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A note to readers: Science, accountability and elections
Dear readers, As early voting begins, I wanted to share some news — and why it connects to the decisions we make at the ballot box. I’ve been selected for the inaugural cohort of the South Atlantic Climate Journalism Hub mentorship program, hosted by Covering Climate Now. I’m excited to join this group, learn from scientists and fellow journalists, and expand my science reporting. Science directly ties to governance. Local officials make decisions about where development goes, how infrastructure is maintained, what emergency preparations receive funding, and how communities rebuild after disasters. Understanding the evidence behind those decisions helps us evaluate whether our government is serving us well. Here in western North Carolina, those connections are all around us, in Lake Lure and beyond. Flood maps inform decisions about property and development. Engineering assessments help identify risks at dams and bridges. Rainfall forecasts guide emergency preparations. Geological information helps explain landslide hazards. Water testing gives communities information they need to assess conditions. Meteorologists’ knowledge and public perception of weather events shape public safety. Each involves scientific or technical knowledge. Each also raises questions about public responsibility: What did officials know? How did they use that information? What did they tell the public? What did taxpayers receive for their money? A study can identify a problem. Elected officials still have to decide what to do about it, how to pay for it, and how to explain their choices. Reporting should examine both the evidence and the response. That is where I want to strengthen my work. My reporting on Helene recovery, infrastructure, flooding, public safety, and public spending has repeatedly brought me to questions that require scientific expertise alongside public records. This mentorship may help me better understand the research, ask more precise questions, and explain the answers clearly. I also bring the perspective of someone living with these concerns. I live downstream of Lake Lure Dam, and landslides affected my property during Helene. Those experiences bring urgency to my questions. Careful reporting helps establish the answers. Readers deserve to know what the evidence shows, where uncertainty remains, and whether officials accurately describe the information guiding their decisions. You also deserve scrutiny of proposed solutions: what they cost, what they are expected to accomplish, and what risks remain. Access to that information matters. As a mostly deaf journalist who relies on written communication, I will continue pressing for written public warnings, records, and explanations that people can read and use in real time. As you consider the candidates seeking your vote, consider how they approach evidence, preparedness, and transparency. Do they support local journalism, even when it’s not parroting a press release? Do they explain weather events clearly in plain English and explain their decisions after them? Make supporting records available? Acknowledge uncertainty? Follow through when a report identifies a risk? Those are practical questions about governing. Thank you for supporting Cops & Congress and the work that makes these questions part of the public conversation. I’m grateful to David Dickson and the CC Now team for this opportunity, and I look forward to bringing what I learn back to you. Annie DanceEditor & Publisher, Cops & Congress — Learn more about this newsletter, ethics policy, how you can help shape this work, and support it. Follow on X and Facebook. Send constructive criticism, fan mail, and tips with public documents for future stories: CopsandCongress@gmail.com ICYMI: View the Cops & Congress archive — Annie Dance is the publisher of Cops & Congress, a newsletter that analyzes what happens when crime, courts, disaster, democracy, and small-town policies collide. Views expressed here are covered by the First Amendment. Dance has a Bachelor of Arts from Manhattan University in Communication with a focus in Journalism and Government. She has been a journalist for over 20 years. Share Upgrade now or give a gift subscription
Tasteless Democratic ads highlight need for civility in politics
Give voters the information they need and leave the inappropriate theatrics out of it.
Tasteless Democratic ads highlight need for civility in politics
Give voters the information they need and leave the inappropriate theatrics out of it.
As midterm tensions mount, here's how to have civil disagreement
My friend had the wisdom to see being flexible and pragmatic was more effective in real-world situations than following preapproved talking points.
Pfizer makes ‘business decision’ to end phase 2 trial of autoimmune drug as program’s future uncertain
Pfizer has called time on a phase 2 trial of its CXCR5 antibody in an autoimmune blood disorder, with the company tight-lipped on whether this marks the end of the road for the asset. The Big Pharma had been evaluating the therapy, dubbed PF-06835375, in a phase 2 study of 61 patients with primary immune thrombocytopenia (ITP) that kicked off in 2022, according to the federal trials register. However, Pfizer confirmed to Fierce on Monday that this study had been terminated “due to a business decision.” “The decision to terminate the trial was not based on any safety concerns,” a spokesperson pointed out. At time of publication, PF-06835375 remained listed on Pfizer’s website for both ITP and lupus. A phase 1 study in lupus wrapped up in 2022, according to the trials database. ITP is an autoimmune disorder characterized by a low platelet count. Novartis was at one point evaluating its B-cell-depleting antibody ianalumab—recently approved as Fabhalta to treat immunoglobulin A nephropathy—as a potential treatment ITP. But the therapy struggled to demonstrate a benefit in the clinic for this indication. When contacted by Fierce, Pfizer wouldn’t confirm whether all work on PF-06835375 has been halted, and whether the company has any other plans to explore C-X-C chemokine receptor type 5 (CXCR5) as a mechanism. CXCR5 is found in blood cancers such as diffuse large B-cell lymphoma and mantle cell lymphoma chemokine receptor. However, there is little expression in normal tissue, which has led some drug developers to explore its potential. Vincerx Pharma had at one point been planning to take an anti-CXCR5 ADC into the clinic to treat B-cell malignancies, but that ambition was scrapped due to cash constraints. Where Big Pharma is placing its bets is one of the hot topics being discussed at Fierce Biotech's high-impact event in London next month. Find out more information and register by clicking on the banner below: [ ](https://qtxasset.com/quartz/qcloud5/media/image/where_big_pharma_is_placing_its_bets.png?VersionId=B8JrRbJ.pFUSK1pJgjeWHLGm_18RdLAy)
Trump’s Approval Rating Plunges to Historic Low Ahead of Midterm Elections
68% of Americans disapprove of Trump's handling of the economy, including 37% of respondents who identify as Republicans.
A materials-first approach to entertainment
It's our duty to tell professionals from the creative industry what it really entails to make 3D printing part of its production environment.
Low Testosterone Opens the Door to a Broader Health Conversation
Low testosterone can signal broader health concerns involving weight, metabolic health, sleep and lifestyle. Cleveland Clinic’s Mark Paulos, MD, explains why comprehensive evaluation and a whole-person treatment approach matter.
Taylorville City Council Approves Three Business District Projects
The Taylorville City Council approved a trio of projects inside the Business Development District One. At the Taylorville City Council meeting on Monday night, three locations were approved which included 216 South Main Street, 800 West Springfield Road, and 204 West Market Street. Mayor Bruce […]
Proposed New Visa for Home Health Aides and Nursing Assistants: What Healthcare Staffing Companies Need to Know
A new policy proposal published by the Brookings Institution recommends creating a temporary work visa that would let US employers sponsor foreign home health aides, personal care aides, and nursing assistants to help ease a growing shortage of caregivers. The September 29 proposal, authored by Brookings scholar Tara Watson through the Hamilton Project, would create an “H-1D” visa category built specifically for the direct-care workforce, launching as a pilot program of 30,000 visas per year. It would require employers to pay wages near the top of the local market, guarantee workers a minimum number of weekly hours, and contemplate a potential pathway to permanent residence after six years, although implementing that pathway would require additional changes to immigration law. The H-1D is only a proposal at this point. No H-1D legislation has been enacted, and employers cannot currently sponsor workers under this proposed classification. But if the idea gains traction, healthcare staffing companies could find themselves with both a significant recruiting opportunity and a new set of compliance obligations. This Insight walks through the proposal’s general immigration and employment requirements, then turns to the specific opportunities and challenges it could create for staffing firms.
FNCS Solos Last Chance Qualifier in NA West: Session 1
Keep your FNCS Solos journey alive in the Last Chance Qualifier! LCQ Round 1 is open to eligible players who participated in an FNCS Solos Qualifier Round 1 session but have not already advanced to the LCQ Final or the FNCS Solos Finals. Players will compete in a single three-hour session with up to 11 matches. After the session concludes, the top 70 players in each region will advance to the LCQ Final. The LCQ Final lasts approximately two and a half hours and features up to five matches. Every match provides a direct path to the Finals: the player who earns the Victory Royale will receive 1,000 points and immediately qualify for the FNCS Solos Finals. Once qualified through a Victory Royale, that player may not compete in any remaining LCQ Final matches. After the LCQ Final concludes, the next 17 highest-scoring players who have not earned a Victory Royale will also advance to the FNCS Solos Finals. This is your last chance to secure a spot—good luck and have fun!
Trump administration holds up Patriot missiles for Ukraine
Delays in approving transfers from partner countries coincide with a worsening rupture between President Donald Trump and Volodymyr Zelensky.
City of Fate Approves Chapter 380 Agreement Advancing Fate Yards Entertainment Development
FATE, TX (Oct. 19, 2026)— The City of Fate City Council voted 6-0 to approve a Chapter 380 Economic Development Agreement to support the creation of Fate Yards, a major entertainment and tourism-focused commercial center planned for the southeast quadrant of I‑30 and Memorial Parkway. The Fate Yards development represents approximately 274,000 square feet of...
$4.5 million approved for over 60 Florida small businesses impacted by Hurricane Isaias
DESTIN, Fla. -- Governor Ron DeSantis announced Monday that more than $4.5 million has been approved through the Florida Small Business Emergency Bridge Loan Pr
Florida Republican Party wants court to block Democrats’ Hope Florida ads
A grand jury found $10 million of Medicaid settlement money had been misappropriated, funneled through Hope Florida for political purposes.
What Does a Human Heart Need to Grow? Scientists Found the Answer in a Bioprinted Model
Heart problems that babies are born with, called congenital heart defects, often begin developing early in pregnancy. Approximately three weeks after fertilization, the human heart is still a simple, straight tube of cells and, over the course of about five weeks, this tiny structure must undergo a remarkable transformation to reshape itself into the complex organ that eventually pumps blood throughout the body.
Scientists Create “Super Ice” That’s 10 Times Stronger and Rivals Concrete in Strength
A new form of reinforced ice could offer an unconventional building material for extreme polar environments, although questions about its long-term durability remain. Scientists have developed a new form of ice that approaches the compressive strength of conventional concrete while resisting the sudden fractures that make ordinary ice so brittle. Known as BioPykrete, the material
North Dakota approves health insurance rate increases for 2027 ACA plans
The North Dakota Insurance Department has approved average rate increases for 2027 Affordable Care Act plans.
Richland County Foundation funds $1.4 million in grants for health & housing needs
MANSFIELD – The Richland County Foundation Board of Trustees approved grants totaling $1,477,004.99 to non-profit organizations during its October meeting. Competitive and field of interest fund grants were approved by the board to four organizations. Community Health Access Project (CHAP) received a grant to enhance care coordination services for uninsured and underinsured residents in Richland […]
South Brunswick BOE Approves High School Computer Science Research Study Involving ChatGPT
South Brunswick High School students will participate in research exploring how ChatGPT and AI tools can support computer science education.
Betting on the election? Here’s where it’s prohibited
The midterm elections are fast-approaching, but can you wager on them?
Get Covered Illinois offering health coverage to 9,300 residents affected by Medicaid cuts
Approximately 9,300 Illinois residents who lost Medicaid coverage due to the One Big Beautiful Bill Act can now enroll in health insurance plans through Get Covered Illinois until December 31, 2026…
Could Faith, Science, and the Simulation Be Mutually Reinforcing?
MIT-trained Rizwan Virk says something that is surprising: that his approach to cosmology is a branch of intelligent design.
The Latest: Democrats gain ground with AAPI adults as trust in GOP fades, poll finds
According to a new AP-NORC/AAPI Data poll, Asian Americans, Native Hawaiians and Pacific Islander adults have become more disillusioned with President Donald Trump and Republicans as the Nov. 3 midterm elections approach, giving Democrats a substantial edge on major issues like the economy and health care
Senator urges FCC to reject conservative group's bid to use political AI-generated robocalls
By David Shepardson WASHINGTON, Oct 19 (Reuters) - Senate Democratic leader Chuck Schumer on Monday urged the Federal Communications Commission not to approve a petition to allow political AI-
Senator Urges FCC to Reject Conservative Group's Bid to Use Political AI-Generated Robocalls
WASHINGTON, Oct 19 (Reuters) - Senate Democratic leader Chuck Schumer on Monday urged the Federal Communications Commission not to approve a petition to allow political AI-generated robocalls from conservative political group Club for Growth ahead of the November congressional ...
Professional golfer from Finland moves business to Fairview
A golf professional who hails from Finland and moved his business to Fairview approaches teaching the sport differently. For Jari Hakonen, it is all about focusing on the little things […]
Professional golfer from Finland moves business to Fairview
A golf professional who hails from Finland and moved his business to Fairview approaches teaching the sport differently. For Jari Hakonen, it is all about focusing on the little things […]
Violence in France is a consequence of the last decade's political reconfiguration
NEWS ANALYSIS. The violence on the fringes of protests across France on Saturday is the result of the evolution of the political system during Emmanuel Macron's presidency, marked by the rise of radical parties that promote a conflict-driven vision of society and a confrontational approach.
Commentary: Opportunity Zones can help bring investment, development to Idaho areas that need it most
Idaho’s newly approved Opportunity Zones could help bring more housing, businesses and jobs to communities across the state. The attraction for investors is the potential tax savings. This month, Idaho Commerce announced that the U.S. Treasury approved 25 zones, including areas in Boise, Coeur d’Alene and Post Falls. The new Opportunity Zone designations take effect […]
Consumer apprehension grows as US retailers adopt AI-assisted pricing tools
U.S. consumers are uneasy about the increasingly high-tech ways that restaurant chains and major retailers are setting prices. Digital price tags are replacing paper ones in grocery aisles. AI tools
Health Innovation South West and Helfie AI announce partnership to evaluate digital-first hypertension screening
/PRNewswire/ -- Helfie AI and UK-based Health Innovation South West have announced a partnership to explore how digital-first approaches to hypertension...
Plan for £3.8m health facility in Rutland set for approval
Rutland County Council's planning committee is recommended to approve the application on Tuesday.
Democrats gain ground with AAPI adults as trust in Republicans fades, AP-NORC/AAPI Data poll finds
A new AP-NORC/AAPI data poll finds that Asian Americans, Native Hawaiians and Pacific Islander adults have become more disillusioned with President Donald Trump and Republicans as the midterm elections approach
Democrats gain ground with AAPI adults as trust in Republicans fades, AP-NORC/AAPI Data poll finds
A new AP-NORC/AAPI data poll finds that Asian Americans, Native Hawaiians and Pacific Islander adults have become more disillusioned with President Donald Trump and Republicans as the midterm elections approach.
Democrats gain ground with AAPI adults as trust in Republicans fades, AP-NORC/AAPI Data poll finds
A new AP-NORC/AAPI data poll finds that Asian Americans, Native Hawaiians and Pacific Islander adults have become more disillusioned with President Donald Trump and Republicans as the midterm elections approach.
Democrats gain ground with AAPI adults as trust in Republicans fades, AP-NORC/AAPI Data poll finds
A new AP-NORC/AAPI data poll finds that Asian Americans, Native Hawaiians and Pacific Islander adults have become more disillusioned with President Donald Trump and Republicans as the midterm elections approach.
Executives from finance, healthcare and energy will explore where quantum could help businesses.
Only approved guests may attend; roundtables will cover combining quantum and AI, security readiness and adoption policies at the Nov. 3 London forum.
Fact or fiction? Examining the claims behind North Carolina political ads
As Election Day approaches, political ads across North Carolina are making claims about candidates’ past. The Chronicle examines the claims and the context behind them.
Haverhill Councilors to Hear School Roof Borrowing, Condo Changes, Health Board Choice
Haverhill city councilors Tuesday are expected to hear plans for the estimated $3.6 million roof replacement at Golden Hill Elementary School, proposed changes to a Marshland Street condominium plan and approve a changing of the guard on the city Board of Health. Councilors are expected to file the school roof request for the required 10
‘I will not comment on his anatomy’: Ohio Republicans buzz about Trump’s analysis of a senator’s body
A day after President Donald Trump offered his latest appraisal of Ohio Sen. Jon Husted’s physique, it had already become a running joke — if not explicitly stated — during a GOP gathering in rural western Ohio.
Democrats lead across polls as Trump’s approval rating dips
An RNC official says the president’s rallies this month are aimed at getting Republican voters to the polls, even as his approval sits near record lows.
Hooksett sewer project aims to spur Route 3A business growth
Hooksett approved a $1 million underwater sewer extension near I-93 Exit 10, aiming to support future Route 3A business growth without using residents’ property...
Talk Business & Politics: Analysis of Talk Business & Politics-Hendrix College poll
It’s been a busy week of polling as Arkansas took a focused approach to the November midterm elections ahead.
Talk Business & Politics: Analysis of Talk Business & Politics-Hendrix College poll
It’s been a busy week of polling as Arkansas took a focused approach to the November midterm elections ahead.
Talk Business & Politics: Analysis of Talk Business & Politics-Hendrix College poll
It’s been a busy week of polling as Arkansas took a focused approach to the November midterm elections ahead.
Talk Business & Politics: Analysis of Talk Business & Politics-Hendrix College poll
It’s been a busy week of polling as Arkansas took a focused approach to the November midterm elections ahead.
Capitol View: Analysis of Talk Business & Politics-Hendrix College poll
It’s been a busy week of polling as Arkansas took a focused approach to the November midterm elections ahead.
Capitol View: Analysis of Talk Business & Politics-Hendrix College poll
It’s been a busy week of polling as Arkansas took a focused approach to the November midterm elections ahead.
Johnny Garcia pitches bipartisan approach in congressional bid
The former Bexar County sheriff’s deputy hopes to win Texas’ 35th Congressional District with a message of service over party affiliation.
Poll: Americans are anxious, pessimistic and deeply unhappy with Trump ahead of the midterms
The share of Americans who believe the country is on the wrong track is at the highest level of the president’s second term, according to the NBC News Decision Desk Poll.
Small business owners are doing OK – but will that help Trump overcome his low approval ratings?
Overall, economic sentiment for Trump is poor, but small businesses seem fairly confident, according to several surveys
Magic mushroom ingredient takes the fight out of aggressive fish
A psychedelic compound found in magic mushrooms appears to have an unexpected effect: calming highly aggressive fish. Researchers discovered that low doses of psilocybin significantly reduced aggressive attacks in mangrove rivulus fish without disrupting their normal social interactions. The findings suggest psilocybin may selectively calm escalating aggression rather than simply suppressing all behavior.
Cart Smarts: Think pink, eat colorful: A dietitian’s guide to women’s health
This October, keep it simple with more color, more nourishment, more movement and a little less pressure to be perfect. Here are five dietitian-approved ways to support your health; one bite, and one habit, at a time.
Consumer apprehension grows as US retailers adopt AI-assisted pricing tools
U.S. consumers aren't just frustrated with high prices. They're angry and confused about the increasingly high-tech ways that restaurant chains and major retailers are setting those prices.
Review: 'The Social Reckoning,' director Sorkin takes a more subdued approach
Movie reviewer Joshua Hill says 'xxxxxxx' xxxxxxxxx.
My dad's death showed me that experiences matter more than money
When my dad died, I reevaluated how I approach work. I'm honoring him by living a more full life, and valuing experiences over money.
He retired after student-loan forgiveness. Then his payments returned.
A 71-year-old student-loan borrower got notified that he was approved for Public Service Loan Forgiveness. Now, he's fighting to keep that relief.
AI-assisted pricing tools increase US consumer apprehension
It’s unclear how widely retailers use AI to help set prices, but research suggests businesses across industries are adopting it.
Consumer apprehension grows as US retailers adopt AI-assisted pricing tools
U.S. consumers are uneasy about the increasingly high-tech ways that restaurant chains and major retailers are setting prices.
Consumer apprehension grows as US retailers adopt AI-assisted pricing tools
U.S. consumers are uneasy about the increasingly high-tech ways that restaurant chains and major retailers are setting prices.
Consumer apprehension grows as US retailers adopt AI-assisted pricing tools
U.S. consumers are uneasy about the increasingly high-tech ways that restaurant chains and major retailers are setting prices.
Democrats lead Republicans in House vote choice as Trump's approval rating hits record low: ABC/Post/Ipsos poll
Half or more Americans call every household purchase category measured "unaffordable."
Trump approval hits record low, handing Democrats a clear midterm edge
President Donald Trump’s approval rating has fallen to a new low and support for Democrats in the race for control of Congress rising, as inflationary pressures contribute to the acrid mood among voters, according to a Washington Post-ABC News-Ipsos poll.
“What I Appreciate in Gevorg Is His Commitment to Making Global Health More Equitable, Transparent, and Accountable” – Pietro Presti, CEO of Sharing Progress in Cancer Care
“What I Appreciate in Gevorg Is His Commitment to Making Global Health More Equitable, Transparent, and Accountable” – Pietro Presti, CEO of Sharing Progress
Val Booted Next DWTS Episode, Jenna Dewan Dance With Alan
“The well-being of everyone who works on 'Dancing With the Stars' is non-negotiable. Val’s social media post was inappropriate and does not reflect the values or standards expected of anyone connected with the show. As a result, he will not participate in next week’s show," BBC Studios said in a statement.
Reddit Users Share Wild First-Day Firing Stories
Reddit users share shocking first-day firing stories involving a forklift mishap, an IT security blunder and inappropriate behavior.
SpaceX Dragon Delivers Groundbreaking Science and Solar Arrays to ISS
SpaceX has delivered tiny brain models, 3D heart tissue, and artificial retina technology to the space station in a mission that could open new doors for medical research on Earth. SpaceX’s Dragon spacecraft successfully arrived at the International Space Station on October 15, docking at 10:27 a.m. EDT with the space-facing port of the station’s
I suspected cancer lurked in my body. I hoped this test would ease my fears.
The FDA is expected to approve a new kind of blood test that may allow earlier diagnosis and less invasive, more effective treatment. But doctors warn of drawbacks.
Several Petah Tikva synagogues refuse to host Smotrich, cite objections to politics during services
Some congregants argued that withdrawing the invitation after it had already been extended and publicly announced would be inappropriate, particularly since the synagogue had hosted other speakers.
Bundesliga Heavyweights Collide: Bayern And Leipzig Unleash Their Attacking Stars
Bayern Munich and RB Leipzig are preparing for Saturday's Bundesliga showdown at the Allianz Arena, with the predicted lineups offering an early indication of how both teams could approach one of the biggest fixtures of the weekend.
Franciscan Health, Tonn and Blank planning Michigan City medical office building at former Marquette Mall
Press release, Franciscan Health: Project supports healthcare ministry’s regional approach to healthcare MICHIGAN CITY, Ind. – Franciscan Health, in partnership with Tonn and Blank Construction, is planning a medical office building on a portion of the former Marquette Mall property. Franciscan Health plans to operate a 120,000-square-foot medical office building through the renovation of the former J.C. Penney store at the northwest corner of U.S. 421 and U.S. 20. The land is just 2.5 miles north of Franciscan Health Michigan City, which sits at U.S. 421 and Interstate 94. The building will house more than 45 physicians, cost-effective imaging, an
Candidates talk fighting for 7th District seat in Congress
As the midterms approach, Congressman Ryan McKenzie and Democratic candidate for Congress Bob Brooks talked about the race for Battleground Politics.
Political violence: How justifications influence voter approval
What happens when political violence is presented as a justified response to threat or injustice coming from an out-group? A study by Ursula Daxecker, director at the Max Planck Institute for Politics ...
Spokane approves new public safety sales tax as business owner calls for more accountability
Millions of dollars spent on AI-generated political ads as midterms approach
Political action groups and candidates have been using artificial intelligence for campaign ads, spending over $137 million for the midterm elections.
Dave & Buster's Entertainment Sees Unusually High Options Volume (NASDAQ:PLAY)
Dave & Buster's Entertainment, Inc. (NASDAQ:PLAY - Get Free Report) was the target of unusually large options trading on Friday. Investors purchased 5,009 call options on the stock. This represents an increase of approximately 37% compared to the typical daily volume of 3,653 call options.
Small Business Administration loans approved for Aspen Acres Fire
The U.S. Small Business Administration has approved Colorado's request for disaster assistance loans following the Aspen Acres Fire in Pueblo and Custer Counties, Gov. Jared Polis announced Friday.
Dunleavy was confident that Butler would appreciate …
Dunleavy was confident that Butler would appreciate …
Napoli must separate McTominay contract negotiations from their midfield plan
Scott McTominay’s reported contract discussions have brought Napoli’s approach to retaining important players back into focus.The immediate temptation is to read every negotiating position as a pr...
AASHTO Journal - State DOTs Use Art to Promote Safety, Health, Beautification
Across the country, state departments of transportation are using a bevy of artistic approaches to promote safety, health, and community beautification efforts. [Above photo by Oklahoma DOT] For example, the Oklahoma Department of Transportation is currently seeking student participants for its “Keep Our Land Grand” poster contest. Formerly known as the “Trash Poster Contest,” the […]
Can AI solve our mental health access problem?
Last week I asked you what worries you most about AI in health. It was close, but your top answer was “AI giving bad health advice.” Last week’s poll results: You’re in good company. This concern was top of mind at a conference I joined at Stanford last week, where researchers, clinicians, and people who build AI systems spent a day debating trust and safety in health AI. Stepping back, I’m also hearing your emerging concerns about AI’s impact on our well-being generally. I see this as a matter of public health, and we’ll take it in pieces as we learn together. Today we’ll focus on AI chatbots used for therapy for mental health. Early this month, Governor Newsom vetoed Senate Bill 903, California’s most ambitious attempt to regulate AI use for mental health. It’s at the center of active debate, and raises the questions patients, family members, citizens, and voters will face as AI moves deeper into health care. Let’s work through it. What is “AI-based therapy”? It’s really two things: purpose-built mental health apps designed to deliver structured support, and general chatbots like ChatGPT, Claude, and Gemini that people increasingly use for emotional support—even if they weren’t built for it. Spoiler alert: I don’t know whether the shift toward AI therapy is good or bad. The evidence isn’t there yet. But I do know it’s already happening, and I have some ideas about how we can roll it out with safety in mind. The therapy dilemma, in a nutshell Mental health challenges are common, and strain health and well-being across populations. Therapy (interactive dialogue with a trained, empathetic practitioner) helps many people heal. The demand for licensed therapists far exceeds the supply in California, and AI-based therapy can narrow that gap. AI-based therapy remains novel, unproven, and not well tested. Right off the bat, we can see we’re dealing with trade-offs here. Since the main driver of demand for therapy from a robot is lack of access to therapy from a human, we’ll start there. It’s too hard to find and afford a human therapist California is short roughly 55,000 licensed, non-prescribing therapists and counselors, about 40% of what we need. Psychiatrists, who rely on talk therapy as a complement to prescribed medications, are even more scarce. Eight counties have none, and density ranges from 1.7 per 100,000 residents in San Benito County, to 68.1 in Marin County. My wife is a psychiatrist in Marin, and even here access is tight. If it’s hard in the best-supplied county, imagine rural Sierra County, or the San Joaquin Valley. In 2024, more than half of Californians who tried to make a mental health appointment struggled to find a provider who took their insurance, compared with 14% for physical health care. When Senate staff posed as “secret shopper” patients and called 120 mental health providers in Medicare Advantage networks, they landed an appointment less than once for every five tries. Insurers pay behavioral health clinicians about 22% less than medical and surgical clinicians for comparable office visits. On top of that, billing denials and prior authorizations hit hardest at the solo and small practices common in mental health. Psychiatrists opt out of Medicare at the highest rate of any specialty. In many places, a cash practice for therapy fills quickly with patients paying $250 or more an hour, with no insurance paperwork at all. Families who can pay cash find providers more easily. Those who rely on insurance, including Medi-Cal enrollees, older adults, rural residents, and non-English speakers, compete for what’s left. So we can’t pretend the human system works, and we can’t blame people for turning to AI for support when they’re in distress. AI is filling the gap It’s estimated that roughly a quarter of AI users use it for mental health support. If you have internet, it’s available 24/7, it’s cheap, and it speaks your language. Uninsured adults are about twice as likely as insured adults to do it (30% vs. 14%). It feels anonymous in ways that may enable people to ask things they’re unsure or embarrassed about. The largely hidden, personal use makes it hard to study whether it’s actually helping people with their mental health issues, but researchers are trying. Does AI therapy work? A 2026 analysis of nearly 40 randomized trials found chatbots showed a real but small reduction in depression symptoms. But most of these trials were compared to an alternative of no therapy, not a human therapist. So the benefit of AI therapy is probably real, but modest, and mostly untested against the alternative of human contact. We need more studies. Serious concerns OpenAI’s own estimate is that more than a million ChatGPT users each week show signs of suicidal planning or intent. These are high stakes encounters, and AI doesn’t always get it right. That’s partly because a chatbot can sound like a therapist, but it has no license, no duty of care, and it’s not clear who to hold accountable when it gets things wrong. AI is also designed to help users in whatever task they’re seeking to accomplish. People may feel like they’re getting therapy, but they’re mainly getting a convincing conversation. It’s easy for an AI companion to wander into gray areas, like playing along with “creative writing” that may be about the user’s own suicidal intent. Courts are driving safety conversations A wave of lawsuits have been filed on behalf of families claiming that chatbots pushed people they loved toward self-harm, including teens who died by suicide. The first settlements came this year. OpenAI is headquartered in San Francisco, and dozens of cases alleging that ChatGPT drove users to suicide or self-harm are now before a San Francisco judge. Character.ai has filed for bankruptcy after several states brought lawsuits accusing the chatbot of pushing dangerous content to kids. But the technology seems to be improving. Last month, an independent evaluation found that newer AI models “almost never endorse suicide.” That’s progress, but our societal appetite for even one preventable death is very low. So how do we move forward? Finding a middle ground Earlier this month the governor vetoed Senate Bill 903, a bill designed to place guardrails on the use of AI for therapy. The bill would have prohibited any AI-based platform from being advertised as psychotherapy, and would have required a licensed professional to review and approve each encounter where AI was used to support therapeutic decisions. Newsom called it overly broad, since even routine screening questions would have needed clinician sign-off. Knowing we’re already short on mental health providers, requiring human review of AI encounters may not relieve our access problems. Still, the answer isn’t no oversight. Here’s one feasible short term solution. Rather than reviewing each encounter, a licensed clinician can design the guardrails: what counts as a crisis, what triggers an immediate handoff to a human, and what gets sampled for audit each month. The AI runs inside that structure. Conversations get checked, failures get reported, and a real clinician owns the framework. Medicine already has models to learn from. The FDA process for rolling out newly approved medications is an example. After a product reaches patients, we keep watching for adverse events. Patient-facing AI needs the same “digital pharmacovigilance”: systematic tracking of harms, near misses, and the types of groups that get hurt and why. It’s also critical that users know that they can reach a human if they’re in crisis. Most chatbots now include messages like these: Bottom line The rush to use unproven AI tools for mental health support is mostly a workaround, a sign of a health system people can’t get into. We need better access to proven care from licensed clinicians. That takes reimbursement that makes accepting insurance viable, and a bigger workforce. But, built and tested well, AI could be part of the answer. It could be the 2 a.m. check-in when no one else is awake, or a way for patients to practice skills their therapist taught them. It could be the first step to get someone the right level of care, and take paperwork off clinicians’ plates so they spend more time with patients. None of this is simple. The SB 903 veto doesn’t end the debate, and the legislature will be back. In the meantime, those of us using these tools need to stay informed, ask hard questions, and hold the companies building them accountable. I’ll try to do my part, and we’ll keep learning together. Love,Matt P.S. If you or someone you know is struggling with mental health challenges, emotional distress, substance use problems, or just needs to talk, call or text 988- you’ll reach a real person— or chat at 988lifeline.org 24/7. Dr. Matt Willis is the author of Your Local Epidemiologist in California. A California native, he’s served as a primary care physician, CDC epidemiologist, and public health officer for Marin County, where he guided the pandemic response. He lives in Marin with his family and their dogs, Teddy and Ramona. Thank you Cynthia He, MD, PhD, and Parnika Saxena, MD, for their guidance in preparing this article. Cynthia works in an outpatient mental health clinic, treating patients who have Medi-Cal or, sometimes, no insurance. Parnika works in an inpatient psychiatric unit, treating patients with public or private insurance or self-pay ability. All opinions are their own and do not represent their employers.
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