I agree that institutionalized everything can develope blind spots that makes those institutions work broadly, but can't help (and in extreme cases hurts) individuals within said institutional context — although that doesn't really contradict my point.

Just because getting kicked into the head occasionally helps someone with a neorological defect, doesn't mean we should recommend getting kicked in the head by a horse as a remedy, if you follow my point. It means we need to figure out why it helped those people and maybe find a way that doesn't require an equiestrian.

And in the case of therapy we already have a lot of knowledge what works and what doesn't. Therapeutic psychiatrists typically can't give patients the time and attention they would require for structural reasons, so LLMs have real potential here. But that LLM needs to know how to deal with patients in different conditions. E.g. imagine a patient with a schizophenic disorder convincing a LLM into feeding into their paranoid schizophrenia. My experience with LLMs so far is, that they would happily just do this, if you're persistent enough..