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Winds of weather change blow into Green Country, affecting health and home comfort
The recent blast of fall air finds many sniffling, sneezing or fighting off a headache; but is the huge temperature swing actually to blame?
Trunk or Treat Held at Newport City Elementary School
Trunk or Treat was held at the Newport Elementary School on Saturday, and to see a full display of photos from the event, see The Express on 10-20-26. Pictured above,
Streaming’s Biggest Show Returns…and a Buzzy Genre Struggles
(Welcome to my weekly streaming ratings report, the single best guide to what’s popular in streaming TV and what isn’t. I’m the Entertainment Strategy Guy, a former streaming executive who now analyzes business strategy in the entertainment industry. If you were forwarded this email, please subscribe to get these insights each week.) Obviously, the big news of the week (if not month) is Netflix letting go of executive Bela Bajaria, their chief content officer. I’m going to cover this in my next “Most Important Story of the Week”, but I also have a data angle that I might publish before then. (Too much news this month, am I right?) But first, I have a bonus Streaming Ratings Report issue for you. Today’s article is a bit of a grab bag of topics I’ve wanted to write about, but couldn’t squeeze into the (already very long) Streaming Ratings Report issues. The NFL drives huge viewership numbers, so I’ve got a look at that. A whole bunch of TV shows returned to the traditional broadcast channels, and I have thoughts. And I have a quick look at adult animated shows, since a couple flopped earlier this month. Plus, the Emmys aired earlier this month, and we got some fun data bout how popular those nominated shows are and why I’m not optimistic about the show’s future. That’s a lot, so let’s dive right in. Subscribe Sports - Football Remains the King of Streaming Over the last two Streaming Ratings Reports, I sorta ignored the biggest “show” each week. (I was tempted to say “piece of content” but I know that word bugs folks.) In my database, I call these “specials”, and they sure are special. I speak of the king of American TV: football!!! Streaming football is back and, unlike some other sports, it routinely dominates all viewership. Probably the best way to show this is to update one of my favorite graphics, the “40 Million Hour Club”1 since football games have joined that club each week they’ve premiered: (Yep, that’s the data through 28-Sep, the first four weeks of the season. As a reminder, I take the average minute audience provided by Nielsen, factor out a percentage of linear TV viewers in home markets, and multiply the run time by the three-hour runtime.) Again, the numbers are huge. Let’s start with Netflix. They grabbed the rights to the bonus opening week NFL Kickoff game (which was on YouTube last year) and it put up 18.5 million viewers on average. That nets out to 47.4 million hours of estimated streaming hours. That’s good! Though, notably, it’s well below Christmas Day games from previous years. Compared to other streamers/broadcasters, that’s a bit of a mixed result. On one hand, Netflix’s 18.5 million average is about what YouTube claimed last year, though Nielsen used a bespoke methodology at that time, so I trust this viewership figure more. So that’s good. (The game also shifted from a Friday to a Thursday and that could have helped the viewership as well.) And Netflix continues to best Prime Video in total viewership—as you’ll see next—though Netflix has had much higher-profile (opening week and Christmas Day) games. NBC/Peacock’s opening game the night before averaged 25.1 million average viewers, which is just much bigger than Netflix (or Prime Video). That’s the big caveat to all streaming viewership records: even in success, they can’t compete with traditional linear TV. Previously, I called this my “hierarchy of viewership”, and the data keeps supporting that thesis. The downside for NBC is that this game’s viewership was down compared to previous years, though it may be a counting issue. Here’s a great chart from Sports Media Watch: Indeed, looking at all the opening week games across all windows, Netflix still lags the other primetime windows, but does well compared to the afternoon games: I saw a few folks make the case that streamers still lag traditional broadcasters in reach, and I’d add they really lag compared to “broadcast plus streaming” options like NBC/Peacock, ESPN/Disney+ and CBS/Paramount+. The best data I saw for this came from Samba TV, who charted reach through the 2025 season, and, wow. (Samba TV’s numbers are historically lower than Nielsen’s, so don’t compare their household figures to Nielsen’s hours, but use them as a proxy for the relative reach of the streamers.) The good news is Prime Video is NOT having a down year. Their opening Thursday Night Football game reached 18.6 million viewers (about what Netflix got), but that’s a high for Prime Video on Thursdays and the biggest Thursday night game since 2015. The TNF games the weeks of 21-Sep and 28-Sep continued this streak, getting 43.1 (16.8 million average viewers) and 42.5 total hours (16.6 million average viewers), which were both up from last year. Still, that continues the (typical) season slide: (For those new-to-streaming-football-numbers folks, the viewership declines for Thursday Night Football as the year goes along.) Overall, it appears as if Prime Video is now part of the “football habit”, be it for customers at home or out at places like bars and restaurants. And its viewership is slowly catching up to broadcast. One last chart shows this. Last season, Nielsen started adding out-of-home viewership to the charts, so I try not to do season-to-season comparisons as I did for the first few years. And while Nielsen added Big Data viewing this year, I’m going to compare the last two seasons. Here’s that chart, which shows the season-over-season gains: When it comes to streaming football, we have to keep a few seemingly contradictory thoughts in our head… First, streaming doesn’t come close to matching broadcast’s reach and, thus, viewership. Second, even with that gap, football is still the biggest “thing” on streaming. It’s very, very popular. Third, while some methodology changes have likely helped Prime Video’s numbers, their viewership does appear to be growing. Lastly, yeah, the NFL started the season off poorly, with week one dragging down the numbers in year-over-year comparisons. However—and again, methodology changes may have helped this—the viewership grew compared to previous seasons over the next couple of weeks. So football is still king. On streaming and off. Television - Adult Animation Continues to NOT Make the Streaming Charts In the last two reports, two adult-animated shows whiffed: Netflix’s animated comedy, Dang! Paramount+’s Sega-video-game-inspired fantasy/comedy, Golden Axe. Neither made the charts, but that’s usually the case for animated shows. I mean, here’s literally every animated show that’s made the Nielsen Original charts since the start of 2025: And one of those shows is G_abby’s Dollhouse_! A kids show! The problem with charts like this is that they don’t give you a sense of how many shows miss the charts. Netflix had at least eleven animated flops, including comedies like Big Mouth (a show everyone assumed was popular in the pre-Streaming Ratings Era), Long Story Short, Haunted Hotel, Mating Season, Strip Law, and Alley Cats, and action shows like Blood of Zeus, Castlevania: Nocturne, Devil May Cry, Splinter Cell: Deathwatch, and Tomb Raider: The Legend of Lara Croft. Prime Video had at least six animated misses, two in the same universe (Hazbin Hotel, Helluva Boss), three more comedies (#1 Happy Family USA, The Second Best Hospital in the Galaxy and Kevin) and an action show (The Mighty Nein). Disney+ had MCU and Star Wars animated misses (Eyes of Wakanda, Marvel Zombies, Star Wars: Visions, Star Wars: Maul – Shadow Lord, and Star Wars: Tales of the Underworld) but I can’t tell how many of those shows were geared towards adults. HBO Max had Harley Quinn and Hulu had Solar Opposites. None of these shows made the charts! That’s a lot of misses! If I remade the chart with all those misses, here’s how it would look: Listen, I know the counter arguments. First, it’s cheaper to produce animated shows than live action. Fair enough, but with viewership this low, even that cheaper price point starts to not matter. Second, just look at the acquired charts. Hit animated comedies can generate viewership for years! Shows like The Simpsons, South Park, Family Guy, and Bob’s Burgers do really, really well. Fair enough, but streaming has failed to recreate the dynamic that Fox has mastered so well. That’s a problem for streaming still. Television - Emmys! The annual Emmys broadcast was a few weeks ago, and I’ve got data on how the nominees performed on streaming, plus hot takes on this year’s viewership (and the big news about the broadcast’s, er, streamcast’s future). We’re just getting started with this issue, but the rest is for paid subscribers of the Entertainment Strategy Guy, so if you’d like to find out… The top Emmy-nominated shows… ...why I’m worried about the future of the Emmys telecast... ...the pros of broadcast television ...and the cons... ...please subscribe! We can only keep doing this great work with your support. Coming Soon! Next week, we’ve got a double issue (since the weeks of 21-Sep and 28-Sep were so light), but then I’ll be all caught up after a deluge of streaming ratings data from Nielsen in September. In the meantime, I’m going to try to take a look at Netflix’s stats to explain why Bela Bajaria is out. But even light weeks give me plenty to talk about. The Great British Baking Show returns to Netflix and Apple TV has a buzzy new star-studded comedy. And Netflix has a controversial-but-appears-to-be-popular new game show. Plus big films like Toy Story 5, Backrooms and The Breadwinner head to streaming. And is East of Eden a hit? After that, The Kardashians return to Hulu, Prime Video has a reboot of Carrie, and Netflix has a horror show, Below. Disclosure Day heads to Peacock, The Housemaid heads to HBO Max_,_ a new Ben Affleck film, Animals, lands on Netflix, and Apple TV has a new John Cena action film based on, checks notes, Hasbro’s Matchbox toys. Okay. Longterm, some interesting TV production news. HBO Max ordered How to Survive Without Me, starring Kaley Cuoco, Joshua Jackson, Ray Romano and Rita Wilson, for fifteen episodes! I love that some streamers (or, at least, HBO Max) are finally ordering TV shows with more than eight episodes. In less wise production news, Landman does not appear to be coming back this year, since it just started production. Frankly, I don’t love this (get your shows out on time) but Landman is so popular, I doubt it matters.
Donaldson’s Finer Chocolates celebrates 60 years
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iOS 27's new CarPlay features are great, but only these iPhones can actually use them
With iOS 27, car owners with CarPlay support can enjoy lots of cool new features. The problem is, only the iPhone 15 Pro and newer can support them all.
Mark Gurman: Apple Made 'Major Mistake' With iPhone Duo Pre-Orders
Despite knowing that the iPhone Duo would face "severe supply constraints" due to manufacturing challenges, Apple chose to begin iPhone Duo pre-orders on Friday instead of waiting until it had more inventory ready, according to Bloomberg's Mark Gurman. In his Power On newsletter today, he called this decision a "major mistake". "Let me cut to the chase: Apple made a major mistake here," he said.
Can You Get Actually Swallowed By A Whale? Here's The Real Science Behind 'Whalefall'
'Whalefall' is a whale of a tale, but poor Austin Abrams might be a little luckier in reality.
MGM+'s 'From' will debut on Netflix ahead of Halloween. How to watch
This Halloween-worthy binge hits the spooky checklist: monsters, mystery, and jaw-dropping moments.
FULL SHOW: Inside INdiana Business 10/18/26
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Business Briefcase: MAEA schedules HR roundtable
POTTSVILLE — The Northeast Pennsylvania Manufacturers and Employers Association, 250 One Norwegian Plaza, will stage an HR Schuylkill roundtable 11 a.m. to 1 p.m. Nov. 6 titled, “We Did It Right … And Still Faced Backlash: When Good HR Deci…
Who passed health checks in Wichita KS? Asian, burgers, food trucks & more
See Wichita-area restaurants, stores & hotels that passed health inspections. Sixty-nine locations made the Oct. 4-10 list.
Flaws become reinforcements: Engineered crystal defects strengthen metals without changing their chemistry
Scientists have found a way to use defects in crystals to engineer stronger materials, according to a new study.
Is Universal Health Services (UHS) Fairly Valued Or Is More Upside Left?
Universal Health Services: Stock Performance Snapshot With no single headline event driving trading, Universal Health Services (UHS) has been moving on recent performance data, including a last close of US$185.10 and mixed short and longer term returns. Over the past week the share price gained 4.4%. The move builds on a gain of 4.8% over the past month and 22.9% over the past 3 months, set against a year to date decline of 15.8%. For investors tracking the bigger picture, Universal Health...
Springfield barbecue spot re-opens for business after fire
This week in 417 foodie news, a barbecue spot returns, a food truck goes up for sale and a speakeasy gets in the Halloween spirit. Plus, 7 Brew expands to another Ozarks town.
Dental floss is shedding potentially harmful chemicals
Manufacturers are switching to different materials, trading smoothness for safety.
Nestle, Unilever face regulatory action in India over misleading health claims
Investing.com -- India’s food safety regulator has issued notices to Nestle India and Hindustan Unilever over allegedly misleading nutritional and health claims on dietary supplements, as authorities intensify scrutiny of food manufacturers.
Chinese scientists develop nanoparticles to improve pesticide
In a study published in the Journal of Controlled Release, researchers mimicked gut bacteria pili-hair-like structures that function as hooks-to design hollow, rough-surfaced silica nanoparticles
After deaths at Stryker Sports Complex, Comcare emphasizes mental health support
“Events like this affect far more people than those that were directly involved.”
Durand voters to decide $30.29M school bond this November
Durand Area Schools voters will decide on a $30.29 million bond proposal on the Nov. 3, 2026 ballot that would pay for safety, infrastructure and building upgrades across the district,
Arista vs. Vertiv: Which AI Infrastructure Business Has the Bigger Profit Cushion?
Arista and Vertiv rank tenth and ninth in our 10 Best AI Infrastructure Stocks to Buy for the Long Term. The list shows which eight infrastructure businesses attracted more hedge-fund holders. Both benefit when AI campuses become operational, but their profit cushions differ sharply. Arista Networks, Inc. (NYSE:ANET) supplies data-center networking; Vertiv Holdings Co (NYSE:VRT) […]
Nvidia vs. AMD: Which AI Business Has More Room for Margins to Fall?
What separates earnings resilience between NVIDIA Corporation (NASDAQ:NVDA) and Advanced Micro Devices, Inc. (NASDAQ:AMD)? Both sell AI compute, but a dollar of lost margin has a very different effect on their current profits. The stocks rank first and fifth in our 10 Best AI Infrastructure Stocks to Buy for the Long Term, respectively. See which […]
Nvidia vs. AMD: Which Business Is More Exposed to a Data-Center Slowdown?
NVIDIA Corporation (NASDAQ:NVDA) depends far more heavily on data centers than Advanced Micro Devices, Inc. (NASDAQ:AMD). That makes AMD more diversified by reported sales, although diversification alone cannot establish which stock is safer. The two AI stocks made it to our list of Best AI Infrastructure Stocks to Buy for the Long Term, but their revenue […]
SMH and United Healthcare at odds on Medicare Advantage pact
About 33,000 UnitedHealthcare Medicare Advantage subscribers who receive healthcare services at both Sarasota Memorial Hospital and First Physicians Group will be out of network starting Jan. 1, 2027, unless the two sides sign a new contract before the end of the year.
Rep. Ritchie Torres Wants Gamers to Own the Games They Buy, Announces Power To The Players Act
U.S. Representative Ritchie Torres (D-NY) has announced plans to introduce the "Power To The Players Act," a federal bill that would direct the FTC to write rules making a game purchase actual ownership rather than a revocable license. Games that rely on online servers would also need to offer an...
Thunder’s Preseason Finale Revealed Their First Real Test
Houston’s barrage exposed cracks in Oklahoma City’s defensive communication, forcing a new-look supporting cast to master complex rotations before the games actually count toward the standings.
Scientists Found a Way to Upgrade the Powerhouses of Our Cells Without Shutting Them Down
Scientists have developed a new way to coat mitochondria, the tiny structures that power our cells, while preserving much of their function. Researchers at two Italian institutions found that coated m...
Can Sacramento become a chip hub? Business leaders make their pitch to global firms
Energized by a string of investments by semiconductor firms, business officials pitched the region to a group of global companies.
Keri Russell on politics, escapism and 'Diplomat' twists she literally forgot
Spoiler alert! The following contains spoilers for Season 4 of "The Diplomat" on Netflix."
Is OPKO Health (OPK) Pricing In Too Much For Sales?
OPKO Health has seen sharp swings over the past few years, and the stock now sits at US$1.53 with investors reassessing what its current sales actually support. With such a mixed share price history and a changing business mix, the question is how much of the story around its revenue base is already priced in. Over the past 5 years the share price has fallen 58.5%, which puts the focus firmly on whether the current market value still lines up with what OPKO Health generates from its...
Is the brain actually 2 nervous systems smooshed together? A new study claims it is.
A recent study may reshape our understanding of brain evolution and open new avenues for studying neurological diseases.
Why is a New York-based betting site donating to Idaho politicians?
A donation doesn’t necessarily buy a vote, a Boise State political science professor said. But it “gets you a foot in the door.”
What Is The Little Circle Tool On A Leatherman For?
If you have a Leatherman multi-tool, you might have noticed a little circle at the base of your product. It actually has a very specific purpose.
Opinion: Do social media bans protect teens' mental health? Research suggests bans aren’t the answer.
Opinion by Ari Lightman: I research digital media and marketing and measure the impact of new technologies, and I’m skeptical about whether prohibiting access to social media platforms will actually improve young people’s mental health.
Central District Health has $250K to fight Ada County rats. Here’s where it’s going
The health district is making money available to help homeowners combat rat infestations. Does your household qualify?
Nvidia's RTX Spark Event in San Francisco Attracts Long Lines, But Few Buyers
Dozens lined up to check out the first RTX Spark laptops on launch day, but actual purchases were few and far between, with curious Nvidia fans citing the machines' high cost.
How laughter can help improve your mental health
They say laughter is the best medicine, but can adding a dose of humor to your life actually improve your mental well-being? According to the Journal of Psychiatric Research, the answer is yes.
Why Red Bull Got Into the Ski Business—And Teamed Up with an Austrian Racing Legend to Do It
Red Bull teamed up with an Austrian racing legend to manufacture skis, and it’s the mashup we’ve all been waiting for
Nvidia reshapes communications amid AI boom and departures
Nvidia's communications team has restructured amid the AI boom, with staff changes as the company sees increased growth and workloads.
It’s time to bring back science in campaign policy discussions
Despite the politicization of science, a majority of both liberals and conservatives feel that government investment in scientific research is worthwhile for society.
Great bake: Cheyenne entrepreneur finds sweet success after a cupcake business reboot
CHEYENNE, Wyo. –– Munching on product is usually frowned upon in most food service environments. For Brian Harris, sampling the food is actually
God Help Me, I Actually Loved Street Fighter
Stupid, surreal, and a little sexy are how best I can describe yet another video game movie.
Billy Joel just gave an update on his health — there are two things he can’t do
‘It’s someone else’s turn to hit the road.’
What a subscription business actually automates when it sets up recurring billing
The word "automatic" in subscription billing can mean two very different things depending on which part of the process it describes.
SACE’s $31 billion US portfolio underscores the strength of Italy-US business ties
Italy’s export credit agency, SACE, has €27 billion in outstanding commitments in the United States, highlighting the strong economic ties between the two countries. The agency is actively facilitating Italian companies’ access to the US market and attracting investment into Italy, with a focus on high-value sectors like advanced manufacturing and strategic technologies. SACE’s presence in the US underscores the growing integration of Italian industrial supply chains into major American projects
Robots could boost US manufacturing as America races to keep pace with China, expert says
A Path Robotics executive told FOX Business that automation will be critical to expanding U.S. manufacturing as worker shortages persist and China moves faster to adopt robotics.
IU Kelley School of Business Expert Weights in on Prediction Markets and Midterm Elections
As prediction markets play a growing role in election forecasting and increasingly compete with traditional polling, Russell Rhoads, clinical associate professor of finance at the Indiana University Kelley School of Business Indianapolis, is available to provide expert analysis and commentary. Rhoads can help audiences understand how prediction markets work, what market odds actually signal about election outcomes, and why investors, analysts, and political observers are payin
Registration is open for high school winter sports
Registration is now officially open for high school winter sports for the City School District of Albany! Any student in grades 9-12 who is interested in trying out for boys' basketball, girls' basketball, bowling, cheerleading, boys' indoor track, girls' indoor track, spirit team, boys' swimming and diving, boys' wrestling and girls' wrestling is invited to register via Final Forms. Important: please note that registration for winter sports ends on Friday, Nov. 13. Practices and tryouts for winter sports begin on Monday, Nov. 16. FINAL FORMS Each season, the following must be done prior to the first day of tryouts and practices: A parent or guardian must initiate the registration process for their student-athlete in Final Forms, filling out the required forms such as Interval Sports Health History and the Athletic Consent Form. The student-athlete must sign and complete their required forms. A reminder that all students who would like to play an interscholastic sport need to have a current physical conducted within a year on file. PHYSICALS A physical conducted within the last 12 months is mandatory for any student interested in trying out for an athletic team and must be uploaded into the Final Forms platform. Families are encouraged to get a completed physical from their child's physician. If you are unable to get a physical from your child's physician, you can schedule a free physical with Whitney Young's school-based health center by calling (518) 573-2556. Additionally, the district physician will also be available to facilitate sports physicals at Albany High in room 4253 on the following dates: Thursday, Nov. 12 from 10:30 a.m.-2:30 p.m. Friday, Nov. 13 from 10:30 a.m.-2:30 p.m. Sports physicals on Nov. 12 and 13 are free and no appointment is necessary. ACADEMIC ELIGIBILITY REQUIREMENTS Please note that students must have a good attendance record and be in good standing academically to be eligible to participate in an athletic team. Eligibility is determined based on quarterly grades, and interim progress reports will serve as an important academic checkpoint for all student‑athletes. For additional details about academic eligibility, please see our Athletic Code of Conduct. For our winter teams, academic eligibility to start the season will be based on final first-quarter grades. The first marking period ends Nov. 13. Albany High offers free tutoring facilitated by Albany High teachers Monday-Thursday from 3:30-5 p.m. for students who need extra help with their academics. See this flyer for additional details. IMPORTANT DATES Seniors, please mark your calendars for Senior Media Day for winter sports, which will take place on Monday, Nov. 30. All student-athletes playing winter sports will also participate in our winter sports picture days, which will take place Tuesday, Dec. 15–Thursday, Dec. 18. Specific dates and times for each team will be shared once rosters are finalized. OPEN GYM SESSIONS Student-athletes are encouraged to check out our open gym sessions as they prepare for upcoming sports seasons. We’re looking forward to a rewarding winter sports season this year! If you have any questions, please contact the Athletic Department at (518) 475-6310. Go Falcons!
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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