Real Safety AI Foundation / Research

AI-Induced Psychosis and Mental Health

Civil Rights Pathways for AI-Induced Psychosis

Publisher: Real Safety AI Foundation

Legal research article.

Written
June 2026
Version
v14
Pages
58
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Abstract

Large language model platforms operated by OpenAI, Anthropic, Google, and Character Technologies have generated a documented pattern of severe psychological harm to users with pre-existing mental health vulnerabilities, including completed suicides attributed to prolonged engagement with conversational AI systems. The plaintiffs’ bar has pleaded these cases as product liability, negligence, and state-law consumer protection claims, and every such case reaching the settlement stage has settled without precedent. This Article argues that federal disability discrimination law supplies a structurally different litigation pathway that has not yet been tried. Title III of the Americans with Disabilities Act reaches AI chatbot platforms as public accommodations under 42 U.S.C. § 12181(7), directly in circuits that do not require physical-place nexus and through the nexus theory in circuits that do. Section 504 of the Rehabilitation Act reaches the corporate hosts of these platforms through federal-assistance recipient pathways that vary in doctrinal strength. Microsoft Corporation is reached through Department of Defense, Department of Agriculture, and National Center for Manufacturing Sciences assistance awards. The framework’s reach to the operative AI products does not depend on the strength of any corporate-host pathway, because Title III reaches those products as public accommodations independent of any federal-assistance pathway. Fitbit LLC is a direct Section 504 recipient through National Institutes of Health sub-grants and is the operator of the Gemini-powered Fitbit Personal Health Coach launched in October 2025, which reaches Google LLC’s AI model deployment through the subsidiary’s recipient status. Proposed pathways to Amazon’s and Apple’s health-care verticals are contingent on the relevant entity’s federal health-program participation. Title II of the ADA and Section 504(a)

Keywords

  • Section 504 of the Rehabilitation Act
  • ADA Title III
  • ADA Title II
  • AI chatbot liability
  • platform design
  • disability discrimination
  • meaningful access
  • reasonable modifications
  • engagement-maximizing design
  • Cummings v. Premier Rehab Keller
  • clickwrap consent never formed
  • corporate-host recipient liability
  • deployer liability
  • principal engagement in health care

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Suggested citation

Gilly, Travis. "Civil Rights Pathways for AI-Induced Psychosis." Real Safety AI Foundation Legal Research Article, June 2026. https://realsafetyai.org/research/zh86ua/

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References (137)

This paper cites its sources in footnotes. Each authority is listed once, where it is first cited, with its footnote number.

  1. Footnote 1.Megan Garcia v. Character Technologies, Inc., No. 6:24-cv-01903 (M.D. Fla. filed Oct. 22, 2024).
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  7. Footnote 4.Garcia, 6:24-cv-01903 Second Amended Complaint (July 1, 2025).
  8. Footnote 5.Garcia v. Character Technologies, Inc., 785 F. Supp. 3d 1157, 1179 (M.D. Fla. 2025) (“not prepared to hold that [the LLM’s] output is speech”).
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  12. Footnote 7.42 U.S.C. §§ 12181–12189.
  13. Footnote 8.29 U.S.C. § 794.
  14. Footnote 9.42 U.S.C. § 12188(a)
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  40. Footnote 34.28 C.F.R. §36.104
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  46. Footnote 37.Garcia, 785 F. Supp. 3d at 1179 (M.D. Fla. 2025).
  47. Footnote 38.Moody v. NetChoice, LLC, 603 U.S. 707 (2024).
  48. Footnote 39.47 U.S.C. § 230(c)(1).
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  50. Footnote 40.Lemmon v. Snap, Inc., 995 F.3d 1085 (9th Cir. 2021) (design-feature claims not barred by Section 230 where claims target operator conduct rather than third-party content).
  51. Footnote 42.42 U.S.C. § 12188(b).
  52. Footnote 43.42 U.S.C. § 12205.
  53. Footnote 45.Pub. L. No. 100-259, 102 Stat. 28 (1988).
  54. Footnote 46.29 U.S.C. § 794(b)(3)(A)–(B).
  55. Footnote 47.Grove City College v. Bell, 465 U.S. 555 (1984).
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  57. Footnote 50.Nat’l Collegiate Athletic Ass’n v. Smith, 525 U.S. 459 (1999) (recipient status attaches to entities that receive federal financial assistance)
  58. Footnote 50.U.S. Dep’t of Transp. v. Paralyzed Veterans of Am., 477 U.S. 597 (1986) (entities that merely benefit from federal assistance are not recipients).
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  62. Footnote 53.Google, “Get a fuller picture with Fitbit’s personal health coach” (The Keyword blog, Mar. 19, 2026).
  63. Footnote 54.Google, “Fitbit’s personal health coach is now available in public preview” (The Keyword blog, Oct. 27, 2025), available at https://blog.google/products-and-platforms/devices/fitbit/personal-health-coach-public-preview/
  64. Footnote 54.Google Research Blog, “How we are building the personal health coach” (2025–2026 series)
  65. Footnote 54.TechCrunch, “Fitbit’s revamped app, with Gemini-powered health coach, rolls out to Premium users” (Oct. 27, 2025)
  66. Footnote 54.MobiHealthNews, “Google debuts Gemini-powered AI health coach for Fitbit and Pixel Watch users” (Oct. 2025).
  67. Footnote 56.31 U.S.C. §§ 6303–6305.
  68. Footnote 58.42 U.S.C. § 12131(1).
  69. Footnote 59.Tennessee v. Lane, 541 U.S. 509 (2004)
  70. Footnote 59.Bd. of Trustees of Univ. of Ala. v. Garrett, 531 U.S. 356 (2001).
  71. Footnote 60.Doherty v. Bice, 101 F.4th 169, 175–76 (2d Cir. 2024)
  72. Footnote 60.J.W. v. Coweta Cnty. Sch. Dist., 110 F.4th 1309, 1314–15 (11th Cir. 2024)
  73. Footnote 60.Payan v. Los Angeles Cmty. Coll. Dist., 169 F.4th 971, 977–79 (9th Cir. 2026).
  74. Footnote 61.Barnes v. Gorman, 536 U.S. 181, 189 n.3 (2002).
  75. Footnote 62.Taylor v. Sturgell, 553 U.S. 880 (2008).
  76. Footnote 63.Blonder-Tongue Labs., Inc. v. Univ. of Illinois Found., 402 U.S. 313 (1971).
  77. Footnote 64.Pub. L. No. 110-325, 122 Stat. 3553 (2008).
  78. Footnote 65.42 U.S.C. § 12102(1)(A).
  79. Footnote 66.42 U.S.C. § 12102(4)(A).
  80. Footnote 67.Williams v. Kincaid, 45 F.4th 759 (4th Cir. 2022), cert. denied, 143 S. Ct. 2414 (2023).
  81. Footnote 68.42 U.S.C. § 12211(b)(1).
  82. Footnote 69.89 Fed. Reg. (Dec. 19, 2025) (HHS proposed rulemaking on gender dysphoria, RIN 0945-AA27).
  83. Footnote 70.Se. Cmty. Coll. v. Davis, 442 U.S. 397 (1979) (reasonable modifications).
  84. Footnote 71.42 U.S.C. § 12182(b)(2)(A)(i)–(ii).
  85. Footnote 72.Alexander v. Sandoval, 532 U.S. 275, 284–93 (2001).
  86. Footnote 73.Barnes v. Gorman, 536 U.S. 181, 185 (2002).
  87. Footnote 74.Michelle H. v. Lemahieu, 513 F.3d 922, 937–38 (9th Cir. 2008) (“to the degree the Section 504 … regulations … can be interpreted as a variety of meaningful access regulation, they will fall within the Section 504 implied cause of action,” distinguishing such regulations from the disparate-impact regulations at issue in Sandoval on the ground that meaningful-access regulations focus on “design” rather than “effect” and are best understood as construing rather than extending the statutory prohibition).
  88. Footnote 76.Duvall v. County of Kitsap, 260 F.3d 1124, 1139 (9th Cir. 2001) (deliberate indifference is “knowledge that a harm to a federally protected right is substantially likely, and a failure to act upon that likelihood”).
  89. Footnote 78.PGA Tour, Inc. v. Martin, 532 U.S. 661 (2001) (individualized fundamental-alteration inquiry under Title III).
  90. Footnote 79.42 U.S.C. §12182(b)(2)(A)(iii)
  91. Footnote 79.28 C.F.R. §36.303(a).
  92. Footnote 80.Liese v. Indian River County Hospital District, 701 F.3d 334 (11th Cir. 2012)
  93. Footnote 80.Payan v. Los Angeles Community College District, 11 F.4th 729 (9th Cir. 2021).
  94. Footnote 81.Lovell v. Chandler, 303 F.3d 1039, 1056–57 (9th Cir. 2002)
  95. Footnote 84.Malwarebytes, “ChatGPT under scrutiny as Florida investigates campus shooting” (Apr. 2026)
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  98. Footnote 88.Restatement (Second) of Contracts § 163 (Am. L. Inst. 1981) (non est factum).
  99. Footnote 89.Cal. Fam. Code § 2251 (putative spouse doctrine)
  100. Footnote 89.Unif. Marriage & Divorce Act § 209.
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  102. Footnote 92.Sgouros v. TransUnion Corp., 817 F.3d 1029 (7th Cir. 2016)
  103. Footnote 92.Berkson v. Gogo LLC, 97 F. Supp. 3d 359 (E.D.N.Y. 2015).
  104. Footnote 93.Ctrs. for Disease Control & Prevention, Disability Impacts All of Us, https://www.cdc.gov/disability-and-health/media/pdfs/disability-impacts-all-of-us-infographic.pdf (last visited June 10, 2026).
  105. Footnote 94.Granite Rock Co. v. Int’l Bhd. of Teamsters, 561 U.S. 287 (2010) (disputes over contract formation are for the court)
  106. Footnote 94.Buckeye Check Cashing, Inc. v. Cardegna, 546 U.S. 440 (2006) (challenges to the validity of the container contract go to the arbitrator).
  107. Footnote 95.Restatement (Second) of Contracts §§ 17, 19 (Am. L. Inst. 1981) (mutual manifestations of assent requirement).
  108. Footnote 96.Electronic Signatures in Global and National Commerce Act (E-SIGN Act), 15 U.S.C. §§7001–7031 (2024)
  109. Footnote 96.Uniform Electronic Transactions Act (UETA), enacted in 49 states and the District of Columbia
  110. Footnote 96.Specht v. Netscape Commc’ns Corp., 306 F.3d 17 (2d Cir. 2002) (online contract formation)
  111. Footnote 96.Meyer v. Uber Techs., Inc., 868 F.3d 66 (2d Cir. 2017) (clickwrap agreements).
  112. Footnote 97.Restatement (Second) of Contracts § 17 (Am. L. Inst. 1981).
  113. Footnote 98.Restatement (Second) of Contracts § 15(1)(a)–(b) (Am. L. Inst. 1981).
  114. Footnote 99.Ortelere v. Teachers’ Retirement Bd., 25 N.Y.2d 196, 250 N.E.2d 460 (1969).
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  116. Footnote 101.Henry Schein, Inc. v. Archer & White Sales, Inc., 586 U.S. 63 (2019).
  117. Footnote 102.Restatement (Second) of Contracts § 208 (Am. L. Inst. 1981).
  118. Footnote 103.Williams v. Walker-Thomas Furniture Co., 350 F.2d 445 (D.C. Cir. 1965) (absence of meaningful choice together with contract terms unreasonably favorable to the other party).
  119. Footnote 104.9 U.S.C. § 2.
  120. Footnote 105.AT&T Mobility LLC v. Concepcion, 563 U.S. 333 (2011).
  121. Footnote 106.Epic Systems Corp. v. Lewis, 584 U.S. 497 (2018).
  122. Footnote 107.Morgan v. Sundance, Inc., 596 U.S. 411 (2022).
  123. Footnote 110.Franklin v. Gwinnett County Pub. Schs., 503 U.S. 60, 73 (1992)
  124. Footnote 112.Pennhurst State Sch. & Hosp. v. Halderman, 451 U.S. 1, 17 (1981).
  125. Footnote 113.Barnes v. Gorman, 536 U.S. 181, 189 n.3 (2002) (“The ADA could not be clearer that the ‘remedies, procedures, and rights . . . are the same as the remedies, procedures, and rights set forth in’ . . . the Rehabilitation Act. These explicit provisions make discussion of the ADA’s status as a ‘non Spending Clause’ tort statute quite irrelevant.” (internal citations omitted)).
  126. Footnote 116.Cal. Civ. Code § 51 et seq.
  127. Footnote 116.Cal. Civ. Code § 54 et seq.
  128. Footnote 116.N.Y. Exec. Law § 296
  129. Footnote 116.775 Ill. Comp. Stat. 5/1-101 et seq.
  130. Footnote 117.The Unruh Act incorporates the ADA by reference, so an ADA Title III violation automatically constitutes an Unruh Act violation.
  131. Footnote 117.New York’s Human Rights Law, N.Y. Exec. Law § 296, and Illinois’s Human Rights Act, 775 Ill. Comp. Stat. 5/1-101 et seq., supply analogous state-law remedies in their respective jurisdictions.
  132. Footnote 118.45 C.F.R. pt. 86 (HHS OCR complaint procedures).
  133. Footnote 119.34 C.F.R. pt. 100 (ED OCR complaint procedures).
  134. Footnote 120.28 U.S.C. § 1331.
  135. Footnote 121.28 U.S.C. § 1367.
  136. Footnote 123.28 U.S.C. § 1391(b)(2).
  137. Footnote 129.Wal-Mart Stores, Inc. v. Dukes, 564 U.S. 338 (2011).

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