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Lizzo Says She Was Healthy Before Losing Weight
After critics claimed getting smaller hurt her image, Lizzo fired back with a powerful reminder: Her brand was never her body - it was joy.
The Politics of Heat, Homes, and Lobster Boats.
The Bar Harbor Story is generously sponsored by First National Bank. MOUNT DESERT ISLAND REGION—The candidates’ forum focusing on House District 15 and incumbent Holly Eaton and Clifford Noyes last week spent a lot of time on the candidates’ thought of heating, communication with constituents, property taxes, education costs, and other issues. It also was a time for the community to ask their own questions and see two candidates up close and personal at the Southwest Harbor Fire Department firehouse. Jim Vallette organized the hour-long event, which was moderated by Carrie Jones of the Bar Harbor Story. Ken Rozsahegyi provided technical support for the congenial event. House District 15 serves Brooklin, Deer Isle, Eagle Island Township, Frenchboro, Isle au Haut, Marshall Island, Southwest Harbor, Stonington, Swan's Island, Tremont, and Vinalhaven. Jones advised as she began the question and answer part of the event, ”Treat everyone here like they are going to be the ones who might give you a ride in a rainstorm, pull your pet out of a burning building, or be the one grading your kids’ papers at school, okay?” She continued. “That’s it. Tonight isn’t meant to be a gotcha debate. The goal is to give people in the district a chance to get to know both candidates, hear what they care about, and understand what they’d actually try to accomplish in Augusta.” The questions and discussion throughout were kind. Eaton currently serves in the position. She’s a Democrat from Deer Isle, raised in a fishing family and has worked in nonprofits and volunteered for her school board. Noyes is unenrolled (politically) and from Southwest Harbor and currently a school board member, self employed as a mason. He focused on fiscal issues throughout the forum. Eventually, at Jones’ prompting, the candidates played “Rock, Paper, Scissors” for who would go first for their closing statements. Noyes used the opportunity to urge others to head to the ballot. “Whether you vote for me or Holly, it’s important that people vote,” Noyes said. He hoped the voter turnout in the district would be over 35 percent because that would mean people were truly engaged. Eaton stressed that she’s a Democrat, but in Augusta, her role isn’t about party. “I am a Democrat, but when I go to Augusta, I am there to represent the people of District 15. I want people to feel as though I’m accessible, that I’m responsive, and that I show up for the district,” Eaton said. Being there for others was vital, she explained. “When something comes before me in Augusta, I try to look at it through the lens of the people and the communities that I represent. How will this affect the people who live here? Does it make it easier or harder to raise a family here, to operate a small business, to work on the water, to afford a home, to keep our schools open, or provide the essential services our communities depend on?” Eaton said. Noyes spoke about fiscal responsibility and about the state being more responsive to communities and the ideas that come from them. “I feel that we desperately need to restore some fiscal sanity, a little bit. So when the legislature meets again,” Noyes said, “it could be critical for Maine residents that we don’t keep digging this hole that we’re in financially and keep raising our taxes so the struggling families struggle even more.” The two answered a series of questions from Jones, then answered questions from the audience and participants via Zoom. Jones asked what they heard the most from people about what was making their lives hard and what can the legislature in Augusta do it about those issues. Both spoke to concerns about heating oil costs. Noyes spoke to the three H’s: health, home, and heat. Eaton and Noyes spoke to the burdens of families with lower incomes, with Eaton mentioning LIHEAP (Low-Income Home Energy Assistance Program). They both were in favor of free community college and trade programs. They both supported the working waterfront. Both said that data centers—such as the one proposed in Eastport, which is out of the district—should be a local decision, but neither were in favor of it. The working waterfront was supported by both. Eaton’s served on the Maine Marine Resource Committee in the legislature. She advocated a diversity of fishing resources and less of a reliance on lobstering. Shrimp, she hoped, would make a comeback. Noyes worried about out-of-state pressure on the lobstering industry, also spoke of shrimp harvesting timings, and said he supported the lobstering industry. QUICK NOTE Carrie Jones is, obviously, the co-founder of the Bar Harbor Story, which made us have a bit of a hard time putting out this story and thinking it through and how to present it. We ended up with this article. The debate in its entirety is below, many thanks to Ken and Jim for making it publicly available. UPCOMING AND PAST EVENTS The following events are or were organized by the League of Women Voters Downeast. DISTRICT 7 DISTRICT ATTORNEY DISTRICT 13 Thursday, Oct 15, 2026 5:30 PM to 6:30 PM Candidate Forum: House District 13 125 State St , Ellsworth Featuring candidates Michael Cunningham (D) and Russell White (R), moderated by Cyndi Wood, managing editor of the Ellsworth American. DEMOCRACY FORUM Friday, Oct 16, 2026 4:00 PM to 5:00 PM Democracy Forum — Election 2026: What’s on Your Ballot RECENT PRESS RELEASES AND BRIEFS To see all the press releases, click here. To see our news, click here. For the full archive, click here. All of these are on our dedicated website. [ ](https://barharborstory.substack.com/p/feeling-stressed-kids-corner-invites) [ Feeling Stressed? Kids’ Corner Invites Parents, Educators, and Caregivers to Rediscover the Joy with National Speaker Raelene Ostberg Oct 14 ](https://barharborstory.substack.com/p/feeling-stressed-kids-corner-invites) [ Read full story ](https://barharborstory.substack.com/p/feeling-stressed-kids-corner-invites) [ ](https://barharborstory.substack.com/p/mainely-meats-pink-party-for-breast) [ Mainely Meat’s Pink Party for Breast Cancer Awareness is October 18! Oct 14 ](https://barharborstory.substack.com/p/mainely-meats-pink-party-for-breast) [ Read full story ](https://barharborstory.substack.com/p/mainely-meats-pink-party-for-breast) [ ](https://barharborstory.substack.com/p/conners-emerson-school-announces) [ Conners Emerson School Announces Public Surplus Property Sale Oct 14 ](https://barharborstory.substack.com/p/conners-emerson-school-announces) [ Read full story ](https://barharborstory.substack.com/p/conners-emerson-school-announces) [ ](https://barharborstory.substack.com/p/planting-the-writers-garden) [ Planting the Writer’s Garden 12:15 AM ](https://barharborstory.substack.com/p/planting-the-writers-garden) [ Read full story ](https://barharborstory.substack.com/p/planting-the-writers-garden) [ ](https://barharborstory.substack.com/p/artist-maria-de-los-angeles-explores) [ Artist Maria de los Angeles explores migration and belonging in COA public lecture 12:19 AM ](https://barharborstory.substack.com/p/artist-maria-de-los-angeles-explores) [ Read full story ](https://barharborstory.substack.com/p/artist-maria-de-los-angeles-explores) HELP SUPPORT THE BAR HARBOR STORY When we started The Bar Harbor Story, we didn’t know if anyone would read it. But you showed up. You shared. You sent tips. Now—over 400,000 views every month later—it’s clear: people here care about their community and each other. We’ve kept everything free because news should never be out of reach, but every one of our stories takes time to write, and your support keeps The Bar Harbor Story going. If you value our work, please consider a paid subscription, a founding membership, or a sponsorship. It truly helps us cover one more meeting, tell one more story, shine one more light. Even $5 a month makes a difference. Click here to become a one-time supporter now. Thank you so much for being here. Founding member information can be found here. Have questions about sponsorships? Just send Shaun an email at sfarrar86@gmail.com, he’d love to hear from you. Subscribe Share Bar Harbor Story Share Leave a comment
10/15/26: White Paper - Small Business Trends in Chattanooga - Center for Regional Economic Research
A new white paper released by the CRER looks at trends in small business in Chattanooga since 1978. Small firms are much more numerous in Chattanooga than are medium and large firms, although their number has grown much more slowly. Between 1978 and 2023, the number of small firms grew by 27 percent whereas the… Continue Reading
Single 2D crystal transforms into transistor with built-in insulation and electrical contacts
A transistor normally requires several fundamentally different materials—a semiconductor to carry current, an insulating dielectric to control it and metallic contacts through which current enters and ...
NVIDIA Joins European Commission Initiative to Expand AI Resources for Science
Oct. 15, 2026 — Much of today’s scientific progress begins with computation. But turning accelerated computing’s potential into scientific progress — modeling climate systems, designing molecules, simulating materials and more — depends on more than breakthrough technology. Especially for smaller labs, early-career scientists or science-based startups, the hardest part of research can be everything that […]
Thirty Seconds in Texas Costs $12,000 as Politics Dominates TV
Buying a 30-second television ad in Harlingen, Texas, typically cost political candidates less than $500 two years ago. These days the spots are going for the price of a serviceable used car in the small city near the Mexican border.
How Chick-fil-A started, grew into a major company
Chick-fil-A has come a long way since opening as a small roadside diner in Georgia in 1946.
Apple Reveals iPhone Duo's Battery Capacity
Apple on Friday published an EU energy label for the iPhone Duo that reveals the device has a total battery capacity of 4,883 mAh. The document appears to confirm a previous leak that showed the iPhone Duo has 2,962 mAh and 1,921 mAh battery cells totaling 4,883 mAh. iPhone Duo is an eSIM-only device, so this battery capacity figure should apply worldwide, as there is no version of the device with a physical SIM card tray that would have a slightly smaller battery.
SBA Offers Relief to Small Businesses and Nonprofits Impacted by Grand Canyon Flooding
Congressman Eli Crane
A small business incubator: How 3 entrepreneurs started at the Downtown Farmers’ Market
The Des Moines Downtown Farmers’ Market has served as a launchpad for a variety of businesses, acting as an incubator for new ideas and products. “I think it’s not unusual for a farmers market in general to be an incubator for businesses and young entrepreneurs, and it’s a space for them to interact with the…
Massachusetts can protect data privacy without hurting small businesses
As lawmakers debate the Massachusetts Data Privacy Act, they should be careful not to adopt an approach that unintentionally makes it harder and more expensive for local businesses to compete, grow, and innovate online.
Morocco health alert issued due to diphtheria: US Embassy
In the North African country of Morocco, the country’s Ministry of Health reported a small diphtheria outbreak with clusters in multiple regions in Morocco in late September. Moroccan health teams are tracing contacts and providing preventive treatment and vaccines. This has prompted the US Embassy to issue a health alert for U.S. citizens in Morocco. Diphtheria is a serious bacterial infection. It spreads primarily from person to person through coughs and sneezes (respiratory droplets). Most Americans were vaccinated as children and have received Td or TdaP boosters as adults. The risk to U.S. citizens in Morocco remains low. U.S. Citizens may contact their local doctors if they would like immunizations. Embassy officials advise citizens to watch out for the following symptoms: Sore throat or hoarse voice, mild fever, a thick gray or white coating in the throat or nose, swollen neck and trouble swallowing or breathing. If you or a family member has trouble breathing or swallowing, please contact your local doctor. They also advise on the following actions concerning vaccines: Check your vaccination records and your family members’ records. Get a booster if you need one. Adults need a diphtheria booster (Td or Tdap) every 10 years. Make sure your children are up to date on their routine vaccines. Outbreak News Today is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
Brenner named Guardian of Small Businesses
COLUMBUS – The National Federation of Independent Business (NFIB), Ohio’s leading small business advocacy organization, named state Sen. Andrew Brenner and state Rep. Meredith Craig as Guardians of Small Business, NFIB’s highest legislative honor. NFIB Ohio State Director Jared Weiser presented the awards at NFIB’s Ohio Leadership Council meeting Thursday.
Marshmallow Root’s Chemistry Revealed: The Science Behind an Ancient Cough Remedy
A new review in Pharmacia compiles the chemical compounds and pharmacological effects of Althaea officinalis, the marshmallow plant long used for coughs, wounds, and inflammation.
New SBA lending rules create hurdles for aspiring business owners
Some worry the updated rules to the Small Business Administration's 7(a) loan program would make it harder for some would-be buyers to obtain financing, putting business acquisitions further out of reach.
Draper small business outfits Garth Brooks' crew with custom hats
A small business owner in Draper turns a chance encounter with country music superstar Garth Brooks into an unforgettable experience.
Small Business Administration offering loans to small businesses and nonprofits impacted by the Aspen Acres Fire
The Small Business Administration will be offering low-interest loans to those impacted by the Aspen Acres fire this summer.
Colorado Springs Named Bluevine's Best City in US for Small Business in New Study
/PRNewswire/ -- A new monthlong study of government-data and internal financial data from more than 200,000 active banking accounts across its 100 most-active...
Commentary: Trump slashed healthcare for Ohio families and spiked premiums. Now he's offering small checks.
Do you celebrate an arsonist who brings a cup of water to a fire they started? Is the president a hero for cutting small, healthcare relief checks to people struggling under his policy, the largest rollback of federal support for health care in American history?
Atrium Health's $340M behavioral health push includes north Charlotte hospital
A planned 168-bed facility near Mallard Creek will offer emergency, inpatient and outpatient care.
SBA Opens 2027 Small Business Awards Nominations » CBIA
The U.S. Small Business Administration is accepting nominations for its 2027 National Small Business Week Awards through December 7.
First Apple TV 4K Pre-Order Discount Arrives at Amazon
Following in the footsteps of a small pre-order discount on the HomeView, Amazon is now offering the first cash discount on the brand new A19 Apple TV 4K. You can get this model for $289.99, down from $299.00. Note: MacRumors is an affiliate partner with some of these vendors. When you click a link and make a purchase, we may receive a small payment, which helps us keep the site running.
Scientists Uncover a Hidden Factor That Could Change How We Manage Diabetes
Timing may matter in insulin-treated type 2 diabetes; patients with the steadiest daily rhythms were 2.3 times as likely to meet blood sugar goals, while afternoon activity was linked to smaller swings. People with type 2 diabetes who use insulin need to keep blood glucose from climbing too high or falling too low. In a
A Childhood Experience May Lower Mental Health Risk By 11%, New Research Finds
Small moments of support in childhood may have benefits that last into adulthood.
QLED, Mini LED or standard LED? Here are 5 43-inch TVs to compare before upgrading your home entertainment setup
New Delhi, Oct. 18 -- A 43-inch television can be a practical fit for a bedroom, a smaller living room or a home where a larger screen simply will not work. But screen size is only one part of the buying decision. A conventional LED panel, a QLED screen and a Mini LED display can deliver different…
Davids Urges Federal Action as Kansas Small Businesses Squeezed Out of Tariff Refunds While Large Corporations Cash In
Today, Representative Sharice Davids demanded immediate action to ensure Kansas small businesses receive the tariff refunds they are owed. Following this year’s Supreme Court ruling overturning the president’s reckless tariffs, the federal government began processing billions of dollars in refunds.
Scientists Kept Finding The Same Mysterious DNA In Their Samples. The Marine Microbe It Belongs To Has The Smallest Genome Ever Identified
This tiny marine organism may demonstrate just how little genetic material a cell needs to survive.
Scientists Examine 5,000-Year-Old Skulls and Uncover a Disturbing Secret of Egypt’s First Kings
Serving Egypt’s earliest kings may have carried a deadly cost, and overlooked skull injuries are giving a century-old suspicion new weight. Some of Egypt’s earliest royal tombs at Abydos are surrounded by hundreds of smaller graves. When Flinders Petrie excavated the site in the 1920s, he suspected that so many people could not have died
New Franciscan Health office could come to Marquette Mall in Michigan City
From a shopping mall to helping save lives.Part of the Marquette Mall in Michigan City could be on its way to becoming a new office for Franciscan Health.The he
IP Saves the Day On Streaming
(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.) Before we get started, I wanted to highlight a new idea I saw from Real Good AI, proposing a ratings system for AI use. (H/T to Anthony Kaufman’s article highlighting this.) It would look something like this: In general, I think that this is a solid, middle-ground solution that should appease both the pro-AI camp (who love AI) and the anti-AI camp (who wants to know if what they’re watching didn’t come from humans). Regardless of your feelings on AI/LLMs—I’ll never use it for my writing—transparency is often the best solution to many problems. In general, I think way more media outlets need to be using way more AI disclosures. My quick “Yes and...” to this idea: what about ads? In particular, I hate it when I see or hear ads that are obviously AI-generated, but a person or voice says, “I used this product”. AI doesn’t use products! Just today, I watched a YouTube ad where a “person” said they use some sort of rain wind chime...but that’s not a real person! They didn’t use this product. (Especially since the video of the wind chime itself also appeared to be AI-generated...) I believe most traditional advertising already has standards like this anyway.1 Okay, on to this week’s issue. We’re covering the week of 14-Sep, and then next issue, I’ll be fully caught up with Nielsen’s new release schedule. In the future, I plan to put out Streaming Ratings Reports each Monday after Nielsen’s Thursday releases. Overall, we had some big new shows this week, like Prime Video’s Reacher spinoff_, Neagley_, which is off to a big, big start, and Netflix’s latest in its Monster anthology, which is their largest opening since June and the second-largest since One Piece came out in March. All that, plus Slow Horses returns, the trio of returning shows (Lioness, Reacher and Ted Lasso) continue to dominate the top tens, Paramount+’s latest crime drama, a big whiff for a Netflix original film and a precipitous drop for Netflix film charts, all the flops, bombs and misses, and a whole lot more. Let’s dive right in! (Reminder: The streaming ratings report focuses on the U.S. market and compiles data from Nielsen’s weekly top ten viewership ranks, Luminate’s Top Ten Data, JustWatch and Reelgood interest data, Samba TV household viewership, company datecdotes, Netflix hours viewed data, Google Trends, and IMDb to determine the most popular content. While most data points are current, Nielsen’s data covers the weeks of September 14th to September 20th 2026. You can find a link to my terminology here.) Subscribe Television - IP For the TV Win Can I use the dirty word of entertainment journalism right now? IP. Shhh. Don’t tell anyone I said it. But IP works at the box office, and we’ve seen some evidence it works in TV too. Not as well, and not all the time—no absolutes here!—but often enough. And glancing at the Nielsen top ten…it worked this week! Take Prime Video, who has a monster hit in the crime drama Reacher. Would a spinoff work for that show? Yep! They binge-released Neagley, about a detective from the original Reacher series, and its eight episodes debuted to 29.6 million hours. Here’s how it stacks up to Reacher, one of Prime Video’s biggest shows: That’s great. Nearly as strong as Reacher’s opening! (Both shows started with eight, binge-released episodes, so this comparison is apples-to-apples.) Notably, Prime Video scheduled the debut of Neagley to overlap with Reacher’s most recent season, to help drive tune-in. Obviously, I love smart release strategies like that. And even though I wrote “obviously”, it’s not really that obvious, since streamers don’t often take advantage of natural overlaps like this_._2 Other data backs how well Neagley performed. It opened at second place on Samba TV for two weeks and got 51.7 million hours on Luminate. That’s the eleventh biggest opening on Luminate since May of 2024 and tied with Bridgerton’s third season opening. That’s a huge opening! Its IMDb is solid too, a 7.7 on 24K reviews. Netflix’s latest edition in the “Monster” series—which started with Jeffrey Dahmer and comes from Ryan Murphy—did well too, opening to 24.7 million hours. That’s the biggest opening for Netflix since I Will Find You in June, and second biggest since March. Unlike the Reacher series, this franchise is trending downward, though. The first Monster show—Dahmer - Monster—was giant. More than anything, I think this reflects that Netflix running out of extremely popular—if that’s the right word?—serial killers to feature. Still, the data says this is a very good opening. It made it to third place on Samba TV for two weeks. It also opened to 40.0 million hours on Luminate. That’s not quite as elite as Neagley, but still very, very strong. I’ll be honest: my priors coming into any given week are that IP works to help drive buzz for new shows, but TV shows need to stand on their own even more than movies, so they will succeed or fail based on their quality. But these two spinoffs definitely worked. Quick Notes on TV The top show, film or special this week? Football, again. Specifically, Prime Video’s season opener of Thursday Night Football. The games run long (three hours) but mainly a lot of people watch each game. That adds up to a lot of viewership. Paramount released the second season of MobLand on an unusual day for that service, a Friday! Often, they put their new shows out on a Sunday, as they did last year with a run of shows (Lioness, Tulsa King and Landman). MobLand didn’t make Nielsen in its first week, but on Samba TV it got to eighth and seventh place. Luminate had a smaller opening too, only 5.3 million hours. MobLand missed the Nielsen charts for its first eight weeks, so this season is off to a stronger start. (Bonus note: the first season streams on both Prime Video and The Roku Channel, but I only have it as Paramount+ on those charts.) I’ve mentioned a few times that foreign-language originals do lower numbers than English-language originals on Netflix most of the time. But I don’t usually emphasize what country those originals come from, and observationally, they tend to be from Western or Northern European countries, in general. So credit to Not a Stranger, a Turkish Netflix original, for breaking through on Luminate, getting to 7.9 million hours in its first full week on those charts. As I mentioned last issue, Crew Girl ended up making the Nielsen charts in its second week. That’s still a soft performance compared to many shows, but again this, one looks affordable. And if you’re curious, here’s how it stacks up to some other sports romance shows: 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… …about a new data source and how it drives streaming viewership… ...what reality show is struggling in its latest season…. ...what Netflix film bombed…. ...How Reacher, Ted Lasso, and Lioness are doing on the charts… ...what obscure sport put up great viewership numbers… …how far streaming films are falling… …all the flops, bombs and misses for the last week… …and more… ...please subscribe! We can only keep doing this great work with your support. If you want an idea of just how much content you’d get in a full issue, check out this older issue. Coming Soon! Next week, we’ve got a double issue, then we’ll be all caught up with Nielsen’s data. Yes! The goal is to have my report out on the Monday after I get Nielsen’s data. So next issue, I’m looking at East of Eden, The Great British Baking Show, a Willy Wonka game show (that people are upset uses AI, but viewers might not care), and a Cosby show spinoff reboot on Netflix, and Brothers on Apple TV (starring Woody Harrelson and Matthew McConaughey). That’s about it for TV, but who’s going to win the streaming week, The Breadwinner or Backrooms on streaming? Answer: Toy Story 5. Plus Netflix has a Unabomber film and a new Tyler Perry film, Teenage Sex and Death at Camp Miasma tries to repeat The Substance’s run on MUBI, and Paramount+ has Jackass: Best and Last. Long term, Netflix is remaking Lonesome Dove. I love this choice, but man, there are a lot of westerns on TV right now. And they’re making Sega TV shows, including a Crazy Taxi TV show and Sonic show with an “edge”.
Majority of Small Business Owners Rely on Their Businesses to Fund Their Future, New Survey Finds
For many U.S. small business owners, their financial future depends heavily on the businesses they've built, yet new research reveals significant gaps in the planning and preparation needed to support a successful exit.
Scientists find 'gemstones' in atmosphere of bizarre, scorching-hot 'marshmallow' exoplanet
"Planets are temperamental, their atmospheres complex and chaotic."
Idaho receives $329,000 federal grant to boost small business exports
Idaho secures a $329,000 federal grant through the State Trade Expansion Program to help small businesses expand into international markets.
Truist CEO shakes up bank's consumer, small business leadership
New Truist Financial CEO Mike Lyons revamped the Charlotte-based bank’s consumer and small business leadership and jettisoned one of the key digital initiatives of his predecessor CEO.
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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As I explained in a recent interview, this incident is very unlikely to lead to a pandemic. Plague is still active, including in the U.S., which sees a handful of cases each year. But it is a disease we can prevent and treat. Plague doesn’t spread readily, and it responds to antibiotics. The standard response—isolate the patient, trace contacts, and administer antibiotics and monitor for symptoms among contacts for seven days—works. We have even planned for antibiotic-resistant plague. At CDC, we developed a playbook for antibiotic-resistant plague and ran exercises on how to find and stop it. CDC guidance anticipates engineered resistance and recommends two different classes of antibiotics if there’s reason to suspect it. There is no evidence that resistance—or even confirmed plague—is involved in this incident. We have thought through how to address plague, but we’re not ready for the next major health threat that emerges from a lab or from animal spillover to humans. What should concern people is how little stands between the world and the next pathogen to get loose. Since peak COVID, epidemic preparedness has fallen off the political agenda, but the risk is greater than ever. More labs handle dangerous pathogens with more ways to make those pathogens deadlier, and more people live and work in close contact with animals. There are actions we can take now: We need better lab safety in every country. The number of labs that work with dangerous pathogens has increased worldwide over two decades, but there’s no enforceable international standard and no inspection regime; the Biological Weapons Convention, fifty years on, still has no verification mechanism. Labs that study dangerous germs need strong safety systems, training, and oversight. We need to reduce spillover events. Three in four emerging human infections start in animals, and there’s a lot we can do to reduce spillover risk, but the world is doing very little of it. Live-animal markets are one place to act. For instance, closing live-bird markets helped control H7N9 influenza in China. Reducing opportunities for people to encounter infected animals can prevent infections before they become outbreaks. In The Formula for Better Health, which is now out in paperback along with the hardcover, Kindle, and audiobook versions, I argue that labs do too many risky experiments with too many dangerous pathogens in too many institutions, and that every experiment should first answer one basic question: Is the likely benefit greater than the risk? Spillover risk can also be reduced: In the book, I discuss how Brazil cut its deforestation rate by 70% from 2004 to 2012 while increasing agricultural production and reducing risky contact between people and forest animals. We need faster detection and response. Delay costs lives. Strong surveillance, good labs, and trained responders can turn a single case into a small cluster of infections instead of an epidemic. Resolve to Save Lives has worked for nearly a decade to help countries find and stop outbreaks faster. The 7-1-7 target, which Resolve to Save Lives developed with partners in Uganda and elsewhere, provides a clear standard: detect within 7 days, notify within 1 day and complete all essential early response actions within 7 days. In Uganda’s Kasese district, for example, a review of a measles outbreak using 7-1-7 identified shortages of accessible funds, fuel, and vehicles that delayed the response. District leaders established funds they could access quickly. When, a few months later, the Crimean-Congo hemorrhagic fever appeared, the district detected it in three days, notified authorities in one, and mounted an effective response in two. Only one case was confirmed, and the patient survived. Because funds were available before the emergency, authorities were prepared and able to act. This kind of preparation can’t wait until the next crisis begins. Plague is an old disease we that know how to stop. The next threat may be harder to recognize, harder to treat, and easier to spread. Safer labs, less risk of spillover, and faster outbreak detection and response need sustained investment now, while we still have time to prevent the next emergency. Share
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