Where will we be in 20 years?
STUDY: Luty J, British Journal of Psychiatry 2026
STUDY TYPE: Opinion essay (Letter)
FUNDING: Independent
Summary
Psychiatric diagnosis and treatment follows standardized manuals and algorithms: the DSM, structured interviews, treatment guidelines. Following those requires boolean (if… then) logic, and large language AI models can do that and so much more. This letter imagines we are headed toward obsolescence.
Two niches will survive automation:
- Forensic psychiatry, since no legal system will let a computer authorize involuntary detention or testify in court
- Academic psychiatry, though he calls that exemption doubtful too
He imagines that pharmaceutical companies will fund these machines, shaping the chatbots toward branded drugs. He predicts that the change will be slower for psychotherapists, and faster in poorer countries.
As the change takes place, psychiatrists will argue that they are irreplaceable, but AI already can read the mental state examination, and it recently beat trained clinicians at detecting tardive dyskinesia, an antipsychotic side effect.
Practice Implications
- AI is a tool. Let’s learn how to use it creatively in ways that preserve our humanity, like reducing paperwork and improving eye contact and presence.
—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
