Most states are exploring ways to legislate AI use

As artificial intelligence (AI) capabilities continue to advance and public adoption of the tools rapidly increases, U.S. state legislatures are actively exploring how best to regulate the technology. In 2025, it is estimated that 47 states introduced over 250 bills related to AI use in health careopens in new window. Several states, including California, Illinois, Nevada, New York, and Utah, have passed key AI legislation regulating how health insurers can use AI, how to regulate AI chatbots, and how AI can be used in the delivery of clinical care, among other issues.

APA has been tracking several types of bills specific to mental health. Often these bills contain some of the following features:

• a prohibition on AI chatbots representing themselves as a human, licensed professional such as psychologists;
• requirements for developers of AI chatbots—such as regular reminders that the chatbot is not human, crisis protocols to enhance user safety and direct them to appropriate resources, and requirements to report to the appropriate state authority how often crisis resources are being provided; and
• conditions on how mental health professionals can and cannot use AI in their clinical practice.

APA has been clear in advocating for the safe and responsible use of AI technologies. In the health advisory on the use of generative AI chatbots and wellness applications for mental health, there are several recommendations for policymakers that could guide emerging legislation to enhance AI safety. These include:

• prohibiting chatbots from falsely representing themselves as licensed professionals, such as psychologists;
• requiring developers to adopt proactive safeguards, including clear and persistent disclosures that the user is interacting with an AI, not a human;
• adopting industry-wide safeguards to reduce harm, including evidence-based crisis protocols;
• enacting comprehensive data privacy legislation that mandates “Safe-by-Default” settings—in other words, the most protective settings must be the default;
• mandating age-appropriate design and predeployment testing—require that AI systems accessible to children and adolescents undergo rigorous, independent, predeployment testing for potential harms to psychological and social development;
• developing guidelines for generative AI (GenAI) and digital literacy education and fund the development of curricula and training programs in this field; and
• funding rigorous and independent research on GenAI chatbots and apps.

In addition to the role of policymakers and developers, APA also has been clear that psychologists have a critical role to play in the safe and ethical use of AI in clinical practice. Ethical Guidance for AI in the Professional Practice of Psychology highlights psychologists’ responsibilities to exercise clinical judgment in selecting high quality and HIPAA-compliant AI tools, transparency about the tools they are using in care and obtaining patients’ consent for their use, maintaining professional oversight of care, and engaging in continuing technological education.

However, there are unintended consequences of legislation that propose overly restrictive conditions on how mental health professionals are allowed to use AI. Many of the emerging bills allow AI to be used for administrative functions like note generation, scheduling, and billing, but limit AI from directly interacting with patients in any sort of supportive or “therapeutic” communication. Notably, the bills often do not distinguish between general purpose AI tools and clinical tools. AI-enabled clinical tools are already in use in health care systems, and other GenAI tools are in development that directly engage with patients to enhance their care. These tools often are considered medical devices and are subject to regulatory oversight. While AI safeguards are needed, it is also crucial that psychologists have access to the novel clinical tools that are being developed that can augment and extend care to the communities that they serve.

To address the potential impact on patient care and help policymakers focus legislation on the core harms, APA Services is collaborating with state, provincial, and territorial psychological association leaders in states where such bills are pending to develop an advocacy strategy and messaging. If you have questions about the implications of proposed legislation in your state, contact APA’s Office of Professional Legal and Regulatory Affairs.