Human Cost of Automated Care

Articles
Written By Rayshaun Johnson

The growing presence of artificial intelligence in healthcare and mental healthcare is often discussed as a technological issue. From my perspective, however, the larger concern is not AI itself. AI appears to be a product of broader social, political, and economic forces that have gradually invalidated, deconstructed, and weakened systems that were once built around human relationships, professional expertise, and community support.

The conversation surrounding AI frequently centers on innovation, efficiency, and cost reduction. Missing from much of that discussion is an honest examination of the conditions that have made AI appear necessary in the first place. During COVID, mental health providers experienced an unprecedented influx of individuals seeking support as people struggled with grief, isolation, uncertainty, financial hardship, and collective trauma. The demand revealed both the necessity of mental healthcare and the limitations of existing systems.

Today's crisis looks different. Many individuals are navigating worsening economic conditions marked by underemployment, rising costs of living, shrinking insurance coverage, reduced healthcare benefits, and declining access to services. At the same time, increasingly divisive political, social, and racial agendas have contributed to chronic stress, uncertainty, mistrust, and emotional exhaustion across communities. While public conversations often focus on technological solutions, the underlying conditions driving psychological distress remain largely unaddressed.

From a therapist’s perspective, there is also a troubling pattern in which growing social, cultural, and racial tensions appear to be continuously amplified in ways that overwhelm communities and erode collective well-being. As people become increasingly burdened by economic instability, social fragmentation, institutional distrust, and psychological fatigue, AI is often presented as a form of relief or salvation. The concern is not simply that AI is offered as a tool, but that it risks becoming a substitute for confronting the social and economic realities contributing to distress in the first place. Like many products marketed during periods of widespread uncertainty, its appeal may grow precisely because the problems it promises to ease remain unresolved.

This is where AI enters the conversation. It is increasingly presented as a necessary solution to problems created by economic, social, and political decisions. The messaging often suggests that technological intervention can compensate for deteriorating access to care, workforce shortages, and strained systems. The parallels are difficult to ignore. Much like other products historically marketed as solutions to widespread social problems, AI is frequently promoted as the answer to challenges whose roots extend far beyond technology itself.

To be clear, this is not an argument against AI. AI can increase efficiency, provide immediate support, reduce administrative burdens, and expand access for individuals who might otherwise receive no support at all. In communities facing long waitlists, provider shortages, transportation barriers, or limited resources, AI-driven tools may serve a meaningful purpose. The concern is not the existence of AI but the possibility that technological solutions will reduce pressure to address the structural causes of these problems.

These concerns are particularly important when considering marginalized communities. Communities already affected by economic hardship, underemployment, inadequate insurance coverage, healthcare disparities, and longstanding barriers to care often experience system failures first and most intensely. Researchers and policy experts have warned that AI systems can reproduce existing inequities when trained on incomplete or biased data, potentially excluding or misrepresenting historically underserved populations (American Psychological Association, 2024b; Brookings Institution, 2025a, 2025b).

More importantly, there is a broader concern that technological expansion could become a substitute for meaningful investment in those communities. There is a significant difference between expanding options and replacing services. For individuals with financial resources and comprehensive insurance coverage, AI may function as one option among many. For disadvantaged populations facing fewer choices, AI risks becoming one of the primary options available. In that scenario, technology does not eliminate disparities. It simply changes their form.

Another often-overlooked concern involves individuals who lack reliable access to technology altogether. Discussions about AI frequently assume access to smartphones, broadband internet, digital literacy, and technological confidence. Yet many older adults, low-income families, rural communities, individuals experiencing homelessness, and people living in underserved areas continue to face barriers to technology access. As services become increasingly digitized, these populations risk being excluded from both traditional services and the technologies promoted as alternatives. In such cases, AI does not expand access. It may simply create another layer of separation between vulnerable populations and the care they need.

These concerns must also be understood within the context of persistent workforce shortages and limited access to human providers. Psychotherapists, physicians, social workers, and other healthcare professionals face practical limits on how many individuals they can ethically and sustainably serve. Burnout, staffing shortages, reimbursement challenges, administrative burdens, and increasing operational costs continue to strain healthcare systems (American Psychological Association, 2023, 2024a).

In this environment, it is understandable why many individuals turn to AI-based support systems that offer immediate access and minimal wait times. Yet their growing popularity raises larger questions. Are technological solutions being used to genuinely expand access, or are they increasingly being relied upon to compensate for systems that have been allowed to deteriorate?

Another concern involves the broader economic environment surrounding AI adoption. AI advancement alone may not represent the greatest challenge facing healthcare professionals. Equally significant are rising healthcare costs, insurance barriers, declining reimbursement rates, growing corporate consolidation, and increasing pressure to deliver services more efficiently while operating with fewer resources. Within that environment, legitimate questions emerge regarding whether AI will remain a supportive tool or increasingly become a justification for reducing investment in human labor and professional expertise.

Accessible Pathways to Knowledge, Insight, and Healing

While discussions about solutions often focus on technology, valuable resources exist outside both healthcare systems and digital platforms.

It is important to recognize that support and personal growth are not limited to formal healthcare systems or emerging technologies. One approach I frequently recommend is reading. I often share book recommendations not only for leisure, but also as a supplement to therapy and personal growth. Through books, individuals can explore topics such as generational trauma, resilience, grief, healthy relationships, emotional regulation, and personal development while gaining language, perspective, and insight from the experiences of others.

There is also a practical reality that cannot be ignored. Many individuals face significant financial barriers to healthcare, including rising premiums, deductibles, copayments, and out-of-pocket costs. Under certain circumstances, purchasing a well-researched book on topics such as healing, resilience, or generational trauma may be far more realistic than paying repeated copayments for treatment. A $12.99 book is not a replacement for psychotherapy when psychotherapy is needed, but it can provide valuable education, encouragement, practical tools, and a meaningful starting point for growth when access to care is limited.

As conversations continue regarding AI, healthcare access, and the future of mental health services, it may be equally important to remember that not every solution requires new technology. Some of the most effective and cost-conscious resources remain those that have been available for generations: education, community, meaningful relationships, critical thinking, and the written experiences of others.

Moving Forward: A Call for Mindful Action

Identifying concerns is only part of the conversation. The challenge moving forward is not preventing technological advancement but ensuring that innovation develops alongside meaningful investment in the systems and communities it is intended to serve. This includes strengthening healthcare and mental healthcare infrastructure, expanding access to affordable care, protecting privacy and informed consent, and evaluating emerging technologies through measures of equity, quality, community impact, and long-term sustainability rather than efficiency and cost reduction alone.

Ultimately, the central issue extends beyond technology itself. It involves healthcare access, economic priorities, social responsibility, equity, workforce stability, and the value society places on human-centered services. While I do not claim expertise in environmental science, I believe any meaningful cost-benefit analysis should also acknowledge ongoing discussions regarding the environmental footprint of AI and its growing demand for technological resources.

AI may improve efficiency, increase access, and help address genuine resource shortages, but a meaningful evaluation must also ask why those shortages exist and whether technological solutions are addressing root causes or merely compensating for them.

The future of healthcare should not be measured solely by efficiency or cost savings. It should also be measured by how effectively systems preserve dignity, trust, professional expertise, meaningful human connection, and equitable access for all communities, including those who remain disconnected from the technologies increasingly being promoted as solutions. The goal should not be to resist innovation, but to ensure that innovation remains accountable to the people, communities, and systems it is intended to serve.

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Rayshaun Johnson
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