When AI Notetaking In Therapy Becomes a Breach of Trust

AI notetakers in therapy: useful tool or violation of privacy? 

Some therapists are now using AI to record, transcribe and store patient sessions, and not all patients are comfortable with it – for good reason, according to NPR. For one thing, just knowing a third party is listening in and taking notes subtly changes the nature of the session, according to Marisa Cohen, a couples and sex therapist in New York. Therapy, she says, relies on absolute privacy. She also worries about AI’s accuracy.

“If errors are introduced and a clinician isn’t meticulously checking the notes, that error is now part of the record,” she told NPR. “If those notes are ever subpoenaed, that becomes part of someone’s history.” 

Molly Quinn recalls that when her therapist mentioned wanting to experiment with an AI notetaking tool, Quinn said she’d like to do some research on it first to make sure her data was staying local. But as the session went on, Quinn realized she was already being recorded, her therapist not taking the usual notes. After a moment she resumed talking, but afterwards realized that her trust in that therapist was shattered.

“The more I thought about it, the more I just started getting more and more sick to my stomach,” she says. “This person who I’m supposed to be able to trust with some very private and very intense emotions had just completely disregarded something I said I was not comfortable with. I felt completely violated.” 

She’s not alone. Americans are reluctant to use AI for mental health care, with only 8% saying they trust the technology according to a national survey by YouGov. Nearly half said they are reluctant to use the technology, which is designed to save therapists time they would normally spend weekly compiling and organizing their notes.

These fears are not unreasonable: Despite privacy protection laws like HIPAA, there are no guarantees that private information will remain so forever. For example, deeply personal information could be divulged in a data breach, according to Kellie Owens, an assistant professor of medical ethics at NYU Grossman School of Medicine. 

“Any time you are recording a conversation, that should require a verbal conversation that a recording is taking place,” Owens told NPR. “If patients feel that privacy has been compromised, that can do real damage to the therapeutic relationship.” And as in any relationship,”no” means just that.

Climate disasters are fueling homelessness and mental health problems

The charred ruins of a house in Pacific Palisades on January 8, 2025 after the most destructive wildfire in the history of Los Angeles. Draco Guan/Shutterstock

Public health experts have long believed that housing lost to climate change could fuel homelessness, and now UCLA researchers have quantified that link. A research team found that, in the U.S., for every home per 10,000 people lost to wildfires and other climate-related disasters, homelessness in the area increased by 1%. 

In a different paper, the researchers, led by Dr. Kathryn Leifheit and Dr. Randall Kuhn, both professors in the university’s Fielding School of Public Health, looked at the impact that wildfires have on people who are already homeless and at the extent of health problems experienced by unhoused people.

They found that an estimated 40% of the homeless population suffered from mental health conditions and 33% from substance abuse issues, most commonly involving stimulants. Post-traumatic stress-disorder and major depression were among the most common mental health conditions, with nearly 60% also afflicted by physical disorders. More than 72,000 people are homeless in Los Angeles County, the largest in the country, according to the 2025 Greater Los Angeles Homeless Count.

In addition to the 200,000 or so people whose homes were destroyed, more than three-quarters of those who were already homeless in the same communities reported injuries or other major significant disruption to their lives from the fires. Those included excessive coughing, wheezing, sore throats and difficulty breathing, as well as aggravated preexisting conditions like asthma, due to extended smoke inhalation.

“The wildfires were among the most devastating urban wildfires in history, and as traumatic as they have been for those who lost their homes, those living on the street suffered as well,” Kuhn, co-author of three of the four studies released this spring, said in a statement.

Stopping evictions and providing housing after wildfires results in better health outcomes. Researchers recommend a moratorium on evictions after disasters, using mobile clinics to treat homeless residents escaping blazes and focusing on housing both before and after disasters. 

“Our findings underscore the reality that homelessness can be seen as a predictable consequence of climate disasters,” said Leifheit, assistant professor in the Department of Health Policy and Management and a lead author of the national study. “Governments should focus on housing stabilization in their disaster response plans.”

In other news…. 

My college professor friends tell me that AI is taking the joy out of teaching, since so many students now generate their essays with it. In his recent essay for The Atlantic, “College Should Be Way More Fun,” Amherst College president Michael A. Elliott says it doesn’t have to be that way: “I’m not talking about keg stands. I’m talking about the joyous mysteries of intellectual life.” He recalls that last fall his class forgot that he was there entirely during a loud, animated discussion about the ending of Henry James’ Turn of the Screw: Were the ghosts haunting two children in a sprawling country house real, or only imagined by their dotty governess? Why does one of the children die at the end…or does he? Amid the laughter, “nobody was waiting for me to tell them the answer; the room was theirs, all eight sides of it, Elliott writes.”

AI could have churned an answer to those questions in a few seconds but that’s not the point, Elliott argues: “What makes The Turn of the Screw so generative isn’t that it has a hidden answer waiting to be unlocked. James built the ambiguity in on purpose, and lingering over that uncertainty, turning it over, is the entire point.” (I have to agree: the course I took on Henry James, taught by the great literature professor and author Paul Skenazy, was one of the highlights of my time at UCSC, along with the marvelous Spanish-language literature classes by Andrés Avellaneda and Martha Morello-Frosch)

“That kind of intellectual experience—irreducibly human, stubbornly inconclusive—is precisely what artificial intelligence cannot offer. AI is a certainty machine: Ask a question, get an answer. But the most important questions don’t work that way, and learning to live inside them, and to enjoy living inside them, may be the most valuable thing that a liberal education can teach. In all the hand-wringing about higher education and its future, we risk turning our colleges into joyless job preparation, political death matches, or both. We’ve forgotten the most important thing of all—that thinking can be deeply pleasurable.”

Social media behemoths will pay $27 million to settle a school mental health lawsuit. Meta, TikTok, Snap Inc. and Google’s YouTube all settled with the Breathitt County School District in rural Kentucky, avoiding a trial, according to Bloomberg News. More than 1,300 other school districts have filed similar lawsuits and are awaiting trial, with the next scheduled for February 2027. As these lawsuits progress, who knows? We may see a resurgence in public education funds.