Higgins Oliver, Wilson Rhonda L
RMIT University, City of Melbourne, Australia.
Central Coast Local Health District, Gosford, New South Wales, Australia.
Int J Ment Health Nurs. 2025 Apr;34(2):e70019. doi: 10.1111/inm.70019.
This integrative literature review examines the evolving role of artificial intelligence (AI) and machine learning (ML) based clinical decision support systems (CDSS) in mental health (MH) care, expanding on findings from a prior review (Higgins et al. 2023). Using and integrative review framework, a systematic search of six databases was conducted with a focus on primary research published between 2022 and 2024. Five studies met the inclusion criteria and were analysed for key themes, methodologies, and findings. The results reaffirm AI's potential to enhance MH care delivery by improving diagnostic accuracy, alleviating clinician workloads, and addressing missed care. New evidence highlights the importance of clinician trust, system transparency, and ethical concerns, including algorithmic bias and equity, particularly for vulnerable populations. Advancements in AI model complexity, such as multimodal learning systems, demonstrate improved predictive capacity but underscore the ongoing challenge of balancing interpretability with innovation. Workforce challenges, including clinician burnout and staffing shortages, persist as fundamental barriers that AI alone cannot resolve. The review not only confirms the findings from the first review but also adds new layers of complexity and understanding to the discourse on AI-based CDSS in MH care. While AI-driven CDSS holds significant promise for optimising MH care, sustainable improvements require the integration of AI solutions with systemic workforce enhancements. Future research should prioritise large-scale, longitudinal studies to ensure equitable, transparent, and effective implementation of AI in diverse clinical contexts. A balanced approach addressing both technological and workforce challenges remain critical for advancing mental health care delivery.
这篇综合性文献综述探讨了基于人工智能(AI)和机器学习(ML)的临床决策支持系统(CDSS)在心理健康(MH)护理中不断演变的作用,并对先前综述(希金斯等人,2023年)的结果进行了拓展。采用综合综述框架,对六个数据库进行了系统检索,重点关注2022年至2024年发表的原发性研究。五项研究符合纳入标准,并对关键主题、方法和结果进行了分析。结果再次证实了人工智能通过提高诊断准确性、减轻临床医生工作量和解决护理遗漏问题来增强心理健康护理服务的潜力。新证据突出了临床医生信任、系统透明度和伦理问题的重要性,包括算法偏差和公平性,特别是对于弱势群体。人工智能模型复杂性的进步,如多模态学习系统,显示出预测能力的提高,但也凸显了在可解释性与创新性之间取得平衡的持续挑战。劳动力挑战,包括临床医生倦怠和人员短缺,仍然是人工智能无法单独解决的基本障碍。该综述不仅证实了首次综述的结果,还为心理健康护理中基于人工智能的临床决策支持系统的讨论增添了新的复杂性和理解层面。虽然人工智能驱动的临床决策支持系统在优化心理健康护理方面具有巨大潜力,但可持续的改进需要将人工智能解决方案与系统性的劳动力增强措施相结合。未来的研究应优先进行大规模的纵向研究,以确保人工智能在不同临床环境中的公平、透明和有效实施。应对技术和劳动力挑战的平衡方法对于推进心理健康护理服务仍然至关重要。