By Mike O’Donnell, Chair, National Coalition on Mental Health and Aging
When I started doing research on this topic, the media was buzzing with doomsday scenarios about how artificial intelligence would wipe out humanity. At the same time, I was reading “The Hardest, Longest Race” by Erick Moskowitz, a non-fiction account of a 1909 cross-country automobile contest that changed our nation. The race pitted two Model T Fords against three other auto crews on a 4,106 – mile course from New York City to Seattle, long before the era of paved highways and service stations.
When cars first appeared, critics predicted an apocalypse of chaos, noise, mechanical breakdowns and social disruption before safety regulations like brakes, seat belts, airbags and crash testing were mandatory. Today we are having a vigorous debate over voluntary industry standards versus governmental regulation of AI. In 1909 those competitive drivers relied not only on the durability of their vehicles but on their own determination and endurance. We can learn from their experience and their ability to adapt to uncertainty.
Those daring drivers also relied on their sponsors, a nascent network of auto dealers, and local guides to help them find roads and avoid pitfalls across frontier America. The National Coalition on Mental Health and Aging presents this guide to chart the course of AI, mental health and aging in America. This review finds that artificial intelligence in mental health care for our aging population must rely on common bioethical and digital health principles, adapted for cognitive vulnerability, digital literacy, and personal autonomy.
These core ethical principles include:
- Beneficence and Nonmaleficence
- Beneficence: AI tools should improve access to care, support early detection of cognitive decline or mood changes, and assist with daily medication or therapy reminders.
- Nonmaleficence: Systems must avoid causing harm, such as through false-positive diagnoses, over-reliance on overly affirming chatbots that miss acute crises, or reinforcing isolation in older adults who mistake AI for human empathy.
- Autonomy and Informed Consent
- Informed Consent: Older adults—and their legal surrogates or power-of-attorney representatives, where applicable—must clearly understand when they are interacting with an AI tool rather than a human clinician.
- Right to Opt-Out: Patients should have accessible alternatives to AI-driven monitoring or communication without losing access to standard human care.
- Privacy, Confidentiality, and Data Security
- Data Protection: Mental health and aging data (including speech patterns, cognitive assessments, and daily routines) are highly sensitive. Platforms must adhere to strict standards like HIPAA.
- Vendor Vetting: Third-party app developers and cloud processors must guarantee that personal data is encrypted, securely stored, and never commercialized without consent.
- Justice, Fairness, and Inclusivity
- Bias Mitigation: AI algorithms must be trained on diverse age groups, socio-economic backgrounds, and cultural profiles to prevent digital redlining or misinterpreting symptoms in older or non-tech-savvy populations.
- Countering Ageism: Generative tools must avoid stereotypical portrayals of older adults as frail, disabled, and technologically incompetent.
- Digital Equity: Technology should bridge care gaps for rural or homebound older adults rather than exacerbating the “digital divide” caused by a lack of devices or broadband.
- Transparency and Explainability
- Algorithmic Clarity: Clinicians and patients should be able to understand how an AI tool reaches a conclusion.
- Clear Disclosures: Limitations regarding what the AI can and cannot do must be stated plainly to prevent emotional dependency or false safety nets.
- Human Oversight and Accountability
- Clinician Responsibility: AI must act as an augmentative tool, not a replacement for human judgment. Licensed professionals retain ultimate ethical, clinical, and legal responsibility for patient treatment plans and crisis management.
Resources – This blog features resources from national organizations (presented below in alphabetical order), including NCMHA members, who are adapting AI to advance mental wellness and recovery while upholding the dignity and autonomy of all persons across the lifespan.
We want to hear from you – As we travel this unchartered frontier, we invite you to share your experiences, questions, and concerns by contacting us at: info@ncmha.org
[Disclosure: AI was used by the author in conducting research for this blog.]
About NCMHA
The National Coalition on Mental Health and Aging is the leading voice on behavioral health for older Americans. We are an alliance of national, state, and local organizations and individuals concerned with the mental well-being of older adults. NCMHA is a non-profit 501(c)(3) organization. To learn more about NCMHA, visit our website at https://www.ncmha.org/
Resources from National Organizations on AI, Mental Health and Aging
American Association of Geriatric Psychiatry
While AAGP’s core certificate and board review programs focus on clinical geriatrics, AI intersects with psychiatric education and regulatory frameworks in distinct ways:
- Clinical & Ethical Topics: The AAGP certificate curriculum addresses modern clinical challenges, assessment tools, and ethics in older adult care.
- AI Governance & Companionship: Broader industry standards and certification masterclasses (such as AIGP/AI-related governance discussions) track state and federal laws regarding AI companions, humanness disclosures, and patient interaction safety for vulnerable populations.
AAGP Certificate Program in Geriatric Mental Health | American Association for Geriatric Psychiatry
American Association of Marriage and Family Therapists
AI Is Rapidly Transforming MFT Practice — But Adoption Remains Thoughtful and Measured
AI Is Rapidly Transforming MFT Practice — But Adoption Remains Thoughtful and Measured – AAMFT+
American Association of Retired Persons (AARP)
AI Could Be Your Next Therapist If You’re Feeling Lonely, Depressed or Anxious
By Edward C. Baig, June 06, 2023
Find Out Why AI Might Be Your Future Therapist
American Association of Social Workers
The use of Artificial intelligence (AI) in the social work profession is an emerging area of practice. The use of AI has raised questions about how to harness its benefits, mitigate its risks, and ensure it aligns with the values and standards in the NASW Code of Ethics.
American Geriatrics Society
Statement on generative AI (GenAI) in the care of older adults on July 21, 2026, published in the Journal of the American Geriatrics Society (JAGS).
Generative AI in the Care of Older Adults: A Position Statement From the American Geriatrics Society
American Mental Health Counselors Association
Code of Ethics Addendum Addressing Artificial Intelligence (2023)
AMHCA Publications – American Mental Health Counselors Association
American Psychiatric Association
Applications of Artificial Intelligence in Mental Health Care
Psychiatry.org – Applications of Artificial Intelligence in Mental Health Care
American Psychological Association (APA)
Ethical guidance for AI in the professional practice of health service psychology:
Ethical guidance for AI in the professional practice of health service psychology
American Society on Aging (ASA)
Artificial Intelligence – an Overview
By Angad Sandhu, Vishesh Gupta, and Faizan Wajid, June 24, 2025
Artificial Intelligence: An Overview – ASA Generations
Artificial Intelligence at the Intersection of Aging and Public Policy
By Dorothy Siemens and Karen Lyons
Artificial Intelligence at the Intersection of Aging and Public Policy – ASA Generations
Artificial Intelligence and Technology Collaboratories for Aging Research
The AITC program is designed to serve as a national resource to promote the development and implementation of AI approaches and technology through demonstration projects to improve care and health outcomes for older Americans.
A2Collective
The a2 Collective represents the Artificial Intelligence and Technology Collaboratories (AITC) for Aging Research program funded by the National Institute on Aging (NIA), part of the National Institutes of Health. The a2 Collective comprises AITCs at Johns Hopkins University (JH AITC), the University of Massachusetts Amherst (MassAITC), and the University of Pennsylvania (PennAITech) and the a2 Collective Coordinating Center managed by Rose Li and Associates, Inc. (RLA).
AI AgeTech Non-Dilutive R&D Funding for Startups + Academics
Boston Medical Center (BMC) Geriatrics
Effectiveness of AI-based conversational and socially assistive agents in older adults: a systematic review and meta-analysis
May 7, 2026 26:887. doi: 10.1186/s12877-026-07418-6
Wenling Gou 1, Florian Lefebvre 2, Tongping Yang 3, Robin Recours 1, Jing Yang 4,✉
The Center for Medicare Advocacy
Special Report: The Role of AI-Powered Decision-Making Technology in Medicare Coverage Determinations, January 2022
This paper focuses on AI-powered tools involved in health care utilization management (UM). Such tools automate the medical review and prior authorization processes, direct post-acute care, and affect admission and discharge planning.
Justice in Aging and AI
As a national legal advocacy organization, Justice in Aging has not issued a standalone, comprehensive policy statement dedicated solely to general consumer artificial intelligence. Instead, the organization focuses its advocacy and public statements on systemic legal protections, economic security, and healthcare access for low-income older adults. When AI intersects with these core areas, Justice in Aging advocates for strict human oversight to prevent the denial of critical care or due process.
KFF on Mental Health, AI, and Older Adults
Findings from the KFF Tracking Poll on Health Information and Trust, provide key insights regarding older adults, mental health, and AI usage.
Mental Health America and AI
Mental Health America (MHA) reports that 68% of surveyed individuals described their experience using AI for emotional support as positive.
Key findings from MHA’s survey on AI and mental health
National Alliance on Mental Illness (NAMI)
How NAMI Is Helping Push For Clarity and Safety in AI Mental Health Tools
National Council on Aging (NCOA)
Can AI Help Older Adults Age Well? Benefits, Risks, and What Families Should Know
August 5, 2026
By Debra Berlyn, Executive Director, Project GOAL
How Can AI Help Older Adults? Benefits, Risks, and Safety Tips
Rush University Medical Center
A guide to artificial intelligence and its potential applications in medical literature – a brief introduction to the topic and practical concerns such as proper citation of A.I.-generated content and publisher expectations. Official guidelines from Rush are also included, as are links to various resources.
Overview – Artificial Intelligence – An Overview – Rush Library at Rush
United States Senate
The Aging with Artificial Intelligence Act of 2026 is a bipartisan bill introduced in the U.S. Senate to fund a $2 million independent study on how AI-enabled tools impact older Americans. Introduced 06/24/2026 by Sen. Mark Kelly; Co-Sponsors: Sen. Rick Scott (R-FL), Sen. Roger Marshall (R-KS), and Sen. Kirsten Gillibrand (D-NY).
World Health Organization (WHO)
Policy Brief: Ageism in artificial intelligence for health
This policy brief examines the use of artificial intelligence (AI) in medicine and public health for older people, including the conditions in which AI can exacerbate or introduce new forms of ageism. The brief presents legal, non-legal and technical measures that can be used to minimize the risk of ageism in AI and maximize AI’s benefits for older people as these technologies become more commonly used across the world.