Should NH restrict the use of AI in mental health practice?

Waitlists for many mental health service providers in New Hampshire stretch for months, leaving some to propose a controversial alternative: artificial intelligence. Now, a bill in Concord is asking a critical question: what should be the role of AI in mental health—if any?

Can a chatbot be a “professional”?

Introduced by Sen. Howard Pearl (R-Loudon), SB 640 aims to regulate the use of AI in services requiring a professional license, with a heavy focus on mental healthcare.

“Engagement with such AI tools can have unintended and sometimes tragic consequences, including self harm or suicide,” Sen. Pearl testified at the bill's January public hearing. “There is a need to protect consumers by ensuring that mental health treatment is offered only by licensed professionals who are trained to safely and ethically deliver such services.”

Voices weigh in at the public hearing

The public hearing before the Senate Executive Departments and Administration Committee featured a variety of mental health professionals with differing views on the proposal.

Proponents of the bill, including representatives from the National Association of Social Workers (NASW) and the NH Association of Marriage and Family Therapists, expressed concern about the dangers of unregulated AI.

Lynn Courier, executive director of the NH chapter of NASW, argued that AI lacks the critical thinking and analysis skills to give sound therapy. She cited recent lawsuits against AI platforms and the tragic example of a teenager who took his own life after a chatbot provided instructions for how to tie a noose that could hold a human body. “AI therapy is not the silver bullet that we are looking for,” Courier said. “The risks towards consumers are too high.”

Not all the mental health experts at the hearing supported the bill, however.

Dr. Nicholas Jacobson, a Dartmouth researcher and expert in generative AI psychotherapy, testified that New Hampshire is in a mental health crisis where nearly half of clinicians have waitlists. He argued the bill wouldn't stop teenagers from downloading open-source AI models on their phones, but it would severely penalize well-meaning developers and clinicians trying to use clinically tested AI tools responsibly.

“This bill's review requirements make deploying these tools impractical,” Dr. Jacobson testified. “They turn scalable care back into unscalable care exactly at the moment we need scale.”

The NH Psychological Association also opposed the original draft. The group’s president, Dr. James Bomersbach, raised concerns that the bill's broad definition of AI could inadvertently outlaw the use of standard, FDA-approved “digital therapeutics” simply because the software data is held by a third-party company, making it impossible for a provider to claim “full responsibility” over all data usage as the original bill required. He suggested this might ban providers from offering patients an app to help develop better sleeping routines, since the app’s developer would retain some patient data.

The Senate offers a compromise

Listening to the testimony—and advice from the Office of Professional Licensure and Certification (OPLC) to simplify the approach—the Senate committee significantly altered the bill.

On March 12, the full Senate passed SB 640. The amended bill establishes that no entity can provide or offer mental health services to the public through AI unless those services are provided by a licensed, New Hampshire professional. It also states that AI cannot independently provide “therapeutic communication” directly to a client without a licensed professional's involvement.

Crucially, the amendment adds a clause addressing a key concern of clinicians and researchers: it explicitly allows licensed professionals to use FDA-authorized and/or HIPAA-compliant AI tools, provided the professional exercises due diligence.

Finally, acknowledging how fast this technology is moving, the amendment establishes a study commission to review the implementation and impacts of the new law, with a report due in November 2026.

The National Context

New Hampshire is not alone in grappling with these questions. In 2025, Illinois enacted the Wellness and Oversight for Psychological Resources Act (HB 1806), the first state law specifically regulating AI in professional mental health. It allows licensed clinicians to use AI for ‘behind-the-scenes’ tasks like notes, scheduling, billing, and data analysis, but bars AI from making independent therapeutic decisions, directly interacting with clients in any form of therapeutic communication, detecting emotions, or generating treatment plans without professional review and approval. Similarly, Nevada passed a law prohibiting AI systems designed to provide services that constitute the practice of professional mental or behavioral healthcare.

Alternatively, California's SB 243, enacted in late 2025, focuses on “companion chatbots” rather than clinical therapy. The California law mandates clear disclosures that the user is interacting with an AI and requires platforms to implement safety protocols for suicidal ideation, particularly for minors.

However, the White House is pushing back against state-level AI regulation. Last month, a high-profile bill in Utah that would have required safety plans from chatbot developers stalled in the state House after the Trump administration sent a letter strongly opposing it, calling the bill “unfixable.” This reflects a broader push from the Trump administration to establish a unified national AI policy that promotes innovation and preempts states from setting their own, potentially conflicting, rules.

What do you think?

The New Hampshire Senate has passed the amended version of SB 640, and the bill is now heading to the House of Representatives for consideration. Some libertarian representatives have already vowed to oppose the bill. What do you think—should they pass the bill to establish these new guardrails? Or should legislators wait for the technology to further mature before enacting regulation?

Let your legislators know! Find who represents your town and how to contact them here.