By DEVI SHASTRI

In the absence of stronger federal regulation, some states have begun regulating apps that offer AI “therapy” as more people turn to artificial intelligence for mental health advice.

But the laws, all passed this year, don’t fully address the fast-changing landscape of AI software development. And app developers, policymakers and mental health advocates say the resulting patchwork of state laws isn’t enough to protect users or hold the creators of harmful technology accountable.

“The reality is millions of people are using these tools and they’re not going back,” said Karin Andrea Stephan, CEO and co-founder of the mental health chatbot app Earkick.

EDITOR’S NOTE — This story includes discussion of suicide. If you or someone you know needs help, the national suicide and crisis lifeline in the U.S. is available by calling or texting 988. There is also an online chat at 988lifeline.org.

The state laws take different approaches. Illinois and Nevada have banned the use of AI to treat mental health. Utah placed certain limits on therapy chatbots, including requiring them to protect users’ health information and to clearly disclose that the chatbot isn’t human. Pennsylvania, New Jersey and California are also considering ways to regulate AI therapy.

The impact on users varies. Some apps have blocked access in states with bans. Others say they’re making no changes as they wait for more legal clarity.

And many of the laws don’t cover generic chatbots like ChatGPT, which are not explicitly marketed for therapy but are used by an untold number of people for it. Those bots have attracted lawsuits in horrific instances where users lost their grip on reality or took their own lives after interacting with them.

Vaile Wright, who oversees health care innovation at the American Psychological Association, said the apps could fill a need, noting a nationwide shortage of mental health providers, high costs for care and uneven access for insured patients.

Mental health chatbots that are rooted in science, created with expert input and monitored by humans could change the landscape, Wright said.

“This could be something that helps people before they get to crisis,” she said. “That’s not what’s on the commercial market currently.”

That’s why federal regulation and oversight is needed, she said.

Earlier this month, the Federal Trade Commission announced it was opening inquiries into seven AI chatbot companies — including the parent companies of Instagram and Facebook, Google, ChatGPT, Grok (the chatbot on X), Character.AI and Snapchat — on how they “measure, test and monitor potentially negative impacts of this technology on children and teens.” And the Food and Drug Administration is convening an advisory committee Nov. 6 to review generative AI-enabled mental health devices.

Federal agencies could consider restrictions on how chatbots are marketed, limit addictive practices, require disclosures to users that they are not medical providers, require companies to track and report suicidal thoughts, and offer legal protections for people who report bad practices by companies, Wright said.

Not all apps have blocked access

From “companion apps” to “AI therapists” to “mental wellness” apps, AI’s use in mental health care is varied and hard to define, let alone write laws around.

That has led to different regulatory approaches. Some states, for example, take aim at companion apps that are designed just for friendship, but don’t wade into mental health care. The laws in Illinois and Nevada ban products that claim to provide mental health treatment outright, threatening fines up to $10,000 in Illinois and $15,000 in Nevada.

But even a single app can be tough to categorize.

Earkick’s Stephan said there is still a lot that is “very muddy” about Illinois’ law, for example, and the company has not limited access there.

Stephan and her team initially held off calling their chatbot, which looks like a cartoon panda, a therapist. But when users began using the word in reviews, they embraced the terminology so the app would show up in searches.

Last week, they backed off using therapy and medical terms again. Earkick’s website described its chatbot as “Your empathetic AI counselor, equipped to support your mental health journey,” but now it’s a “chatbot for self care.”

Still, “we’re not diagnosing,” Stephan maintained.

Users can set up a “panic button” to call a trusted loved one if they are in crisis and the chatbot will “nudge” users to seek out a therapist if their mental health worsens. But it was never designed to be a suicide prevention app, Stephan said, and police would not be called if someone told the bot about thoughts of self-harm.

Stephan said she’s happy that people are looking at AI with a critical eye, but worried about states’ ability to keep up with innovation.

“The speed at which everything is evolving is massive,” she said.

Other apps blocked access immediately. When Illinois users download the AI therapy app Ash, a message urges them to email their legislators, arguing “misguided legislation” has banned apps like Ash “while leaving unregulated chatbots it intended to regulate free to cause harm.”

A spokesperson for Ash did not respond to multiple requests for an interview.

Mario Treto Jr., secretary of the Illinois Department of Financial and Professional Regulation, said the goal was ultimately to make sure licensed therapists were the only ones doing therapy.

“Therapy is more than just word exchanges,” Treto said. “It requires empathy, it requires clinical judgment, it requires ethical responsibility, none of which AI can truly replicate right now.”

One chatbot app is trying to fully replicate therapy

In March, a Dartmouth College-based team published the first known randomized clinical trial of a generative AI chatbot for mental health treatment.

The goal was to have the chatbot, called Therabot, treat people diagnosed with anxiety, depression or eating disorders. It was trained on vignettes and transcripts written by the team to illustrate an evidence-based response.

The study found users rated Therabot similar to a therapist and had meaningfully lower symptoms after eight weeks compared with people who didn’t use it. Every interaction was monitored by a human who intervened if the chatbot’s response was harmful or not evidence-based.

Nicholas Jacobson, a clinical psychologist whose lab is leading the research, said the results showed early promise but that larger studies are needed to demonstrate whether Therabot works for large numbers of people.

“The space is so dramatically new that I think the field needs to proceed with much greater caution that is happening right now,” he said.

Many AI apps are optimized for engagement and are built to support everything users say, rather than challenging peoples’ thoughts the way therapists do. Many walk the line of companionship and therapy, blurring intimacy boundaries therapists ethically would not.

Therabot’s team sought to avoid those issues.

The app is still in testing and not widely available. But Jacobson worries about what strict bans will mean for developers taking a careful approach. He noted Illinois had no clear pathway to provide evidence that an app is safe and effective.

“They want to protect folks, but the traditional system right now is really failing folks,” he said. “So, trying to stick with the status quo is really not the thing to do.”

Regulators and advocates of the laws say they are open to changes. But today’s chatbots are not a solution to the mental health provider shortage, said Kyle Hillman, who lobbied for the bills in Illinois and Nevada through his affiliation with the National Association of Social Workers.

“Not everybody who’s feeling sad needs a therapist,” he said. But for people with real mental health issues or suicidal thoughts, “telling them, ‘I know that there’s a workforce shortage but here’s a bot’ — that is such a privileged position.”

This story has been corrected to show that Therabot is not a company and to delete an incorrect reference to Dartmouth as a university.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

DUBAI, United Arab Emirates (AP) — London real estate developer Dar Global said Monday that it plans to launch a Trump Plaza in the Red Sea city of Jeddah, its second collaboration with the Trump Organization, the collection of companies controlled by U.S. President Donald Trump’s children.

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The $1 billion project will be the second Trump-branded development in Saudi Arabia, following the launch of Trump Tower Jeddah in December last year, Dar Global said. It will include residences, serviced apartments, office space and townhouses.

Trump’s company struck many real estate licensing deals overseas before he first entered the White House in 2017, including for hotels and residential towers in Canada, Dubai, Mexico, India and Turkey.

Trump’s close ties to Saudi Arabia’s crown prince and day-to-day ruler, Mohammed bin Salman, drew heavy criticism after the 2018 killing of Jamal Khashoggi, a Saudi columnist for the Washington Post who had written critically about the monarchy.

The first major foreign trip of Trump’s second term was to Saudi Arabia.

Dar Global is the international arm of Dar Al Arkan, a large Saudi developer. It says it has $7.5 billion worth of projects under development in the United Arab Emirates, Oman, Qatar, the United Kingdom, Spain and Saudi Arabia.

By SAMY MAGDY and LEE KEATH, Associated Press

CAIRO (AP) — Much remains unknown about U.S. President Donald Trump’s 21-point peace plan for Gaza. But one difference stands out from previous ceasefire proposals: For the first time, it tries to outline the key question of how the territory will be ruled after the war.

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There are provisions that could be rejected by either Israel or Hamas. Israeli Prime Minister Benjamin Netanyahu is meeting Trump at the White House on Monday to discuss the plan.

For Hamas, the plan means surrender. Not only would the group no longer govern Gaza — a concession it has said it is willing to make — it also would have to disarm, something it has so far rejected.

For Israel, it would mean not having direct security control over the Gaza Strip, which Netanyahu has said Israel wants to maintain. But more importantly, the plan provides for the West Bank-based Palestinian Authority to eventually govern Gaza, which Netanyahu and his hard-line allies resoundingly reject.

It also hints at a process that could lead to the creation of a Palestinian state – also rejected by Israel.

For the near future, the plan envisions a sort of international governance of Gaza. An international security force, likely largely made up from Arab countries, would deploy, and an international committee would oversee an interim administration of Palestinian technocrats who would run day-to-day affairs.

There is still no public text of the proposal, making it hard to judge its provisions. Four Arab officials provided The Associated Press with the outlines of the plan, on condition of anonymity because the text has not been finalized. All cautioned that the broad outlines could still change and that many details still must be hammered out – all potential pitfalls that could cause the plan to fall apart.

Here is what we know so far.

The ceasefire

The plan calls for all hostilities to immediately end. Within 48 hours, Hamas would release all hostages it still holds, living or dead. The group still holds 48 hostages — 20 of whom are believed by Israel to be alive.

In return, Israel would free hundreds of Palestinian prisoners, including some serving life sentences, as well as the bodies of other Palestinians held by Israel.

Israel would also carry out a phased troop withdrawal from the Gaza Strip.

But much remains vague. In two previous ceasefire deals, it took months to hammer out the timing and number of hostage and prisoner releases.

Also, the extent and timing of the Israeli withdrawal is not defined. Hamas has said it will not release all its hostages unless it receives a “clear declaration” the war will end and Israel will leave Gaza completely.

Israel has previously refused to commit to a full withdrawal, saying it wants to keep control of the Philadelphi Corridor, a strip of land on Gaza’s southern border with Egypt, to prevent weapons smuggling. It has also spoken of keeping a buffer zone inside Gaza, though it is not clear if it will stick to that demand.

The fate of Hamas and postwar Gaza

Hamas would have no part in administering Gaza, and all its military infrastructure — including tunnels — would be dismantled. Members who pledge to live peacefully would be granted amnesty, and those who wish to leave Gaza would be allowed to.

The international security force would ensure Hamas’ disarmament and keep order. It would also train Palestinian police to take over law enforcement. Mediator Egypt has said it is training thousands of Palestinian police to deploy to Gaza.

Meanwhile, humanitarian aid would be allowed to flow into Gaza in large amounts and would be run by “neutral international bodies,” including the U.N. and the Red Crescent. It is unclear whether the Gaza Humanitarian Fund, a controversial alternative food distribution system backed by Israel and the U.S., would continue to operate.

The plan also specifies that Palestinians will not be expelled from Gaza, and that there will be an international effort to rebuild the territory for Palestinians.

In normal cases, that might not need spelling out. But Palestinians have feared mass expulsion after both Trump and the Israeli government spoke of pushing out Gaza’s population – ostensibly in a “voluntary” manner – and rebuilding the strip as a sort of international real estate venture.

The interim administration of Palestinian technocrats would run day-to-day affairs in Gaza. But the plan also has a vague provision for an “international committee,” possibly headed by the United States, that would “watch its work.” Former British Prime Minister Tony Blair is working on a plan for international administration of Gaza for a transitional period.

The committee would also supervise funding of reconstruction, a role that could give it enormous power over governing Gaza since that is the biggest task facing the territory, almost completely destroyed by Israel’s campaign.

The Palestinian Authority and statehood

During this interim administration, the Palestinian Authority would undergo reforms so it can eventually take over governing Gaza.

The plan appears to intentionally avoid direct talk of eventual Palestinian statehood. Instead, it says the U.S. will facilitate talks between Israelis and Palestinians for “a long-term framework for peaceful coexistence.”

Still, the proposal does not rule out statehood and could build momentum toward it. By agreeing to it, Israel could commit itself to resuming peace talks with the Palestinians for the first time in more than a decade.

The response so far

Arab countries appear to back the outline. The leaders of Egypt and the United Arab Emirates met Monday in Cairo and expressed their support, saying the initiative “paves the way for achieving a lasting and comprehensive peace in the region.”

Hamas officials say they have been briefed on the outlines of the plan. But they aren’t responding until they see the finalized proposal.

Hamas has so far rejected disarmament, saying it has a right to resist until Israeli occupation of Palestinian lands ends.

Ahead of his White House meeting on Monday, Netanyahu said he and Trump were working on the proposal. “It’s not been finalized yet, but we’re working with President Trump’s team, actually as we speak, and I hope we can — we can make it a go,” he told Fox News Sunday’s “The Sunday Briefing.”

Netanyahu also faces pressure from his own ultra-nationalist coalition allies.

Finance Minister Bezalel Smotrich, who is part of Netanyahu’s security cabinet, published a list of his “red lines” on X on Monday, in a warning to Netanyahu ahead of his meeting with Trump.

Smotrich is one of the more vocal members of the right-wing bloc of Netanyahu’s coalition who have previously threatened to leave the government if Netanyahu halts the war in Gaza. Even if these parties do quit, centrist politicians have vowed to give Netanyahu the support he needs to prevent his government from collapsing and for a ceasefire to be approved.

Smotrich said there must be no involvement of the Palestinian Authority in Gaza, “neither today nor in the future, neither explicitly nor implicitly.” He also said there must be no mention of a Palestinian state, “even implicitly.”

“The idea of a Palestinian state must be removed from the table forever,” Smotrich wrote.

By JONEL ALECCIA

On a recent Saturday near Seattle, Cheryl Ewaldsen pulled three golden loaves of wheat bread out of her kitchen oven.

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The fragrant, oat-topped bread was destined not for her table, but for a local food bank, to be distributed to families increasingly struggling with hunger and the high cost of groceries.

“I just get really excited about it knowing that it’s going to someone and they’re going to make, like, 10 sandwiches,” said Ewaldsen, 75, a retired university human resources director.

Ewaldsen is a volunteer with Community Loaves, a Seattle-area nonprofit that started pairing home bakers with food pantries during the COVID-19 pandemic — and hasn’t stopped.

Since 2020, the organization headed by Katherine Kehrli, the former dean of a culinary school, has donated more than 200,000 loaves of fresh bread and some 220,000 energy cookies to food banks. They come from a network of nearly 900 bakers in four states — Washington, Oregon, California and Idaho — and represent one of the largest such efforts in the country.

Now, amid cuts in federal funding for food aid to the poor and rising grocery prices, demand for the group’s donations of nutritious baked goods is greater than ever, Kehrli said.

“Most of our food banks do not get any kind of whole-grain sandwich bread donation,” she said. “When we ask what we could do better, they just say, ‘Bring us more.’”

Volunteers slice bread from Community Loaves at the Edmonds Food Bank in Edmonds, Wash., Monday, Sept. 8, 2025. (AP Photo/Annika Hammerschlag)

Anti-hunger experts expect to see more need

Ewaldsen’s bread goes to the nearby Edmonds Food Bank, where the client list has swelled from 350 households to nearly 1,000 in the past three years, according to program manager Lester Almanza.

Nationwide, more than 50 million people a year receive charitable food assistance, according to Feeding America, a hunger relief organization.

Anti-hunger experts say they expect the need to rise as recent federal legislation sharply cutting food aid to the poor takes effect. The Congressional Budget Office has estimated that the tax and spending cuts bill Republicans muscled through Congress in July means 3 million people would not qualify for food stamps, also known as SNAP benefits.

Gauging the impact, however, could soon be more difficult after the U.S. Agriculture Department recently said it would halt an annual report on hunger in America, saying it was redundant, costly and politicized “subjective liberal fodder.” After 30 years, the 2024 report, to be released on Oct. 22, will be the last, the agency said.

“Ending data collection will not end hunger, it will only make it a hidden crisis that is easier to ignore and more difficult to address,” Crystal FitzSimons, president of the Food Research & Action Center, an advocacy group, said in a statement.

Volunteer shoppers fill grocery orders at the Edmonds Food Bank in Edmonds, Wash., Monday, Sept. 8, 2025. (AP Photo/Annika Hammerschlag)

Almanza said federal funding for his food bank has dropped at least 10% this year, meaning that every donation helps.

“It’s something that a lot of people rely on,” he said.

Food bank breads are often highly processed

That includes people like Chris Redfearn, 42, and his wife, Melanie Rodriguez-Redfearn, 43, who turned to a food bank in Everett, Washington, last spring after moving to the area to find work. They had to stretch their savings until she began a new position this month teaching history at a local college. Chris Redfearn, who has worked for decades in business, is still looking.

“The food pantry assists with anywhere from $40 to $80 worth of savings weekly,” he said. “We’ve been able to keep ourselves afloat.”

Finding homemade bread from Community Loaves at a food pantry was a surprise, the couple said. Often, surplus bread sent by grocery stores includes highly processed white breads or sweets donated near their expiration or sell-by dates.

Katherine Kehrli, founder of Community Loaves, slices bread donated by her organization at the Edmonds Food Bank in Edmonds, Wash., Monday, Sept. 8, 2025. (AP Photo/Annika Hammerschlag)

The breads come in three varieties — honey oat, whole wheat and sunflower rye — all made with whole grains and minimally processed ingredients.

“They make it really wholesome and fibrous,” Chris Redfearn said. “It mimics most of the health-conscious breads that are out there.”

Many food banks don’t accept donated baked goods

The notion of donating home-baked bread came to Kehrli, 61, during the pandemic, when she was displaced from her job at the busy Seattle Culinary Academy.

“I love to bake and just an idea sparked: Would it be possible for us to help from our home and get important valuable nutrition to our food banks?” she recalled.

Many food pantries don’t accept or distribute donations of homemade baked goods. Feeding America warns individual bakers against the practice, saying “since food banks can’t confirm how your baked goods were made or their ingredients, they can’t be donated.”

But health department rules vary by state, Kehrli learned. In Washington and the other three states where Community Loaves now operates, bread is one of the few foods allowed to be donated from a home kitchen through a program like theirs.

“We wouldn’t be able to donate custard pies. We wouldn’t be able to donate lasagna,” Kehrli said. “But bread is deemed safe. Anything that is fully baked and does not require refrigeration.”

Hans Ewaldsen bakes energy cookies for Community Loaves at his home in Edmonds, Wash., Saturday, Sept. 6, 2025. (AP Photo/Annika Hammerschlag)

Still, Community Loaves bakers must follow approved recipes for the bread and two types of energy cookies. They obtain flour from common sources, and bake and deliver on a shared schedule twice a month.

The bakers buy their own supplies, donating the cost of the ingredients as well as their time. Most make a few loaves per baking session before delivering them to local “hubs,” where other volunteers collect the bread and transport it to the food banks.

Bakers range from former professionals to beginners. A robust website with recipes and how-to videos backstops every step, Kehrli said.

Baking the bread is satisfying on several levels, said Ewaldsen, who has donated nearly 800 loaves in less than two years. Part of it is addressing the physical need for food, but part is also addressing the spiritual hunger for connection with neighbors.

“It’s the opportunity for me to bake something and to share something with others in the community, where they don’t necessarily need to know who I am, but they know that there’s a community that loves and cares for them,” she said.

While such sentiments are sincere and admirable, anti-hunger experts stress that individual donations can’t take the place of adequately funded government services for struggling Americans.

“It’s beautiful that our communities act this way,” said Gina Plata-Nino of the Food Research & Action Center. “But it is a loaf of bread. That is going to feed one person — and there are millions in line.”

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.