{ "source": "Cooked Index — occupational AI risk register", "page": "https://cookedindex.com/jobs/psychiatric-technicians/", "methodology": "https://cookedindex.com/methodology", "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.", "scored_at": "2026-08-11", "model": "claude-opus-5", "occupation": { "title": "Psychiatric Technicians", "soc_code": "29-2053", "category": "Healthcare", "us_employment": 156960, "median_annual_wage": 45130 }, "verdict": "SAFE", "risk_resistance": 67, "contested": false, "near_boundary": true, "dimensions": { "task_resistance": 16, "embodiment": 19, "liability_shield": 7, "trust_premium": 14, "judgment_accountability": 11 }, "reasoning": { "task_resistance": "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": "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": "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": "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": "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." }, "rationale": "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.", "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.", "what_would_raise_it": { "levers": [ { "dimension": "liability_shield", "change": "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.", "plausibility": "plausible", "would_add": 4 }, { "dimension": "liability_shield", "change": "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.", "plausibility": "plausible", "would_add": 3 }, { "dimension": "judgment_accountability", "change": "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.", "plausibility": "plausible", "would_add": 3 }, { "dimension": "judgment_accountability", "change": "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.", "plausibility": "already happening", "would_add": 2 }, { "dimension": "task_resistance", "change": "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.", "plausibility": "already happening", "would_add": 2 } ], "ceiling_note": "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." }, "adjudication": { "method": "two independent runs agreed on the verdict", "outcome": "corroborated", "run_totals": [ 67, 68 ], "run_verdicts": [ "SAFE", "SAFE" ] }, "employment_history": { "points": [ { "y": 2017, "emp": 66930, "wage": 31670 }, { "y": 2018, "emp": 71360, "wage": 32870 }, { "y": 2019, "emp": 78470, "wage": 33780 }, { "y": 2020, "emp": 85330, "wage": 35030 }, { "y": 2021, "emp": 93410, "wage": 36570 }, { "y": 2022, "emp": 100950, "wage": 37380 }, { "y": 2023, "emp": 115940, "wage": 39700 }, { "y": 2024, "emp": 136300, "wage": 42590 }, { "y": 2025, "emp": 156960, "wage": 45130 } ], "from": 2017, "to": 2025, "change_pct": 134.5, "comparable_from": 2019, "spans_soc_revision": true }, "pivots": [], "license": "https://cookedindex.com/terms" }