If you’re like many busy inpatient psychiatrists, clinical documentation often competes with direct patient care for your time and energy. This burden is real and contributes to high burnout rates in psychiatry (Tai-Seale M et al, J Am Med Inform Assoc 2023;30(10):1665–1672). Fortunately, new tools are emerging to help. Artificial intelligence (AI) scribes can streamline your documentation, but it’s important to understand both their benefits and their potential pitfalls before integrating them into your workflow.

What are AI scribes?
AI scribes automatically generate structured clinical documentation from recorded patient interviews. Unlike basic dictation that transcribes speech word for word, these tools use AI to summarize a clinical interview into a coherent note. If you want a deeper dive into how this works, a recent review in Current Psychiatry Reports offers a helpful overview for mental health clinicians (King DR et al, Curr Psychiatry Rep 2023;25(12):839–846).

Although there are many commercially available AI scribes, they all follow a similar process (Buckley P et al, Focus 2025;23(1):44–48). After obtaining patient consent, you activate the scribe on your smartphone or computer at the start of your interview. The scribe records the conversation, converts the audio to text, analyzes it, and generates a draft note in standard SOAP (Subjective, Objective, Assessment, Plan) format. You then review and edit the note for accuracy and completeness before signing off. 

What can AI scribes do?
AI scribes have advanced quickly, and features that once sounded aspirational are already part of some tools. Many systems now pull data directly from the chart, including medication lists, problem lists, and labs. Others let you upload or select templates and can learn from your edits, gradually adapting to your phrasing and structure. And because many AI scribes are embedded within major electronic health records (EHRs), you can activate the scribe, review drafts, and finalize notes without leaving the chart. These capabilities vary by platform and health system, but they’re becoming more common in everyday practice.

How can AI scribes help inpatient psychiatrists?

1. Save time. A large rollout at Permanente Medical Group found that clinicians using AI scribes spent significantly less time on documentation after work (Tierney AA et al, NEJM Catal Innov Care Deliv 2025;6(5):0040). I’ve found that using an AI scribe saves me about 20 minutes on each initial evaluation, which amounts to significant time savings over the course of a busy week. 
2. Strengthen rapport. When you no longer need to look down at a keyboard or notebook, you can maintain better eye contact and active listening. Verbalizing your thought process out loud for the scribe can also help patients understand your reasoning in real time.
3. Support billing. Well-structured notes help coders verify the complexity of medical decision making and the need for inpatient care, which can in turn reduce denials and audit risk.
4. Reduce burnout. A big part of burnout comes from the mental juggling act of managing complex patient data while needing to produce detailed notes. AI scribes lighten that cognitive load considerably (Hudson TJ et al, Mayo Clin Proc Digit Health 2025;3(1):100193).

Challenges and risks to consider
AI scribes are promising, but like any technology, they have drawbacks and risks that must be taken into account.  

Accuracy
AI scribes can mischaracterize parts of a psychiatric interview, especially subtle cues like changes in tone, hesitations, or culturally influenced expressions of distress. They may also miss the context behind a patient’s words. For example, a statement like “I sometimes wonder if life is worth it” could be mis-summarized as active suicidal ideation. In addition, scribes can introduce factual errors or outright “hallucinations,” ie, plausible sounding but incorrect (or completely nonsensical) statements.  

Bias
Because AI systems reflect their training data, accuracy may be lower for patients underrepresented in those data, including non-native English speakers and some patients with psychosis.

Privacy and medicolegal concerns
Knowing that their sensitive psychiatric conversations are being recorded may inhibit some patients from speaking ­freely. You must verify that your AI scribe is compliant with federal and state ­regulatory standards, including HIPAA. It is also important to clarify how patient ­recordings are stored, whether they are considered part of the medical record, and when they are deleted. In addition, confirm that AI scribes are permitted within your institution—some hospitals currently allow AI documentation only for medical services, not psychiatry. The American Psychiatric Association provides a resource containing key privacy and regulatory compliance questions to ask potential AI scribe vendors, along with responses on the topic from several companies (www.tinyurl.com/48ft733h).

Cost
AI scribes aren’t cheap. Most companies charge a monthly subscription, usually somewhere between $100 and $400 per clinician. That can be a significant expense for smaller practices. Bigger hospitals sometimes negotiate lower prices because they buy many licenses at once. A few products also need specific devices or extra setup, which can add to the cost.

Training and onboarding
Getting comfortable with a new tool takes time. Users require training on how to use the AI scribe, review drafts efficiently, and troubleshoot common issues, like handling transcription gaps and correcting formatting issues.

Practical implementation tips for AI scribes in inpatient psychiatry
Successful use of AI scribes hinges on more than having the right software. Keep these practical considerations in mind as you implement AI scribes on your unit. 

1. Obtain explicit consent. Explain the purpose of the scribe, how recordings are stored, and how patient data are protected. Confirm that the patient agrees to the tool’s use before you activate it. Let patients know they are free to opt out at any time, in which case you turn off the scribe and revert to conventional documentation. Here is an example script you can use to obtain consent: “I use an artificial intelligence scribe so I can focus on our conversation instead of typing. It securely records our discussion to help me document your visit. The tool is HIPAA compliant, and recordings are later deleted. Do I have your permission to use it?”
2. Use structured verbal cues. Signal shifts in topics to help the scribe organize content under the right headings. For instance, you might say, “Let’s discuss your family history” or “Now I’d like to review your medications and any side effects” to signal a transition to the medication section. These verbal signposts help ensure the scribe groups information correctly.
3. Summarize key points aloud. Periodic recaps not only reinforce understanding for the patient but also highlight essential details for the scribe to capture.
4. Review drafts carefully. Look for inaccuracies or mischaracterizations, which can be subtle. The scribe is just a tool, and you are still responsible for your documentation. 
5. Collaborate with IT. Early discussions with your hospital’s IT team can clarify institutional policies on AI use, how data storage functions, what AI tools are available, and what new AI features might be coming soon.
6. Start with low-stakes interviews. Begin using the scribe with routine follow-ups, rather than ­high-complexity cases, until you’re more confident in the use of the tool and the quality of its output.

Emerging trends and the future of AI in inpatient psychiatry
In my experience, AI scribes have already become noticeably more accurate and useful since I started using them two years ago. As these tools continue to learn from psychiatric interviews and clinician feedback, they will capture subtle details and nuances more reliably across different patient populations. Future versions will get even better at matching your personal style, preferred phrasing, and note structure rather than relying mainly on templates.  

Beyond drafting notes, AI is likely to take on other routine tasks on inpatient units. You may soon see automatic discharge summaries that pull key details from the chart, saving you the effort of weaving together multiple notes (Ganzinger M et al, Sci Rep 2025;15(1):16466). Decision-support tools could draw on the latest evidence to suggest treatment options based on data in the patient’s record. AI coding assistants might flag missing details and help you avoid undercoding. As these tools evolve, keeping up with new features will help you use them safely and effectively. The American Psychiatric Association maintains an updated resource page on Artificial Intelligence in Psychiatric Care that can help you stay current (www.tinyurl.com/yz8rdpmx). 

Carlat Verdict: AI scribes can make your documentation smoother, especially in the hectic inpatient setting where notes often spill into after-hours time. Many tools already plug into the EHR, adapt to your preferred templates, and even learn from your edits, freeing you up for more focused, patient-centered conversations instead of endless charting. They may also help reduce burnout. Just be sure to review drafts carefully—scribes can misinterpret patient statements and occasionally add errors or hallucinations. To make the scribes work well, you’ll need to get clear consent from patients, use structured verbal habits during interviews, review the drafts carefully, and stay in close touch with IT to keep things running safely and smoothly.