us, “What can I do for you? Let’s have fun! I’m concerned about what you told me last week…”?
The Limitations of Pay-Per-Session Models: Why They Hold Back Progress
Meanwhile, are universities continuing to focus on outdated methods, training students to feed the horse rather than teach them to drive the Tesla? Why are we still publishing papers on feeding AI while the population is left confused and underserved? How often do we find ourselves in need of mental health support, only to face long waits and high costs? Is it fair that those who cannot afford to pay are excluded from care?
The COVID-19 pandemic forced the relaxation of rules around transnational services, effectively “legalizing” what had been happening under the radar. So, why are associations still resisting the move to digital care? Could they evolve by offering digital resources and specialized tools to clinicians? What’s stopping them? And is the pay-per-session model really serving professionals and clients well, or is it a relic from a bygone era that needs to be rethought? How might digital tools provide more comprehensive care if we moved beyond these old models?
The Future of Mental Health Services: AI, Digital Integration, and New Business Models
In 2019, an EdTech company called Cibersalud highlighted the disruption between traditional mental health education and the need for re-skilling programs. Why did it take a tech company to point this out, rather than the universities themselves? Are these institutions too slow to respond to the changing landscape? As the digital world evolves, how must mental health workers adapt? Could new models—such as subscription-based or value-based care—better serve the needs of both clients and professionals?
We’re not here to criticize platforms, but should we really be treating mental health professionals like hotels or restaurants? Should platforms be doing more to provide AI resources that enhance human service, while adhering to ethical standards and ensuring data privacy? And how can these tools help mental health professionals offer better, more secure care?
Finally, let’s not forget what happened with the Roman Empire and the barbarians. The empire fell, but the invaders eventually integrated and brought about new ways of living. Are today’s startups, backed by billions in investments, the modern-day “barbarians”? Should we fear them, or recognize that they’re pushing the industry to evolve? As these companies integrate human perspectives and knowledge, will they improve their services? Could this be the opportunity we need to merge digital innovation with traditional care?
But what about higher education institutions? Why do they continue to train STEM students on one side and health and social workers on the other, without any real integration? Isn’t it time for this to change if we are to truly revolutionize mental health care?
Conclusion: Beyond the Debate
When you’re trained under a specific model, like learning to ride a horse, it shapes your entire perspective. But what happens when the conversation shifts from riding a horse to driving a Tesla? The core purpose remains the same—locomotion, just as the core purpose of psychotherapy and digital mental health remains helping people. Yet, arguing about whether digital mental health is valid or not seems almost comic when the real issue is how to redefine the entire model. Maintaining the current system, particularly the pay-per-session model, doesn’t address the deeper issues of inequality and access.
Mental health isn’t just a service—it’s a common good. It’s the forest, and too often, the analogical solutions we cling to are like trees that obscure our view of the entire landscape. We can’t afford to get lost in the details when the whole forest is at stake.
“When someone shows you the moon, don’t look at their finger.”
This isn’t just about choosing between analog and digital. It’s about recognizing the need for a fundamental shift in how we approach mental health—one that acknowledges the bigger picture and strives to create solutions that serve everyone, not just those who can pay.