← Risk register SOC 29-2053 · reviewed 2026-08-11

Psychiatric Technicians

156,960 US workers · median $45,130/yr · Healthcare

SAFE

The core of this job is being physically in the room with acutely unwell people: observing behavior, de-escalating agitation, assisting with bathing and meals, taking vitals, participating in physical restraint or seclusion, and leading group activities. None of that digitizes, and hospital robotics are nowhere close. AI will absorb the paperwork layer — shift notes, behavior logs, incident report drafting, scheduling — and predictive monitoring tools may reshape how observation rounds are documented, but they increase the need for a human body on the unit rather than reduce it.

10-year outlook: Demand grows with behavioral health caseloads and AI takes over the charting burden, but pay stays low and the main threat to this job is staffing budgets and injury attrition, not automation.

US employment, 2019–2025+100.0%
78,470156,960 workers

Headcount grew steadily across the period.

Median pay $33,780 → $45,130 +6.9% in real terms (nominal +33.6%, less ~25% US inflation over the period)

The job count is not the verdict

This line is counted by the Bureau of Labor Statistics — the one figure on this page that isn't a judgement of ours. Headcount moves on demand, offshoring, demographics and the business cycle, and automation is one term among several, often not the loudest.

So a falling line is not evidence that AI did it, and a rising one is not evidence that it won't. Both happen in this register: some occupations resist automation and shrink anyway, others are highly automatable and keep growing. The marked year is 2020.

BLS projection, 2024–2034

+20% 144,500 → 173,300 on the projections basis

Hard to automate, and growing

The work resists current AI and the BLS projects +20% more of these jobs by 2034. Note that safe does not mean well paid — several of the fastest-growing resistant occupations are among the lowest paid on the register.

Different clocks. The score is what current AI could do to this work today. The projection is how many of these jobs will exist in 2034. Everything between the two — how fast employers actually adopt, whether demand grows in the meantime — is why they can point opposite ways without either being wrong.

~15,900 openings a year on average, including replacing people who leave.

One email if this score changes. Watch as many occupations as you like from the same address — no account, and nothing is sent on a schedule, only when a verdict actually moves.

Also known as — 24 job titles this covers

Titles reported by people doing this work, from the US Department of Labor's O*NET survey. If your job title is here, this page is about your work even though the name doesn't match.

CounselorMilieu TherapistPsychology AssociatePsychiatric AssistantResidential Aide (RA)Mental Health AssociatePatient Care SpecialistMental Health SpecialistSupport Team Member (STM)MHW (Mental Health Worker)Behavioral Health AssociatePsychiatric Technician (PT)MHA (Mental Health Assistant)Mental Health Technician (MHT)BHT (Behavioral Health Technician)Behavior Technician (Behavior Tech)RBT (Registered Behavior Technician)LPT (Licensed Psychiatric Technician)Rehabilitation Technician (Rehab Tech)Behavioral Technician (Behavioral Tech)Psychology Technician (Psychology Tech)Health Care Technician (Health Care Tech)Autism Behavior Technician (Autism Behavior Tech)Psychiatric Safety Tech (Psychiatric Safety Technician)

Score — 67/100 resistance

Holding it up: embodiment (19/20). Weakest point: liability shield (7/20).

Five dimensions, 0–20 each, summed. Higher means more protected. The arithmetic is shown so you can check it: 16 + 19 + 7 + 14 + 11 = 67. · Scored 2026-08-11, and re-examined when evidence accumulates rather than on a schedule.

Task resistance 16/20

Tasks largely resist digitisation Fifteen-minute safety checks, one-to-one observation of a patient on suicide watch, talking someone down from a doorway blockade, and a four-point takedown all require a person who can physically intervene within seconds — the only genuinely automatable share is the charting and med-count paperwork, which is why this sits at 16 rather than a perfect 20.

Embodiment 19/20

Hands-on in uncontrolled environments You work an unlocked-nothing unit where patients spit, swing, and elope, you help shower someone who is actively psychotic, and you put hands on a body during restraint — an uncontrolled environment with an unpredictable human at the center, which is as embodied as healthcare gets short of field EMS.

Liability shield 7/20

Certification preferred, not legally required Most states license or certify psych techs at some level and a few (California's Psychiatric Technician license) make it a real credential with board discipline, but the treatment plan, the restraint order, and the medication decision are all signed by an RN or psychiatrist — you document and execute rather than authorize, which caps this at 7.

Trust premium 14/20

The human relationship is the product Patients who refuse meds from a nurse will take them from the tech who has worked their unit for two years, and knowing that a specific patient paces before they escalate is knowledge that lives in the relationship, not the chart — though rotating shifts and high turnover mean the bond is with the unit as much as with any one of you.

Judgment & accountability 11/20

Meaningful discretion You decide in the moment whether pacing is a warning sign, whether to call a code or keep talking, and when a seclusion is warranted — real calls with real consequences, but made inside standing orders, restraint protocols, and a nurse you can summon down the hall, which is why this lands at 11 rather than in the high teens.

Scored twice. An independent second run returned 68/100 — SAFE, agreeing with the verdict above.

This score sits on a verdict boundary. At 67/100 it is one point from EXPOSED. Re-scoring moves results by a point or two, so here the score is more informative than the label.

Confidence: high · reviewed 2026-08-11 · how scoring works

What this job involves — and which parts are yours

The verdict above describes this occupation as a whole. Almost nobody does the typical version of a job — tick what's actually in your week and see how your own mix sits.

AI already does these at usable quality

These still need a person

Active moats on the surviving side: embodiment, trust, physical-presence

How to future-proof this job

Where to go deeper on what this job runs on: Coursera — communication and interpersonal skills free to audit · Coursera — active listening and communication skills free to audit · edX — performance measurement and evaluation free to audit · Toastmasters — public speaking practice at local clubs worldwide low · Coursera — project coordination and cross-team delivery free to audit · Khan Academy — reading and vocabulary, all levels, free free

All 35 skills ranked by how many jobs they open →

What would move this back up — beyond any one person

The moves above are yours to make. This is the other half: what would have to change in the world for the occupation itself to score higher. None of it is in any one person's gift, but it is where the floor actually comes from. Scores here are not a one-way ratchet. Only two of the five dimensions — task resistance and embodiment — track what machines can do. The other three track law, what buyers will pay for, and who is answerable, and those move in both directions, often in response to the same pressure AI creates. If every lever below landed, this occupation would score around 81/100, still SAFE.

5 specific changes that would raise this score
  • already happening judgment accountability +2

    Task-mix shift: if AI absorbs behavior logging, incident report drafting and rounds documentation, the residual role concentrates on the ambiguous calls — reading escalation before it happens, deciding when to touch a patient, when to call a code. This tier already exists in the job and is the part that survives.

  • already happening task resistance +2

    Same task-mix mechanism: the paperwork tier is the automatable tier and it is a real share of the shift. Its removal raises the resistance of what remains without any new law.

  • plausible liability shield +4

    State licensure/certification for psychiatric technicians expanding beyond the four states that currently license (California, Colorado, Kansas, Arkansas) — with a scope-of-practice rule making the certified tech the named accountable observer on seclusion/restraint documentation, personally subject to board discipline. CMS Conditions of Participation §482.13 already requires trained staff to conduct and document 1:1 monitoring during restraint; naming a licensed role rather than 'trained staff' would harden this.

  • plausible liability shield +3

    A Joint Commission or state licensing rule requiring that AI-generated behavioral observation entries and predictive-agitation alerts be countersigned by a named human staff member who attests to direct visual observation — creating a chain-of-custody signature that cannot be automated.

  • plausible judgment accountability +3

    Mandated minimum-staffing and assignment-accountability laws for behavioral health units (the pattern in California AB 394 and Oregon HB 2697, which name specific units and ratios) that assign the tech, not just the RN, formal responsibility for the restraint/de-escalation decision path and post-incident debrief.

The limit. Trust premium has no realistic route up. Buyers here are hospitals, state facilities and correctional systems purchasing on ratio compliance and cost, not patients choosing a technician; nobody pays extra for a specific human in this role and no credentialing body is positioned to create that market. Embodiment is already near ceiling at 19 and cannot meaningfully rise. Note also that a rising score here does not mean rising wages — the same institutional pressure that hardens liability tends to arrive alongside understaffing.

These are conditions, not forecasts — what would have to happen, not what will. Specific rules, cases and bills are named so you can go and check whether they exist and where they stand; verify before relying on any of them. Nothing here is legal or financial advice.

Where this work is, and what it pays there

BLS metro figures for 221 areas. The verdict above does not change by city — the rubric judges what the work involves, not where it happens — but pay and headcount do, and the national median hides a very wide range.

Most of these jobs

Chicago-Naperville-Elgin, IL-IN 6,730 $46,060 +2%
Phoenix-Mesa-Chandler, AZ 6,630 $46,550 +3%
Los Angeles-Long Beach-Anaheim, CA 4,770 $48,040 +6%
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 4,560 $46,920 +4%
Atlanta-Sandy Springs-Roswell, GA 4,230 $47,650 +6%
Miami-Fort Lauderdale-West Palm Beach, FL 3,890 $44,500 -1%
Boston-Cambridge-Newton, MA-NH 3,460 $57,610 +28%
Houston-Pasadena-The Woodlands, TX 3,300 $43,320 -4%

Best paid

Stockton-Lodi, CA 330 $95,580 +112%
Napa, CA 320 $83,960 +86%
Visalia, CA 200 $76,700 +70%

Percentages are against this occupation's national median of $45,130. Counts are jobs in that metro, not vacancies. Metros where the BLS suppressed the cell are absent rather than shown as zero.

Who is actually doing this — nobody, on the record

We have no reported case of a named organisation automating this occupation. Not one deployment, not one announcement.

That is worth saying out loud next to a score of 67. The verdict above is about what the work exposes — what current AI could do to these tasks. It is not a claim that anyone has done it. For this occupation those two things have come apart completely: the capability argument is on this page, and the evidence column is empty.

Read that as a gap in the reporting we can see, not proof of absence — the dispatch runs on English-language feeds and misses plenty. If you know of a case, tell us, or add a field report from inside the job.

Quick take — do you do this job?

Has AI actually changed your work? One tap, anonymous, and the running tally is public. Nothing else is asked of you.

Self-reported and unverified — a sentiment signal, not a survey. One response per person per occupation; you can change your answer.

Field reports — what people say has changed

No field reports yet. A written account takes a paragraph rather than a tap, goes to an editor before it appears, and is the one thing on this page the rubric cannot produce on its own.

File a field report

Concrete beats general: a tool that arrived, a task that moved, a headcount decision you watched happen. Don't include anything that identifies you or your employer if that would put you at risk.

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