Delusions by design


"Even if some individuals may benefit from AI interactions, for example where the AI functions as a benign and predictable conversational anchor, there is a growing concern that these agents may also reinforce epistemic instability, blur reality boundaries and disrupt self-regulation. 

"In this perspective piece, we propose a framework of AI-integrated care involving 
  • Personalised instruction protocols,
  • Reflective check-ins, 
  • Digital advance statements and 
  • Escalation safeguards to support epistemic security in vulnerable users. 
"These tools reframe the AI agent as an epistemic ally (as opposed to ‘only’ a therapist or a friend) which functions as a partner in relapse prevention and cognitive containment. 

"Given the rapid adoption of LLMs across all domains of digital life, these protocols must be urgently trialled and co-designed with service users and clinicians."



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