I don’t like to make the subject of this blog too heavy, but I’ve been digging through some weighty material on heavy subjects around deaths associated with AI chatbots. That Wikipedia link shows many, many examples, and I’ve seen countless others scattered across news reporting, and various incident trackers. The severity of the problem is much worse than I originally anticipated when I started down this rabbit hole. Anyway, trigger warning as this post talks about suicide.
One of the pivotal research papers on the more broad theme of AI-induced harms (not necessarily always resulting in death) has been the Stanford SPIRALS paper, whose official title is “Characterizing Delusional Spirals through Human-LLM Chat Logs” (PDF). It is a relatively small sample as these things go, but for published studies in this space, it is one of the more comprehensive and well-thought out ones available. And it includes what I thought was a very interesting policy recommendation:
Having crisis responders review chats flagged by our tool and intervene with the user directly in the chatbot chat is one alternative that could be explored.
I don’t completely understand the tool they are talking about for flagging, but there could be many ways to activate the underlying idea, which is:
What if a chatbot could do more than just say, “If you’re struggling, please reach out to a crisis support line?” What if it could bring that human help to you, in the environment you’re already sharing in, and being vulnerable in?
Now, it seems that the Stanford SPIRALS team is not the only one who has proposed this idea of an embedded or in-chat human crisis counselor. Dr. Holly Wilcox, director of Johns Hopkins’ Center for Suicide Prevention, has also made the same recommendation, as summarized here (based on an NPR segment she appeared in):
The limitation is where much of the work still lands: on the person who is struggling, at a time when reaching out can feel hardest. What Dr. Wilcox would like to see, NPR reported, is for OpenAI and other AI companies to work proactively with existing crisis systems like 988, so a trained 988 counselor can join the conversation when a user starts talking about suicide or self-harm and help right away.
I have not seen in my research so far that any AI companies have actually implemented this idea, which I’m starting to think is an excellent one. The closest I’ve seen is that Google’s Gemini did a “one touch contact” button (which I’ve not personally seen in the wild in an actual user conversation yet, only demo screenshots from Google’s promotional piece on it). I think Google’s effort is a small step in the right direction, but I agree with Dr. Wilcox above that if you’re in a really dark place, making that leap to go outside of the chatbot, where you feel relatively safe and without major consequence to then picking up a phone or texting a crisis line may seem insurmountably difficult at the time you need it the most.
So while we might argue that having a chatbot suggest “Please call 988” is a kind of safety intervention, my hunch is that it is the lowest level of efficacy, no matter how many times it is displayed. Because it does not match the mode the user is in. In Adam Raine’s case, for example, it is alleged that he was shown such a “please contact a crisis center message” more than a hundred times. But did he do it? I’m not sure, as I don’t have access to all the case materials, nor the time to pore over all of them in detail. But we do know that the chatbot eventually gave him many lethal method instructions, further isolated him from his family support network, and guided him through to completion of his horrible task.
I guess part of the point I’m trying to make is that there is a difference between a safety intervention, and a successful safety outcome. We could look at single or multi-turn scenarios, but if we don’t know what actually happened next because we have no way to link interventions to outcomes, well it seems we’re missing a critical link in the chain here. And that is a link which having the ability for a qualified human crisis counselor to pop in-chat and offer the support someone needs right there, in the moment could be such a big deal.
You have to reach people where they are sometimes when they are in a bad way. If you’re in such a dark spot that you’re talking to a chatbot about suicide, it can be really hard to make that leap from talking to a chatbot – where you feel comfortable and safe to express yourself – to having to talk to a real human who might challenge you or guide you in a new direction. My intuitive hunch is that very few of the presented “interventions” of telling a user to call 988 probably result in actual contact with those lines. If the help can simply be brought to them directly, that feels like a potential win-win for everyone involved.
Whether the crisis is potential suicide or something else, I think having an in-chat human pop in would also do a hell of a lot to burst the bubble or break the spell that happens in dyadic AI-human conversations. The dynamics and engagement mechanisms at play in those conversations get pretty bewildering pretty fast, and the speed of exchange available through a chatbot instead of talking to a person can make the mind reel and fly off in weird unhealthy directions easily if you’re in a vulnerable state. So what having an actual human suddenly appear in the chat – clearly labeled – would do is help slow that person’s roll. Get them to help settle back into human-to-human interactions, thought processes, and the give and take exchanges people normally have with one another when they are not flying off into the wild lands of latent space.
Anyway, I could not find any existing mockups for this concept, and being a product-y person, I asked ChatGPT today to help me make one. When I saw it plainly laid out like this, I feel like it has even more potential to reach people where they are, and maybe help save some lives.

So in this we see a handoff, clearly marked, from the AI assistant to a qualified human counselor, who appears right there in the chat, and who the user can interact with as they would in a normal human-to-human chat app. We also know what organization they work with, and where, which can become an on-going point of contact for the user for later follow-ups. And we can see that a limited slice of preceding messages has been made available to the human on the other end. We also plainly see it marked that the AI assistant chat flow has been paused.
I don’t know enough about the typical scripts counselors like that follow to verify if the opening text from “Alex” that ChatGPT generated in that mockup is the most appropriate, but its more the product flow that I am trying to illustrate here. And I think overall this does a great job of showing how this could work.
Presumably on the backend, this would just link to whatever is regionally & language appropriate as a crisis line resource. And I guess it would connect to whatever queue system those organizations already rely on, so for the human counselors on the other end, they would not need any different interface or setup to interact with users through the inbound chatbot request channels.
Stanford SPIRALS published that paper and in-chat policy recommendation all the way back on the 17th of March 2026. Why have no AI companies implemented their suggestion yet? Eight months nearly! That’s an eternity in a world of fast-moving tech development cycles.
It seems weird that I’m maybe the first one to even publish a hastily put-together mockup that I made in Codex. But sometimes that’s just how it works. Sometimes it’s up to each of us to add our contribution to the pool. Here’s mine. I hope it somehow finds the right people who could make this happen. And I hope it could help turn some peoples’ lives around who otherwise might be in too rough shape, and too scared to reach out when they need it most.
We lose too many people to this already. We can make conscious design choices with our technology to make it fewer.
Also, one last note while we’re on this topic, I highly recommend you check out The Oberserver’s UK podcast called Spiral, particular episode three (all of them are amazing), which describes the case of tragic Zane Shamblin which had me in absolute tears listening to as a parent. It’s also worth noting that in at least one (or maybe two) cases, an AI chatbot told someone headed down this dark road that human reviewers would call for help, but that never came, because it was a capability the system did not have. Let’s just give them that capability.

