April 5, 2023

Boldly Go Where No Psychiatrist Has Gone Before with AI and Chat GPT

Written by

Carlene MacMillan, MD

AI: The Ultimate Crew Member in Your Psychiatric Practice

“Computers make excellent and efficient servants, but I have no wish to serve under them.” – Spock

Picture yourself aboard the Starship Enterprise, venturing into the unexplored realms of the psychiatry profession. You have a trusty AI co-pilot—be it Chat GPT, Bard, or Sydney – standing by to support you. Regardless of the specific application, your very own Mr. Spock is prepared to apply its extensive knowledge and analytical skills to streamline your workflow and elevate your practice.

Join us as we uncover how AI becomes the ultimate crew member, assisting with treatment plans and psychoeducation materials while you boldly navigate the future of psychiatry.

Save hours with AI, as the psychiatrist of the future

Exploring Psychiatry AI/Chat GPT Prompts that can save you hours

Chat GPT is a reasoning engine, not a knowledge base. This is an important distinction. It can't look up medical records and find the most relevant studies to inform your clinical decision-making (yet). A recent Stanford study found that "almost 60% of its answers either disagreed with human specialists or provided information that wasn’t clearly relevant."

So, we won't be discussing AI chatbots communicating directly with patients or AI providing medical advice, as this area requires significant ethical, expert, and regulatory oversight.

However, these large language models are well-suited to summarize large bodies of information, and format standardized letters.

In this section, we'll dive into some inspirational prompts you can use with any AI tool to address various aspects of your practice:

  1. Letter of Recommendation for a Colleague
  2. Academic Accommodations for a Male Student
  3. Academic Accommodations for a Student with a Sleep Disorder
  4. Jury Duty Excusal for a Patient with a Chronic Severe Mental Health Condition
  5. Disability Appeal for a Patient with Severe Obsessive-Compulsive Disorder
  6. Parent Guidelines for Cell Phone Use
  7. Prior Authorization for Medication Approval
  8. Marketing Your Practice and Naming a Newsletter or Podcast

How to read this article as a guide:

Below you’ll find the exact prompts you can write—just modify based on your specific case or patient.

Under each prompt, you’ll see a screenshot of Chat GPT’s response, to give you an idea of the output.

I used Chat GPT’s latest model (as of writing), GPT 4, but these prompts will be useful for any generative AI tool.

1) Letter of recommendation for a colleague

“Imagine you are a psychiatrist and the director of a mental health practice that works with trainees and are writing a letter of recommendation for a female psychiatry resident who rotated through your site and is applying to a child psychiatry fellowship. The letter should strongly endorse this individual, highlighting her work with highly challenging and high-risk psychiatric cases as part of the outpatient practice. Mention that you have continued to collaborate with her as she now has her own private practice and that you remain impressed with her skills as a psychiatrist. Emphasize traits common in exceptional psychiatrists and those who excel in collaborative teams. Note that she would be an excellent addition to any fellowship program. Please follow Strunk and White’s Elements of Style recommendations when crafting the letter.”

Here’s the first half of Chat GPT’s response:

2) Academic accommodations for a male student

“Compose a letter to a university's disability services office as a psychiatrist caring for a male patient who has been under your care since [INSERT DATE] and last seen in [INSERT DATE]. The patient requires accommodations for extended deadlines on assignments and permission to miss classes when his mental health interferes with attendance. Diagnoses include [INSERT DX] and please indicate how these diagnoses could potentially interfere with school functioning. He attends a university in California. Include relevant rationale and legal language relevant to the state of California and national disability law supporting these disability accommodations, as well as your professional opinion as a board-certified psychiatrist.”

Here’s the first half of Chat GPT’s response:

3) Academic accommodations for a student with a sleep disorder

“Write a letter to a university's disability services office as a psychiatrist caring for a male patient with Idiopathic Hypersomnia, requesting accommodations such as extra test time and access to recorded lectures and lecture notes. Explain how Idiopathic Hypersomnia affects daytime functioning and why these accommodations are essential, given the persistence of the condition despite optimal treatment.”

Here’s the first half of Chat GPT’s response:

4) Jury duty excusal for a patient with a chronic severe mental health condition

“As a board-certified psychiatrist in Texas, compose a letter explaining why a male patient who is on psychiatric disability with chronic paranoid schizophrenia should be excused from jury duty due to the indefinite nature of his chronic condition. Follow any guidelines for medical professional letters for juror excusal in Texas.”

Here's the first half of Chat GPT's response:

5) Disability appeal for a patient with severe Obsessive Compulsive Disorder

“As a board-certified psychiatrist with two decades of experience, write a letter supporting a female patient with severe OCD, expressing your disagreement with the initial decision to deny disability benefits. State that you have been her outpatient psychiatrist for several years and have not observed her maintaining stable employment. Include any pertinent information typically found in such letters.”

Here’s the first half of Chat GPT’s response:

Follow-up prompt to input scores (modify for your case):

Now, write the same letter but include her Sheehan Disability Scale results from 2/13/2023, with an overall score of 18 and scores of 6 for both disruption to work/school and family life activities. Explain what these scores signify.

Chat GPT added the scores to the letter:

This is an important note: These chat-based AI interfaces, are conversational. It remembers the context of what you typed before, so you can and should add more context to iterate for the best results.

6) Parent guidelines for cell phone use

“Imagine you are a child psychiatrist, and a parent of a 10-year-old female patient has asked for guidelines on when their child should get a cell phone. Provide a written guide of best practice recommendations and tips, ensuring the content is at a high school reading level. Use the format found in "Facts for Families" from AACAP.”

Here’s the first half of Chat GPT’s response:

Follow-up prompt to explain the guidelines to the 10-year-old patient:

“Now write on the same topic but have the explanation directed at the 10-year-old female patient so it is at her reading level.”

Here's the first half of Chat GPT's response:

7) Prior authorization for medication approval

“Pretend you are a NY-based psychiatrist writing an appeal to a specific insurance company to request prior authorization for a specific brand name medication, Trintellix,  for a patient with recurrent severe Major Depressive Disorder. The letter should detail the FDA indication for the medication and what criteria typically need for it to be met for it to be considered medically necessary. Take on a firm, frustrated yet professional tone and indicate the patient has had multiple failed medication trials <<insert details of trials without  any PHI>>. Include that the patient recently scored a 26 on the PH-9 on 3/3/2023 and the significance of this. Include any relevant state laws around mental health parity and your intention to appeal to relevant regulatory agencies should this request be denied due to the risks posed by refusal to cover the medication."

Here’s the first half of Chat GPT’s response:

8) Marketing your practice and naming a newsletter or podcast

Suggest potential names for a podcast hosted by an innovative psychiatrist who discusses advances in the field of psychiatry and mental health and identifies as a psychiatric futurist. The target audience is mental health professionals. (Ok, spoiler alert: this one is real. Stay tuned for our “Psychiatry Tomorrow” podcast coming out soon!)

Tips for Using AI in Your Mental Health Practice

Keep these essential tips in mind when leveraging AI assistance:

  • Never input PHI information into non-HIPAA compliant systems.
  • Provide details such as gender, dates, and data without identifying patients.
  • Be cautious when asking AI systems to cite studies, as they may "hallucinate" citations.
  • Specify the persona, tone, or style you want the AI to adopt.
  • Request adherence to specific writing guidelines or reading levels.
  • Use "Find/Replace" in a word processor to insert identifying information after AI completion.
  • You can enhance what the AI has created with more specific anecdotes after the document has been created, depending on how specific the need is.

Conclusion: Embracing the Future of AI and Psychiatry

As we conclude our thrilling journey through the universe of AI-assisted writing for psychiatric clinicians, we hope you've gained valuable insights into how this remarkable AI companion can elevate your psychiatry practice to new heights.

With its ability to craft compelling letters, fine-tune academic accommodations, and assist in developing treatment plans and teaching materials, this technology truly is a time-saver that can allow you to focus more on practicing at the top of your licensure and less on administrative minutiae.

What lies beyond the event horizon of AI and Psychiatry is still a mystery. Technology has already outpaced our healthcare systems, and it seems that AI is accelerating at an even more exponential rate.

Significant ethical and safety concerns are at the forefront of our minds, especially when it comes to AI bots communicating directly with patients and essentially offering medical advice without a license. But one thing’s for sure. The journey promises to be anything but dull. It's crucial we stay informed and engaged so we may live long and prosper!

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