AI Agents Are Coming: 5-Stage Taxonomy of Language-Based AI Systems for Psychiatry, Psychotherapy, and Counseling

The rapid evolution of large language models has accelerated the development of agentic artificial intelligence (AI) systems capable of pursuing autonomous goals, creating an urgent need for structural frameworks in psychiatry and psychotherapy. While existing classifications often draw parallels to autonomous driving, this paper argues that the mental health domain requires a distinct, domain-specific theoretical foundation, as the 2 domains differ fundamentally in their semantic, ideographic, and epistemological demands. Furthermore, they differ in their end goals, for which we introduce terms such as agentic guidance capability. To guide clinicians and researchers through these developments, we propose a 5-stage taxonomy for language-based AI systems that differentiates technical functionality from clinical effectiveness. The taxonomy progresses from level 1 (knowledge level), in which systems perform static benchmark tasks, to level 2 (elementary level), characterized by dynamic engagement in specific therapeutic microskills. At level 3 (integration level), systems achieve consistency across and within modules, as well as basic case-level conceptualization suitable for blended therapy under human oversight. Level 4 (saturation level) describes therapist-in-the-loop systems capable of autonomous functioning with minimal supervision, whereas level 5 (mastery level) represents AI systems that are technically capable of performing autonomous therapy. By distinguishing technical functionality from clinical effectiveness, we conclude that level 4 or level 5 performance does not automatically translate into full treatment effectiveness, even if high treatment fidelity can be achieved. We conclude by emphasizing the need to shift benchmarking from static knowledge tests to dynamic evaluations of therapeutic capabilities in order to safely navigate the transition toward autonomous care.
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The Download: Claude’s inner workings and OpenAI’s “super app”

This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.

Anthropic found a hidden space where Claude puzzles over concepts

The AI firm Anthropic has got the clearest glimpse yet at what’s really going on inside large language models as they answer questions or carry out tasks. What they found ranges from the mundane to the unnerving. 

Researchers at the company built a tool called the Jacobian lens (or J-lens) and used it to uncover a hidden area, which they named the J-space, inside its flagship LLM, Claude.

The J-space contains words related to the response a model is working on but may not ultimately produce. If Claude were a person (which it is not), you might say these hidden words reveal what’s on its mind before it actually speaks. 

Read the full story on what they found.

—Will Douglas Heaven

The must-reads

I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.

1 OpenAI has unveiled its long-awaited “super app” 
ChatGPT Work blends its chatbot, coding tool, and new models. (Reuters $)
+ It’s designed to do your work for you and with you. (Ars Technica)
+ And arrived the same day as OpenAI’s GPT 5.6 models. (NYT $)
+ It’s also developing a fully automated researcher. (MIT Technology Review)

2  Humanoids have performed teleoperated surgery on living animals
In the world-first, they removed gallbladders from pigs. (Ars Technica)
+ The human work behind humanoids is hidden. (MIT Technology Review)
 
3 SK Hynix has landed the largest US listing by a foreign company
The South Korean chip giant raised $26.5 billion. (CNN)
+ Demand for AI data centres has led its profits to skyrocket. (Guardian)
+ But its jumbo share sale may be a sign of overheated times. (FT $)
+ South Korea’s hottest bachelors are chip workers. (MIT Technology Review)
 
4 Tencent is leading a deal to unwind Meta’s $2 billion Manus acquisition
It’s in talks to become the Chinese AI startup’s largest shareholder. (FT $)
+ Tencent will reportedly buy Manus for no less ​than $2 billion. (Reuters $)
+ Beijing had ordered Meta to unwind the acquisition. (Bloomberg $)
 
5 Resuscitated human retinas responded to light 10 hours after death
It’s a big step towards eye transplants that restore vision. (New Scientist $)
+ As is a new device that revives dead eyeballs. (MIT Technology Review)
 
6 Meta has started charging for AI access
A new version of Muse Spark has a paid tier for developers. (Quartz
+ Meta also plans to start producing an AI chip in September. (Reuters $)
 
7 OpenAI and Google have sold AI models to blacklisted China groups
Via Singapore-based subsidiaries of Alibaba, Baidu and Tencent. (FT $)

8 A daughter tested an AI “death bot” of her father
The technology provided both comfort and unease. (New Yorker $)

9 An astronomer says the hunt for alien life needs more statistics
He wants to replace speculation with mathematical frameworks. (Quanta)

10 Pokémon Go players turned Times Square into a giant battlefield
More than 1,500 fans finally fulfilled the game’s 2016 launch promise. (Wired $)
+ Pokémon Go is also training world models. (MIT Technology Review)

Quote of the day

“When we’re talking about AI, we love the hype, we get excited about it. The damn thing never actually lands in practice.”

—Vijay Janapa Reddi, an engineering professor at Harvard University, tells Wired why he’s skeptical about grand plans for AI.

One More Thing

a hand putting a pigeon into hatch in a missile

B.F. SKINNER FOUNDATION


Why we should thank pigeons for our AI breakthroughs

In 1943, psychologist B.F. Skinner led a secret government project to make bombs more precise. His idea: teach pigeons to guide missiles by pecking at targets on a screen inside a warhead. To train them, Skinner rewarded the birds with food when they made the right decisions, using trial and error to shape their behavior.

Unsurprisingly, the military never deployed Skinner’s kamikaze pigeons. Yet his experiments convinced him that pigeons were “an extremely reliable instrument” for studying learning.  

Decades later, those same principles would help power reinforcement learning, the technology behind some of today’s most advanced AI systems.

Discover how pigeons inspired one of AI’s most powerful techniques.

—Ben Crair

We can still have nice things

A place for comfort, fun, and distraction to brighten up your day. (Got any ideas? Drop me a line.)

+ Here’s a splendid selection of this year’s NSW architecture award winners.
+ Photographers have captured the Strawberry Moon’s golden glow in stunning detail.
+ Idiocracy is the film that best exemplifies the “American experience,” according to a new poll. Look back at the prescient comedy with this Screen Junkies trailer.
+ Get ready for the weekend with this psychedelic house journey from Jamie xx b2b Caribou.

Millions of People in Canada Are Finding AI-Enabled Support for Mental Health Effective Amid Ongoing Questions Around Trust.

(OTTAWA) July 8, 2026 — New polling shows approximately six million people in Canada used AI-enabled tools for mental health support in the past year and most find them effective. Today, the Mental Health Commission of Canada (the Commission), in partnership with Mental Health Research Canada (MHRC) and Pollara Strategic Insights, releases the first nationally representative data on how people in Canada engage with digitally supported mental health tools, including AI and virtual care, across every province and demographic.

Quick Facts:

  • 1 in 7 people in Canada used AI mental health tools in the past year
  • Three out of four who used AI and virtual mental health services found them effective for their well-being
  • Only 14 % trust AI tools, just 2% trust them completely
  • 40 % of AI users said they were more likely to seek professional care
  • Nearly half (45%) who accessed mental health care did so virtually, in whole or in part

WHY IT MATTERS

People in Canada are turning to AI as a convenient way to access mental health support.  AI-enabled tools may offer greater convenience and accessibility. Among those surveyed, AI is being used because it is:

  • Free or low-cost; 46% of AI users cite this as the reason they use it during a time when financial stress is itself a cause for anxiety.
  • Always available; 44% of AI users cite 24/7 access.
  • Immediate and convenient; it can be used from anywhere without travelling or waiting for an appointment. For someone in rural Canada, it saves time and travel costs.
  • Seemingly private; 39 % of AI service users cite private, anonymous support as a reason for use, while privacy and data protection remain key public concerns.

AI is most used for general well-being (42%), companionship (36%), and mild-to-moderate stress (36%), and 40% of AI users said they were more likely to seek professional care.

WHO IS USING IT AND HOW MUCH DO THEY TRUST IT?

Use is higher among people in Canada under 35 (27%; 29% among men aged 25–34), newcomers to Canada (28%), racialized people in Canada (23%), and 2SLGBTQI+ communities (20%), populations that may experience greater barriers to traditional care.

Overall, trust remains low, particularly for AI-enabled tools, where only 2% of people in Canada trust them completely. People in Canada over 55 show the lowest adoption and trust.

VIRTUAL CARE: EFFECTIVE AND MORE TRUSTED BUT FALLS SHORT OF IN-PERSON SERVICES

45% of people in Canada who used mental health services in the past year did so virtually, with 75% reporting positive outcomes. However, nearly 1 in 3 prefer a hybrid model that combines virtual and in-person services. The data signals what people in Canada need: well-designed tools for safer digital mental health care that they can trust.

THE COMMISSION OFFERS GUIDANCE FOR THE DIGITAL MENTAL HEALTH ERA

The Commission is Canada’s trusted resource for safe digital mental health — assessing apps and tools, setting evidence-based standards, and leading the national conversation on guidance for AI in mental health and substance use health care.

As virtual services and AI-enabled tools continue to expand rapidly across the mental health landscape, there is a growing need for evidence-based insight into how people in Canada engage with, understand, and perceive them. The Commission partnered with MHRC to leverage their ongoing national polling initiative and provide timely insights into usage, attitudes, and concerns related to e-mental health and AI.

The polling is clear: people in Canada want to close the gap between availability and trust. The Commission is working with the Canadian Centre on Substance Use and Addiction and collaborators, provincial governments, technology developers, and health system partners to establish guidance for AI.

“Six million people in Canada have already used AI for mental health support and most found it convenient and effective for their well-being. It is critical that AI is safe and equitable to increase public trust and reduce harms.” – Lili-Anna Pereša, President and Chief Executive Officer, Mental Health Commission of Canada

“The people turning to digitally-supported mental health tools are often those facing some of the greatest barriers to care. Making sure these tools are safe, effective, evidence-based and human-centred is a matter of equity. Ongoing research is essential to understanding where they help and where safeguards are needed.”– Akela Peoples, Chief Executive Officer, Mental Health Research Canada

About Mental Health Commission of Canada
As an independent, not-for-profit with charitable status, the Commission collaborates with leading experts and organizations nationally and internationally, including with people with lived and living experience, to develop national guidelines, standards and strategies, promote innovation and best practices, reduce stigma, increase mental health literacy, and support all levels of government to improve mental health outcomes for everyone living in Canada.  The Commission is Canada’s trusted resource for digital mental health best practices with the e-Mental Health Strategy for Canada, app assessment, e-modules for e-mental health implementation, and AI guidance for mental health and substance use health.

About Mental Health Research Canada
As an independent national charity, MHRC works hard to enable a future where mental health in Canada is transformed using evidence, data and stakeholder engagement. We unite researchers, communities, and people with lived experience to bridge gaps in care through national population polling, rapid data reporting, and partnerships that inform policy to improve outcomes. Learn more at www.mhrc.ca

About the Polling
Conducted by Pollara Strategic Insights in partnership with Mental Health Research Canada and the Mental Health Commission of Canada, this national poll (n=3,519) is the first representative data on AI use for mental health in Canada. Full findings: https://mentalhealthcommission.ca/AI-polling-report

About the Funding
The views in this report solely represent the views of the Mental Health Commission of Canada. Production of this report is made possible through financial contribution from Health Canada.

Media Contact
Heather Bakken, Pendulum Group
email: heather@pendulumgroup.ca 
cell: 613-406-5432

The post Millions of People in Canada Are Finding AI-Enabled Support for Mental Health Effective Amid Ongoing Questions Around Trust. appeared first on Mental Health Commission of Canada.

$10 Million Donation Boosts Treatment Development for Ultra-Rare Disease

The Clayco Foundation has gifted $10 million to researchers at the Perelman School of Medicine at the University of Pennsylvania to help them to development a potential treatment for the ultra-rare disease retinal vasculopathy with cerebral leukoencephalopathy (RVCL).

“This is a disease that affects so many organs across the body, so a typical targeted gene therapy doesn’t work,” said Jonathan Miner, MD, PhD, an associate professor of Rheumatology at Penn, who leads the work. “We have developed something that labels abnormal proteins—just like you would a package. The body’s cells can then read that label and ship the protein to a specific location in the cell for destruction.”

RVCL is an inherited, autosomal dominant disease caused by mutations in a gene called TREX1 that affects around 200 people across the world. The mutation causes DNA damage and premature death of the endothelial cells that line small blood vessels. Over time, the surrounding tissue receives less blood and oxygen and begins to malfunction or die.

People with the condition usually present in mid‑adulthood with slow vision loss from retinal vasculopathy and then develop stroke‑like episodes, cognitive decline, and psychiatric symptoms linked to white‑matter damage in the brain. There is no current disease-modifying treatment for the condition and people with the condition usually die in mid-late adulthood.

Miner directs the RVCL Research Center at Penn. He and his team are working on several potential therapies for this very rare disease including the one funded by this donation, a small molecule drug candidate that can degrade damaged TREX1 proteins in the body.

“In mice with the human mutation who get this disease, the degrader molecule saves their lives,” explained Miner in a press statement. “It stops organ damage and stabilizes them from further harms.”

The candidate therapy works by linking the faulty protein to an enzyme, an E3 ligase, that marks unwanted proteins so the cell can break them down. The damaged protein is then rapidly cleared by the cell’s disposal machinery, while normal proteins are spared.

The $10 million donation from the Clayco Foundation will help Miner and colleagues move this drug candidate closer to the clinic.

The Clayco Foundation is Chicago‑based and is closely linked to the design‑build firm Clayco, which was founded in the 1980’s by Bob Clark. Clark’s wife Ellen died of RVCL in 2010 and because of this the foundation has a strong focus on funding research that helps people with the condition.

Miner and colleagues are also working on a couple of genetic therapies for RVCL using CRISPR and prime-editing technology. They are also assessing if crizanlizumab, a P‑selectin–blocking monoclonal antibody currently approved to reduce sickle cell crises, could be repurposed to also treat RVCL.

The post $10 Million Donation Boosts Treatment Development for Ultra-Rare Disease appeared first on Inside Precision Medicine.

The foundational elements of AI architecture that IT leaders need to scale

With the rapid progress of AI capabilities and the move to agentic systems, organizations are expanding their use cases as the technology continues to grow. That constant evolution also introduces risk, leaving IT leaders to wonder which investments will prove valuable even six months into the future.

Returning to the foundational elements of AI architecture—the structural framework required for deploying and managing reliable, integrated AI systems at scale—allows technology leaders to make astute decisions today while supporting a future of AI agents that can retrieve information, make decisions, and execute complex workflows across systems.

Four elements of AI architecture you can count on

The following capabilities provide a stable compass on the path to production-ready deployment, regardless of how the underlying technology evolves.

1. Prepare data for AI at scale

Models are only as reliable as the data they can access, and poor data quality leads to AI hallucinations, bias, and unreliable outputs.

Most enterprises rely on legacy systems, inconsistent data structures, fragmented ownership, and incomplete datasets, making it difficult to scale AI effectively. Powerful as it is, AI itself cannot solve these underlying data problems.

As Adnan Adil, CIO of Elastic, explains: “The data is a durable part of AI architecture because without it, these models won’t run, won’t provide the right context, or won’t give the right level of services that we’re looking to implement.” Industry surveys consistently cite data quality as one of the greatest barriers to AI success. “The data quality has to be good; otherwise, the user loses confidence in the system,” says Adil.

An effective AI strategy begins with connecting data across the organization and ensuring it is organized, accurate, governed, and accessible in real time. These considerations are most effective when built into models and architecture from the start. Scalable data architecture allows AI systems to evolve alongside the business and connect reliably to the internal information needed to deliver meaningful value.

Gartner predicts that companies will abandon 60% of all AI projects through 2026 if they are not supported by AI-ready data. Avoiding that outcome includes clear data standards and ownership, clean and labeled data, and pipelines that support real-time retrieval.

2. Use context engineering to deliver the right data to every AI query

Context engineering ensures that the model draws on the most pertinent information for each query, selecting and organizing the data needed to produce accurate answers efficiently.

Effective context engineering shapes the inputs that guide AI reasoning and action. While prompt engineering focuses on how a request is worded, context engineering designs the entire information environment around the model: retrieving the right data and presenting it in a structured, machine-readable way. Many organizations are discovering that reliable AI depends as much on context quality as on the strength of the model.

Context engineering relies on a modernized, unified data foundation as well as retrieval and memory systems such as retrieval augmented generation (RAG) and vector databases. It also requires careful prioritization to determine what information matters most, what should be excluded, and when different types of information should be used. Feeding models too much context can dilute relevant details, increase costs, and slow response times.

“Minimum context, correct and current data, and machine-readable information are critical to effective context engineering,” Adil says.

3. Build AI governance and LLM observability in from the start

Strong governance and LLM observability help organizations maintain control over how AI systems use data, monitor system performance, and identify problems before they affect operations.

In the absence of clear controls around retrieval, workflows, and model usage, AI systems often process far more information than necessary. This inefficiency also drives up operating costs by requiring additional computing resources, often reflected in higher token consumption and API charges.

Governance also works in tandem with robust security. AI expands the attack surface, introducing risks such as prompt-based data leakage, model vulnerabilities, and adversarial inputs. Protecting sensitive information requires strong access controls, monitoring, and oversight.

Adil notes that essential controls — including those related to security, granular cost management, project controls, data security, and architecture—are frequently insufficient.

For governance systems to support transparent, compliant, trustworthy, and cost-effective AI, organizations cannot leave them as a layer to add later. Governance structures need to be embedded into architecture, workflows, and decision-making processes from the outset.

When governance is established from the start, it enables robust observability. Observability helps organizations understand how AI applications are performing in practice. Mechanisms for LLM observability and benchmarking allow teams to assess accuracy and utility over time, monitor adoption patterns, and adjust systems as conditions change. Observability also helps organizations gain trust by increasing visibility of model performance, behavior, and failure points.

Furthermore, observability is essential to get ROI of AI initiatives, as the benefits of it are often indirect and business value depends heavily on how systems are adopted and used. Real-time visibility into AI behavior allows organizations to measure performance against expectations, identify gaps between intent and reality, and continuously refine systems as requirements evolve.

In a 2026 report from Elastic, 85% of IT decision makers expect to enable LLM observability for their internal generative AI apps.

“Observability is actually huge. We can use observability data for cost control, decision-making, and engineering efficiency,” Adil says.

4. Keep humans in the loop

The thoughtful design, integration, and governance that maximize AI value demand specialized in-house expertise. Nearly 70% of respondents in Deloitte’s 2025 Tech Executive Survey report plan to grow teams in direct response to generative AI, a clear contrast to widely reported AI-related cuts. Adil agrees: “We think the people aspect is largely what’s going to make AI impactful going forward.”

As AI systems become more embedded in operations, organizations need people who can govern workflows, evaluate outputs, redesign processes, and adapt systems as conditions change. Evolution toward increasingly autonomous tools requires teams skilled in prompt engineering, orchestration, and change management. 

Talent adept at critical thinking and prepared to adapt with technology’s rapid advances will be in high demand. Although turnover brings in fresh thinking, it also presents high costs in system continuity, institutional understanding, and innovation. Human-centered strategy needs to be built into AI execution stages to ensure smooth implementation. 

As Adil says, “Many aspects of the stack are moving very, very fast, but institutional knowledge and the ability to adapt remain durable.

Thoughtful AI investment for future growth

As AI systems evolve from single-task assistants to increasingly autonomous agents, the organizations best positioned to benefit will be those that invest in the underlying systems, governance, and expertise that make AI reliable at scale.

Tech leaders who focus on these fundamentals can move effectively from experimentation to reliable, production-level deployment in the medium term, confident that these elements will remain relevant and adaptable amid constant advancements.

“We fundamentally believe that with these tools, velocity of work will get much faster,” Adil says. “We are really focused on how we can do work with these tools in ways we had not thought of before.”

Learn more about how Elastic is building an AI-first enterprise with these core foundational components.

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.

Targeted stool metabolomics suggests exploratory catecholamine- and tryptophan-linked metabolic features in autism spectrum disorder

BackgroundGut-brain axis dysregulation and microbiome-linked metabolic alterations have been implicated in autism spectrum disorder (ASD), but the contribution of gut-derived neuroactive metabolites remains incompletely characterized.MethodsWe conducted a cross-sectional case-control study of 59 participants (32 ASD, 27 controls) and quantified 18 stool metabolites related to catecholamine synthesis, inhibitory neurotransmission, and tryptophan-linked NAD+-precursor metabolism using targeted liquid chromatography-tandem mass spectrometry. Group differences were assessed using fold-change analysis and linear models adjusted for age and sex. Random forest models evaluated classification performance, and within-group Spearman correlations were used to examine metabolic relationships.ResultsNorepinephrine showed the largest increase in ASD, whereas dopamine and tetrahydrobiopterin exhibited nominal group differences that did not remain significant after correction for multiple testing. A three-metabolite panel comprising tetrahydrobiopterin, γ-aminobutyric acid, and kynurenine showed exploratory discrimination between groups (area under the receiver operating characteristic curve = 0.750, 95% confidence interval 0.622–0.878), but this performance requires external validation. Correlation analysis revealed conserved bile acid coupling in both groups. In controls, tryptophan was positively associated with kynurenine, whereas this relationship was not observed in ASD. Instead, ASD samples showed broader associations between tryptophan and metabolites linked to neurotransmission and NAD+-precursor metabolism.ConclusionStool metabolite profiling revealed altered organization of tryptophan- and catecholamine-linked metabolic associations in ASD and identified a small metabolite panel with exploratory discriminative potential. These findings provide a foundation for future studies examining gut-derived neuroactive metabolites in ASD and their relationship to gut-brain axis biology.

MH-POWER for College Students on the Spectrum

Conditions: College Students on the Autism Spectrum With Mental Health Challenges

Interventions: Behavioral: The MH-POWER program

Sponsors: University of Texas Rio Grande Valley; The American Occupational Therapy Foundation

Recruiting

STAT+: Medicare takes another swing at 340B cuts to hospitals

Medicare wants to slash payments to hospitals for drugs acquired through the 340B drug discount program by more than a third beginning next year, after the agency said its surveys found some patients paid more for the drugs than the hospitals did. 

Under a proposal released Thursday, Medicare would pay hospitals for 340B drugs at their average sales price minus 33.4%, dramatically less than they’re getting currently, which is that price plus 6%. The provision, part of a proposed rule on hospital outpatient payments, represents the latest swing at what’s become a hotly debated drug discount program, viewed by some as a lifeline for safety-net hospitals and by others as a profit center for wealthy health systems. 

The proposal drew swift condemnation from groups representing nonprofit and academic hospitals, who said it would disproportionately harm safety-net providers. That’s because only these nonprofit facilities are eligible for 340B, while for-profit hospitals are not. Medicare’s proposed rule shows a 7.4% pay increase to for-profit hospitals under the 340B adjustment. 

Continue to STAT+ to read the full story…