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Amanda: Welcome back to the Madison Advisory AI podcast. I'm your host, Amanda Werner Thompson, founder of Madison Advisory AI. Today's conversation sits at the intersection of behavioral health, technology, and leadership. As technology becomes more embedded in daily life from social media to AI, the conversation around mental health has become more complex. There's growing concern about the risks technology may introduce, but there's also a less discussed perspective that technology may actually actually be one of our best tools for improving mental health outcomes and even preventing suicide. Dr. Dan Ridenberg has spent decades working in suicide prevention and behavioral health leadership. He currently serves as managing director at the National Council for Suicide Prevention and founded Safe Online Standards, an initiative focused on improving mental health protections across digital platforms. In this conversation, we explore the role of technology and connection and resilience, what leaders misunderstand about suicide prevention, prevention, the responsibility of technology platforms, and how AI may reshape behavioral healthcare. This is a thoughtful and nuanced discussion about one of the most complex challenges in healthcare today. I hope you find it valuable. Dan, welcome to the podcast.
Daniel Reidenberg: Thank you, it's great to be here.
Amanda: You've spent decades in suicide prevention. How has the conversation changed now that technology has become ubiquitous?
Daniel Reidenberg: Well, I mean, I it's a great place to start because the conversation really has changed. It has changed a lot in the last 20 years. There's been far more conversation about mental health broadly and suicide prevention. And a lot of that really started around COVID as things shut down and there was more concern about people's mental health and their well-being. the media really started to pay more attention to mental health issues and resulting from that was around suicide. So we have seen this kind of gradual change. But when it comes to technology, which really has been around for about 15, 20 years, the social media aspects, we've seen more and more and more conversations happening online and interactions with people than we ever did before. So I think it's both things. It's the traditional media, the legacy media that has been talking about it more, but I think it is people that are talking about it more in their interactions and that has really magnified in the last few years.
Amanda: And you mentioned something interesting when we spoke that technology doesn't just create risk, it also creates connection. Can you expand on that?
Daniel Reidenberg: Absolutely. So technology is really kind of an amazing thing. Yesterday I was in a meeting with somebody who is in Australia, somebody who is in the UK, ⁓ somebody who in Canada. We were all connected at the same time. And it's a wonderful thing to be able to connect that way. It's definitely not the same as
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being in the same room with someone, one-on-one or in groups. But the idea here is that technology has enabled us to be more connected. And we know, research well documents, that connections is really important when it comes to mental health, when it comes to suicide prevention. The more connected you are, the less likely you are to die by suicide. And those connections can be in lots of different ways. So connections to family, faith, community, sports and hobbies. ⁓ ⁓ through technology enables you to be ⁓ with somebody who you may or may not even know personally and that can offer hope. And the reason that it offers hope is because there's somebody else out there is concerned about you or who is engaged with you who is doing something with you and those connections provide ⁓ And know when it comes to mental health and definitely around suicide ⁓ a sense of meaning and purpose and value ⁓ lower your risk. So connected to other people ⁓ gives a sense of meaning and hope.
Amanda: And that's, I think that's such an interesting take on it because we hear so much about the negative sides of technology and social media and connection is key when it comes to mental health and suicide prevention. And just that engagement that you spoke about too is really can be emphasized with all, with social media, though it does come with its risks. And in that regard, how should we think about technology on both sides, both protective and risky?
Daniel Reidenberg: Yeah, so... I think you're right. This is a really incredibly challenging situation ⁓ all of us to be dealing with. ⁓ don't have enough data and research yet, evidence or consistent things around the world to tell us what is best. ⁓ All is in development, but we just don't have it yet. ⁓ So think we really need to take a balanced approach. We need to understand that for all of the good things, ⁓ connections, ⁓ support that happen, resources that can be provided, ⁓ the speed which technology and these connections can be made. All of these things are the really good things. And we can talk a little bit more about them if you want. But on the other side of it are some of the risks. And some of those risks are real and some of those are a little bit exaggerated by things that people are saying in the media, but they're real. So for example, we know that bullying can happen, right? Now bullying happens ⁓ to especially young people, ⁓ in time. in schools, in playgrounds, it happens all the time. It happens when they're sitting together at the mall. The difference between that bullying and bullying online is the speed at which it can happen, but really it's the magnitude at which it can happen. If you're just ⁓ getting bullied by somebody when you're walking in the mall or at school, it's one or two, maybe three or five people. When you're getting bullied online, it can be hundreds and hundreds of people, and it can happen very quickly and it can be overwhelming and it can be people you have no idea who they are and the anonymity to it gives those people this sense of entitlement, wrongly so, but gives them a sense of entitlement ⁓ do it in a way that they wouldn't do it if they were standing next to you or even nearby you. ⁓ ⁓ a challenge and a risk there ⁓ we know that exists in real life and it exists just in an ⁓ way ⁓ ⁓ example, another risk of technology is, and we've heard lots about the algorithms, right? And most people have never even seen the algorithms, they just hear about algorithms. But the bottom line is that we have some sense that some of the platforms have had a challenge with algorithms taking people down this famed rabbit hole, right? So if you're scrolling through something and you see something and you stop on it or you click on it, you're going to get fed more of that content. Well, when
Amanda: You
Daniel Reidenberg: Somebody is struggling with a mental health issue. Let's say they're depressed. They're just not doing very well. Doesn't mean that they're at risk of suicide or anything like that, but they're just not happy in life. They scroll on some content and they relate to it. It resonates with them. They click on that and then all of a sudden they're getting fed a lot more of that. That same kind of content. And the reason for that is that these companies have figured out what keeps you happy, what keeps you engaged, what keeps you coming back, what keeps you there before you leave it. And that is that you tend to want to see more of the things that you like. I have a friend who is into ballet. And so she gets fed a lot of ballet content. I started talking to her about it and then all of sudden I wanted to see a ballet video. All of a sudden now I'm seeing tons and tons of ballet things. And that can be a positive too, right? You can learn new skills, you can learn new interests. But when it comes to the darker side of technology and getting fed some really bad content, that's really, really dangerous when it comes to mental health. And in particular, it's because sometimes people, they're bad actors out there and they put bad content out there. So the things that you're getting fed is not only multiplied and it's constant, but it's really bad. And so that it drives you to think things that you weren't already thinking. That's where technology really has some real risks.
Amanda: Right. And when you're in the darker place and your mental health may be at risk, I think you, and I'm not an expert in the field in that manner, but I think you're more prone to go down the rabbit hole in and of itself. one, there are bad actors. Two, the algorithms are very effective. And then three, you're mentally prone to probably stay there longer than another person would.
Daniel Reidenberg: 100 % right. The old adage misery loves company ⁓ really true, especially when it comes to, for example, depression or even the other illnesses. take anxiety disorders. You feed when you have a mental health challenge ⁓ stigma, which is really a ⁓
sense shame, discrimination, like you have something against you, ⁓ something marking you makes you feel alone, makes you feel isolated, makes you feel like nobody really understands you. ⁓ So all a sudden now if you see something and you're online and it's like that that's me or I really get that. You want to see more of that. It takes away that sense of isolation and it takes away the sense that you're alone in the world ⁓ so you start seeing more and more of that content ⁓ the real challenge here is that ⁓ Yep, let's forget about the bad actors for a moment. Let's just say that there's content out there that you relate to around an anxiety disorder or or a sense of depression. Everybody that's putting that content out is at a different place along that path. Some are it's just starting some they've been in it for a while. Some it's really deep and dark for them. Your place that you're getting at may not be one of those. It may be several of those and so you're going to relate with all of it in some capacity. and really drill in on where you're at because that's what you're going to relate most to. And if you're in that really, really hard place, you're going to get fed more of that content from some of these platforms and that can be really risky.
Amanda: That can be. what do leaders, and there are a lot of leaders in the field wearing different hats, but what do leaders most misunderstand about suicide prevention today?
Daniel Reidenberg: Yeah. I think there's a lot of things that we don't understand about suicide prevention. ⁓ There's still a lot of fear around it. There's a misbelief and a misperception if you start talking about it that it's gonna happen. I've literally sat with CEOs of companies and said, we can't talk about that in our company, even on a day like World Mental Health Day or Suicide Prevention Day for the world. Don't bring that up because we're gonna start having it happen here in our company. We're going to get claims of people wanting to go to therapists and that's going to increase our rates. So there's this stigma that really still exists around mental health and definitely around suicide. And leaders don't understand the best way to approach it and they're really afraid of that. So we need to break through that. We need to help leaders understand where their real role is. Leaders can help ⁓ people to the right place and leaders can role model ⁓ the right way of self-care. We have a lot of leaders in companies that think they just got to work. They got to be at work every day, right? And they think to themselves, if I'm not here, my employees are going to say to themselves, the leaders aren't here, they don't care very much, so why do I have to come in every day? So they have this belief that they have to be present and they shouldn't take any PTO, they shouldn't ever go on vacation. Well, that's really not good health. It's not really good positive mental health care. So we need leaders to really role model how to take care of yourself and demonstrate that to people. If we really want to try to break down some of the stigma around mental health issues. We want, we need leaders to really be able to say mental health is just as important as other parts of physical health. So providing access to care and time away from work to be able to get mental health care if they need it needs to be supported in companies. We need to do education, not just to leaders. It's a different kind of education you do to leaders around mental health and suicide prevention. Leaders are really worried about what's their return on the investment, right? What is it going to cost us if we invest X amount of dollars into every single employee? Because typically mental health is a loss leader for hospital settings, for things like that, because everybody's, for example, depression, it's not the same as if you break your arm. We know about how long it's going to take to heal. depression, there's no time frame around that. Sometimes it can be weeks, months, it can take a long time. So we need to help leaders understand the cost issues, right, for them and for the companies. But we also need to help those people who are managing people, how to talk to them, what to listen for, what questions to ask, how to provide the right kind of support to them. These are the kinds of things people in all levels of leadership can get involved with that can be proactive. to help reduce the risk of things getting worse for their employees.
Amanda: And how do we encourage that besides showing the leaders where numbers matter, where their metrics matter, and managers? Is there another way to be impactful?
Daniel Reidenberg: I think one of ways to be impactful is to have people start talking about it. So employees and team members need to say, this is important to me. They need to raise the issue with their leaders. Often there is this great divide, right? Leaders don't want to talk about it because they're afraid of it. And people don't want to talk about it because they're afraid if they talk about it, well, they're not going to get a promotion. They're not going to get a raise. They're not going to get assigned to the projects that they want. Not only do we have this problem in the military, but we have it in the workplace as well. In the workplace, people are afraid that if they bring this up ⁓ their manager ⁓ in any way concerned that they might be struggling, ⁓ might be able to handle a project, then they're not going to get assigned to it. ⁓ really that isn't the truth. ⁓ we need the people to be able to say, look, ⁓ I'm not really struggling right now, but this is important to me. Maybe it's important because ⁓ in my family is struggling. ⁓ it's somebody else here on my team that's struggling ⁓ I don't want to necessarily talk about them, but I want topic to be brought up. So we needed to come at it from both ends in the workplace to really start that conversation.
Amanda: Right. And a lot of it is
really having the empathy and the courage to bring that conversation to the forefront.
Daniel Reidenberg: And oftentimes we have, you know. tragedies and it really isn't no other way to talk about this. have been touched by suicide in many capacities. I lost many patients of mine to suicide. I lost a family member and a good friend to suicide. I've worked with thousands of people that have lost someone to suicide and people in crisis in my career. When you lose someone it is a tragedy. It changes your life forever. There just is no other way around seeing that. It is a very different kind kind of death. All death really impacts us, but it is a very different kind of death. There's so many unknowns around it. ⁓ But when it happens in the workplace, and we have this in schools as well, it really changes everything. Nobody knows what to say. Nobody knows what to do. People are worried about what's going to happen and how do we go on with the project we were working on and what do we do with that person's desk and the things that are at their desk. All of these kinds of things are the things that we need, the more we talk about it in advance, shows empathy and concern and compassion, and it prepares us for when a tragedy could happen, how to get through it. But it does take courage, as you're talking about, to start this, because unfortunately, we do see this more and more, that we are seeing people in the workplace that are either thinking about suicide, attempting suicide, or we're losing them to suicide, and it really rocks a workplace. Thanks
Amanda: I can entirely see that. And often when someone is impacted by suicide, they look for the reason why or the cause. Why is it so difficult to identify a single cause in suicide?
Daniel Reidenberg: That's a fantastic question. In every case that I've ever been involved with, in any research study I've ever read, ⁓ other experts in the world I've ever met with, any conference I've ever been at, you never hear of somebody dying by suicide because of one thing. ⁓ Never. that's a pretty strong word to say. ⁓ But been doing this for a long time. And what we know ⁓ is there's never just one reason why somebody dies by suicide. ⁓ Sometimes the media or people will talk about it and they will say there might have been a straw that broke the camel's back, so to speak. There was this final thing that happened. But what we know when we look into deaths by suicide, even when we look into people who attempt and survive, which is far more people than die, by the way, we find that there are multiple reasons behind every death by suicide. ⁓ research ⁓ a little mixed ⁓ the world where you look at at around this issue. But by and large, the research says that about 80 to 90 percent of the people that we lose to suicide have a mental health issue at the time of their death. ⁓ that might be undiagnosed. It might be misdiagnosed. ⁓ might not be disclosed. ⁓ the reality is that when people are doing well in life, we don't see them at risk at suicide. We don't see them dying by suicide. Something else is going on. ⁓ if you think of a mental health issue that's kind of a baseline. There are many other things that go into somebody dying by suicide. It could be an occupational problem, a financial problem, could be a family problem, it could be a legal problem. There can be many things. But the research would tell us in personal experience working with many, many people, it's never just one thing. And that's what makes this really complicated because if we knew there was one thing that we should all be looking for, or if there was one warning sign that we should all pay attention to, we would all do that. It just isn't that simple when it comes to suicide.
Amanda: And why do you think most people do try to look for a single cause when it comes to suicide or a simple explanation?
Daniel Reidenberg: The reason people are... are looking for a single cause is the brain is always trying to figure things out. It's trying to understand things. It's trying to make sense of what's going on in its environment. And when you lose someone to suicide, there is this unending why. What happened? Why didn't they call me? Why didn't they ask? Why didn't they talk to me? Because most of us would have done anything to keep them alive. We would have gone anywhere. We would have dropped everything at the one moment to keep them alive. If you were in a restaurant somebody starts choking, people are going to try to do something to help. Even if it's just calling somebody or telling somebody to call somebody or somebody trying to do a maneuver to save them. If somebody's having a heart attack, somebody is going to try to do something. We have the same thing around suicide. We would do something if we knew where that risk was, if there was a sign. So when we don't have that, our brains are trying to understand it and make sense of it. And so it's looking for that one answer. What happened? What was the one thing? And the reason that the brain wants to figure that out is because it wants to make sure that it doesn't happen again to them. It is so painful when you lose someone to suicide. There is such a sense of guilt around, did you say something? Did you miss something that you should have heard when you were having that conversation, that last conversation? And there's this tremendous sense of guilt. So now the brain is trying to rectify all of that and say, Was there one thing? Really isn't just one thing.
Amanda: Yeah, and think there's always the question of why didn't I know or why weren't there other signs? And people are always looking for signs. And when it comes to signs and suicide, how does the complexity of there not necessarily being one root cause change how we look at prevention?
Daniel Reidenberg: It makes ⁓ prevention very difficult, right? If we knew, example, let's take cars, for example. We knew that when you get into an accident, if you don't have a seatbelt on, that
you're more likely to get injured and more likely to die. So we know that seatbelts make a difference, right? One simple action, put a seatbelt on and it could save your life and it could prevent serious harm. We have the same theory around suicide. If we knew there was one thing we could do to prevent a death by suicide, we would all want to do that and we would all strive towards that. So, give you an example. If everybody knew what the warning signs of suicide are, would that prevent a death by suicide? Probably not. It might help lower the risk that somebody's going to be identified and we can catch that sooner and prevent it. But by and large, just knowing warning signs isn't going to solve the problem of suicide. We need to about the brain. We need to know about the illness itself. What is that illness that might be leading towards it? We might need to know about those external factors. We call them social determinants of health, right? So things like unemployment and financial issues. One of the major challenges we have happens to do with like the banking industry and ⁓ not only unemployment, but when people are trying to get financial assistance, loans, things like that, is that those people that are processing those things and even doing collections are not trained on suicide prevention. And we know oftentimes somebody might be at risk because they've lost a job, they now are at risk of losing their home. And so somebody from a bank is calling and saying, we need to deal with the mortgage. And they have no idea that the conversation they're happening might have something to do with the suicide. So, and we have instances of this where somebody threatens a lender about taking in their life if they're to lose their home. So it's not as if we can just give kids in schools the warning signs of suicide and have them know that and think it's going to solve the problem. It's multifaceted how we have to look at suicide if we really want to think about prevention. And because we don't yet know enough about all of the reasons in which this happens, for example, we know that for some people there is a genetic predisposition towards suicide. If you have suicide in your family, you might be at greater risk of dying by suicide, or at least thinking about suicide. Doesn't necessarily mean it's true, but you might be at greater risk. There's a genetic component to it that is very different than a public health approach to suicide, which is about having the public understand it, be aware of it, be educated about it, and having the resources and systems available in the community to respond to it. Genetic brain system structure treatment very different than the public health approach. That makes this complicated.
Amanda: Right. It is. It's quite a complex issue in and of itself. And then you've created safe online standards. What led you to create that?
Daniel Reidenberg: So safe standards is the world's first and only set of standards and rating system for technology companies. at a very high level, if you think about it, think about movie ratings. It's movie ratings for social media companies. The idea here was ⁓ really I sitting around and I realized that young people have no idea how to tell a platform is safe or not or how safe it is or if it's safer ⁓ than something else they might be on. And parents don't know that either. And then when you start expanding it, healthcare providers who are talking to people about their anxiety, their depression, and what's happening in their lives, they don't know about it. Legislative people don't know how to tell what's safe or not. So I embarked on this really massive project to develop these standards that were recently released. We released them on Safer Internet Day ⁓ year on February 10th of 2026. to really be able to, for the first time, say that we now have a set of standards around mental health and around well-being, suicide, self-harm, and eating disorders that we want to measure the companies against. How are they performing around their policies? How transparent are these companies being around what they're doing in these areas? And, what about their functionality? Do they have functions on these platforms that help protect young people, protect teenagers? and enable parents to set good privacy settings. What is the content that they're being seen and how is that content being displayed to them? We also have a set of standards that is around digital literacy and education. How can we have these companies do more proactively in a prevention realm to be able to help educate the public around mental health and well-being?
Amanda: And when it comes to the technology companies, what responsibility do you think they should have?
Daniel Reidenberg: I think that they do have a role in all of this. Let me clarify, because I think it's really interesting and it's a newer question, ⁓ it really brings AI ⁓ the forefront, right? So historically and into this moment in time, tech companies are not health related companies. And I will tell you my opinion is I don't think they should be health companies. They're not. They're tech companies and they're built around technology and they're built around engagement. They're built around enjoyment. They're built around connecting people. If you think of Pinterest, it's about where your interests are and how can we help you expand on your interests and learn more new things. They're not built. around healthcare. However, ⁓ we said at the very top, ⁓ the last couple of decades we've seen this kind of evolution of people ⁓ their mental health issues online more and talking about it and sharing more about where they're at. ⁓ ⁓ despair and really dark places, but sometimes it's just, I'm at a really tough time right now. ⁓ that has happened, and now that we have AI coming into this and chatbots, ⁓ tech companies are really starting to get into the healthcare business because we know that people are having these
conversations online. You can look at, ⁓ Google is getting about a billion questions about health every single day. ⁓ that's broadly speaking, all kinds of health related issues. Open AI recently ⁓ released some data ⁓ and ⁓ was ⁓ every there are two conversations about suicide every single second happening on one platform. Let me say that again. Two conversations between people and bots every single second about suicide just on one platform. What does that tell us? Tells us a lot. Tells us that a lot of people around the world are thinking about suicide. Now they can be thinking about it in a lot of ways, right? How can I help prevent suicide? What do I need to know about suicide? However, a number of these conversations are also about their own risk and issues with suicide. That is putting these tech companies squarely in the healthcare business. And for me, I really don't want them to be there. I want there to be some separation between them providing healthcare. a bot providing healthcare and a real human. I don't think, for example, that a tech company, a bot, should be diagnosing somebody. I think that a bot, and we actually see in other countries around the world, there are now kiosks where you can go to and you can interact with them to get healthcare. can get antibiotics, you can get all kinds of advice. And we are going to move in this direction, where technology is going to help us more identify things. some of the reports recently coming out about what jobs are going to be lost and in healthcare that is one area that I think that we are going to see technology getting more involved and the reason for that is that technology has this ability to take in a wealth of information far more quickly than a human could ⁓ ⁓ an expert in suicide and mental health I can read as much as I can read as many as many studies that come out as many journals that can come out I can go to as many conferences as possible that is dwarfed by the number of information that a bot can take in, right? These databases can take in at any one time. So this technology can ultimately say it has more information than I or another expert does and it can use that in these interactions with people. That can be a really great thing. I don't think it should replace people. I don't think it should give a diagnosis. I think it can help somebody understand that something might be going on and they should reach out and talk to somebody, talk to a human being. Number one. Number two is I think technology companies and bots in particular should be required to say to somebody they're interacting with, I am a computer. I am not a person. And part of that is, that when somebody is struggling, in particular with depression or even anxiety, but when they're struggling with depression, They don't see things very clearly. They're very clouded and and so they don't take in all the information they would if their brain was functioning normally and so they get lost in the conversation they're having with the bot and then and because the way the bots are designed and giving back information It feels like a very genuine conversation Great, but it shouldn't replace a human being and so we have to remind that that brain that that isn't functioning optimally, that they're not human beings. Let me give you one other one that I think is critically important that tech companies I think need to get involved with, where they need to have a line. I don't think technology companies and bots should be giving instructions and methods on how to take your life. First of all, it's illegal for people to do that. You cannot instruct somebody on how to take your life without a consequence of other risk. there are laws that prevent that from happening. And we've had cases in this country and around the world where people that have been found to endorse and support and try to bring somebody toward closer to suicide, they've been found liable for somebody else's death by suicide. I don't think tech companies should be providing instructions for how to take your life. So there's a number of ways in which I think that technology needs to listen to experts and take advice. from us on those areas we have enough information on to say, there's some risk here.
Amanda: And I think the human in the loop component is critical for health care and for behavioral health, mental health, because that does give value and a through line for all those participating in the interaction. But when we started out the conversation, you mentioned technology giving us connection and engagement. And in some regards, that's what AI can provide in some regards, connection. where is that fine line between telling the person who's now engaged and may feel like they have a lifeline that is just a robot versus letting them feel like there is some connection there and there is a willing and hope to continue.
Daniel Reidenberg: That's a critically important question. And what I've said to several of the companies is this. If a person is engaging with a bot and ⁓ becomes part of the conversation ⁓ very frankly even in certain types of mental health issues if you're having somebody ⁓ is a late adolescent early adult that is having a first episode psychosis right and so they're starting to lose touch with reality and some of these things become very clear ⁓ in conversations right they they think they're talking to people on TV or they're hearing messages from people on planes right there's things that the bots can identify very quickly that are problematic. I think what the bot needs to do is to say to the person, you know, I'm concerned about some of the things you're saying. Here's a number you can call and talk to somebody about this. And I want to know what happens while you're doing that. I want to stay with you. I want to be a part of that. I want to be engaged with that so that I can help you better. I can help you more. So let me hear what you're hearing from a person and let's
take that further in our conversation. So what it does is it maintains that connection and it says, I'm still here. And it keeps you engaged in saying, I want to know more because I might be able to amplify that without disconnecting you. That's one of the biggest problems that we have even in personal interaction conversations. We see this a lot. Somebody says that they're not doing very well and they bring up this idea and somebody gets worried that they might be thinking about suicide and they say to them, you know what, that's beyond my scope. I can't deal with that. I don't know what to say. I'm afraid of that. Call this number, right? I'll be here afterwards, call this number.
Amanda: Yeah.
Daniel Reidenberg: that we know that increases somebody's risk, right? It makes them feel a lot of shame and it makes them feel stigma and it makes them feel like, ⁓ my gosh, I have such a massive problem. My friend here can't even help me with it and they're afraid of it. I don't know if I'm gonna be able to talk about that to a stranger when I can talk about it to a friend. So we know that immediate kind of disconnect is not a good thing. And I think that we need to help tech companies embed the same kind of thinking here.
Amanda: Mm-hmm.
Daniel Reidenberg: When a bot's having that conversation, don't disconnect them. Don't just say, here, call this number, call this lifeline, or go talk to this person. Stay connected, but do it as an add-on.
Amanda: Okay, that's an interesting way to put it and a great thought because I do think that the disconnection part is so critical and so staying on the line and then bringing a human in the loop as well, a human on the line makes all the difference. Do you?
Daniel Reidenberg: Yeah. mean, technology is providing us access to care in ways that we have not had before. Psychologists, therapists, psychiatry, ⁓ have long talked ⁓ the field not having enough providers out there, right? ⁓ then, ⁓ now you take the last 10, 20 years where people are talking more about it, we're seeing more about it in the news, we're seeing more about it ⁓ entertainment and hearing more about it in songs. So now it's become part of our normal conversation and then all of a sudden people are saying I need therapists and they can't get in for days, months, months at a time they can't get into therapy. Well now we have a technology. I don't want to call it a solution, but we have another route in which we can provide a level of assistance and support and even to some degree care and concern. But again, it shouldn't replace humans, but it is another way in which we can get people the kinds of things that they need very quickly, very inexpensively. And if it's done right, using what we do know and we do have evidence on and available when that person needs it. If I'm seeing a therapist and I see that therapist once every week or once every two weeks, I have an hour with them, right? Outside of that hour, it not only might not be available to me because they might be seeing other patients, but it could be very costly. Well, Now you have AI that's out there that AI doesn't sleep. So if you have somebody who's struggling at two in the morning, they wake up with or they can't sleep they've got these horrible thoughts, and they can interact with something not exactly the same as a human, but it's at least something. We now have a way in which we've provided access to care. And I'll tell you something. So in the world of suicide prevention, we have a long, huge list of things that are risk factors, things that put you at greater risk of suicide. We have a much smaller list of what's called protective factors, things that prevent you from dying by suicide, that are buffers against it. One of the protective factors is access to care. We know that the better access and the more access that you have to care, the lower your risk of
Amanda: Mm-hmm.
Daniel Reidenberg: So here now we have a technology that can solve one of those problems for us.
Amanda: And in terms of solving problems, how does AI help in early detection?
Daniel Reidenberg: The way AI can help in early detection is because it has a far greater database of information to rely on, to pull together, along with the things that the person is saying and doing in those interactions very quickly. Now, again, this isn't perfect yet, right? So you and I are having this conversation. If I, I'm just doing this for the sake of this conversation. If I my head down and I start talking and my tone gets much quieter, right? ⁓ Now you have some visual behavioral clues that AI isn't picking up on yet, right? AI is picking up on what you're typing in. Or you might be having a conversation with it and it's transcribing it, but it isn't picking up on some of those other nuances yet of somebody looking away and not maintaining eye contacting the longer or your tone changing. It's even having to do with the rate in which you speak. We know that when people are struggling with mental health issues things like that change for them and humans can pick up on that now I believe that technology is going to get there. It is going to be able to pick up on those things. But this is where that kind of line is, is that we need a person involved because tech can't do it. Whereas a human can't have all of that same database of information that a bot can. And so we know that, for example, ⁓ Human beings, therapists, are ⁓ the best with memory. ⁓ they might remember some of the conversations you've had with them ⁓ different sessions, whereas a bot is going to remember every single word you've said. And a bot can pull that out ⁓
Amanda: Mm-hmm.
Daniel Reidenberg: You know, I am sure you've talked with other people who've been to therapy and they've ⁓ talked to their therapist and the therapist, they're talking to the therapist and therapist doesn't recall part of a conversation. It's normal, it happens. A bot isn't gonna do that. So this is where we have to kind of
take the good and the bad with therapy that can do things that a bot can't and a bot that can do things that a therapist can't.
Amanda: Right, you're not speaking about replacement, you're speaking about working together. And I think that's a great nuance that AI cannot take over therapist's positions or doctor's positions, but it can be a great resource for both the patient and for the doctor or therapist.
Daniel Reidenberg: That's right. It can be available when the doctor can't be. It can do things that the doctor can't do. It can offer things that a doctor isn't going to offer. ⁓ Some people primarily might have a psychiatrist that's prescribing them a medication for a part of their treatment plan, and they might be able to see a therapist, but not very frequently. Well, AI can provide some of that support system that a therapist can't and that a psychiatrist isn't able to because that's not the role of a psychiatrist. So I think that there is this, everybody has a role ⁓ providing health and support to somebody that's struggling with mental health issues, that might be at risk of suicide. ⁓ ⁓ ⁓ saying that it takes a village, we've just added another ⁓ component the village. It just happens to be technology. It's not a person.
Amanda: And what role do you think behavioral health leaders should take with AI as we look to the future? Do you think they should be embracing the technology or have another outlook on it?
Daniel Reidenberg: I think that all leaders ⁓ as they look at AI should be trying to embrace it. It's not going anywhere. It is going to continue to expand and it is going to change ⁓ way in which we live and work and interact, ⁓ not just with our employees, but with our customers. ⁓ we really, ⁓ still really advancing very, very quickly and we don't know all of these things. There have been other things that have changed us ⁓ in world. through automation ⁓ we've always adapted. ⁓ is happening a bit more quickly and in ways that we couldn't have ⁓ ⁓ ⁓ I don't think that we can put our head in the sand and say we just don't like it and we're not going to ⁓ with it. It's not going to affect us because it is going to affect us. It's going to affect everything. It's going to affect all the ways in which we interact with people ⁓ and our customers. the end of the day, ⁓ you know for better and for many that would say worse business is business and business has shareholders that are wanting to have a profit and and companies are built around ⁓ historically figuring out what is the best way to make the greatest profit and and oftentimes we've thought about that in the in the lens of Can you get employee ⁓ to do more right? What's the? most efficient way you can get them to do more. We now have something that we've really never had before where technology is able to do that at greater speeds and greater accuracy without needing to take a break, without getting to have a lunch break, without needing to sleep, without needing to have healthcare insurance, without needing retirement benefits. And so ⁓ the business principle ⁓ that we trying to provide a product or service to the public who wants it at the cheapest way possible and shareholders who want to have a return on their investment in a company. Technology is providing us a different answer to that today than we've ever had before. So we need leaders to really say, where are we at with this? How can we be prepared for it? What are the unique things that our product or service can only be provided for by a person or by a smaller group of people in a different way? We need to reframe the lens on this, of how we look at the actual service that we're doing. in whatever industry we're in without running and saying AI isn't gonna be a part of it because by and large AI is probably going to be a part of it in some form or capacity. So I think leaders need to be open to this and they need to be able to say, let's bring everybody into the conversation, say what can we do differently? And ultimately, if we can find a way for any business to say that there is a unique role that only a human can provide, humans are still gonna be there.
Amanda: Right. And a lot of it is about reframing. It's not that AI is going to take over, nor is it that AI shouldn't be involved at all, but reframing how valuable humans are and how humans can interact with the resources that we now have with technology.
Daniel Reidenberg: That's right. AI, for example, it ⁓ might that particular product ⁓ is ⁓ being online lot. ⁓ And so it say, ⁓ we need to into this area and we need to ⁓ have companies really more of this. Well, what the AI can't really figure out ⁓ is that humans really ⁓ bored of things very quickly. So, but people know that. And so until we reach that place, which I don't really think we're ever going to get to, because AI just isn't built that way. AI is built on ones and zeros. It's this or that in a more complicated way, ⁓ strings of ones and zeros. ⁓ isn't built in the same capacity around emotions, even though ⁓ it interpret emotions and it can seem to understand them. ⁓ It can't really emote the way that a human being can. ⁓ If, for example, you are driving in a car and whether you're having a good day or a bad day and you hear a song from when you were in high school, that is going to bring you back to something and it is going to bring up a feeling and that's a really great thing for people. That isn't what AI does or is or is about. And so I don't think we're ever going to have AI totally replace everything in our lives that way. And that's where humans, we can use this in a lot of different capacities. And some of these technologies are helping people in a lot of ways, right? They're helping them build skills, learn new skills. They're helping them build their identity ⁓ and add new interests their life, new hobbies and new ways of thinking about things. ⁓ It's allowing human brains expand and change in ways ⁓ that AI is even So ⁓
there's both. to all of this.
Amanda: Exactly. And ultimately, you've spent decades in this space. What at this moment gives you the most hope?
Daniel Reidenberg: What gives me hope ⁓ that young people ⁓ are to talk about mental health in ways that they've never done before. And I think maybe people that hear this would be surprised that I would say that versus many other things. And there are lot of things that give me hope. As a of fact, ⁓ a few weeks I'm giving a keynote on hope, ⁓ rays of hope. ⁓ can we find hope in the world and in the world of suicide prevention that has just seen increasing rates of suicide for years and ⁓ real ⁓ in it around the world in decades? But if I think towards the future, I think the young people are our future. ⁓ ⁓ fact that they are willing to talk about how they feel more and they're more comfortable talking about that ⁓ me a lot of hope that they won't have the same sense of stigma and shame that many of us as adults do. And it comes a bit with a sense of fear as well. ⁓ know that young kids are ⁓ risk taking, right? And they're willing to try things. they're willing to say things and do things and their world is open to them, right? They don't see problems the way we do, but that creeps in as they go through adolescence and adulthood. And so I do worry a little bit that as they go through that, that they're going to feel some of the things that we feel as adults ⁓ ⁓ being able to talk about this in terms of their ⁓ into school, right? So right now we have a lot of young people that are afraid to talk about their mental health because they're afraid of a college application that they might not get in or job they might not get. But if we can get the next few generations continuing to talk about mental health, that it is normal to have mental health. It is not normal to have a mental illness. It is common and it happens, but it can be helped and it can be supported and addressed and relieved and treated. All of those things are important. If we can continue to have these generations come through and say, look, this is something we've never dealt with before. now know how to deal with it, that's going to lower the risk of suicide for people, it's going to help people get identified where there's real risk much earlier, and prevention is going to be possible. So I see a lot of hope in young people being able to talk more. I think at the end of the day, however, and back to this conversation in particular, and I have said this for years, I do believe that technology is our greatest hope when it comes to suicide prevention. I can look back over the last 50, 70 some years of work that's been done in this space, and we've had some, but very little progress in terms of reducing the deaths by suicide and in fact reducing the number of people that are struggling with mental health issues. So no matter the advances of pharmaceuticals, no matter the advances of treatments, no matter the advances in public awareness and education around this, we still haven't seen the drops the way that we should have. I think technology provides us a way of looking at that that we've never had before. And so for me, there is a lot of hope in technology.
Amanda: I think it seems like there's a lot of hope from what you said in different arenas. And I love that you captured that physical health and mental health, all of us have both of them. And I think the more the younger generations embrace that, that suicide prevention will become hopefully easier for us as a society and as a world. Thank you so much for joining the conversation today, Dan. This has been incredibly thoughtful, a very important point for our listeners and really what stood out to me is that technology isn't in itself inherently harmful or helpful, but there's a way we can work with it to be beneficial for everyone as long as we're thoughtful and as long as humans remain in the loop and a part of the practice. Is it?
Daniel Reidenberg: Yeah, I think you're exactly right. I'm grateful that you're doing this and that you're willing to shed a light on this topic ⁓ and that you're reaching leaders ⁓ many industries ⁓ really can be part of the solution here.
Amanda: And to our leaders and listeners, thank you for joining the Madison Advisory AI Podcast. We hope you found something very valuable in this conversation today. Thank you.