Daily Papers

Large language models (LLMs) are increasingly applied in mental health support systems, where reliable recognition of high-risk states such as suicidal ideation and self-harm is safety-critical. However, existing evaluations primarily rely on aggregate performance metrics, which often obscure risk-specific failure modes and provide limited insight into model behavior in realistic, multi-turn interactions. We present MHDash, an open-source platform designed to support the development, evaluation, and auditing of AI systems for mental health applications. MHDash integrates data collection, structured annotation, multi-turn dialogue generation, and baseline evaluation into a unified pipeline. The platform supports annotations across multiple dimensions, including Concern Type, Risk Level, and Dialogue Intent, enabling fine-grained and risk-aware analysis. Our results reveal several key findings: (i) simple baselines and advanced LLM APIs exhibit comparable overall accuracy yet diverge significantly on high-risk cases; (ii) some LLMs maintain consistent ordinal severity ranking while failing absolute risk classification, whereas others achieve reasonable aggregate scores but suffer from high false negative rates on severe categories; and (iii) performance gaps are amplified in multi-turn dialogues, where risk signals emerge gradually. These observations demonstrate that conventional benchmarks are insufficient for safety-critical mental health settings. By releasing MHDash as an open platform, we aim to promote reproducible research, transparent evaluation, and safety-aligned development of AI systems for mental health support.

Large language model-powered chatbots have transformed how people seek information, especially in high-stakes contexts like mental health. Despite their support capabilities, safe detection and response to crises such as suicidal ideation and self-harm are still unclear, hindered by the lack of unified crisis taxonomies and clinical evaluation standards. We address this by creating: (1) a taxonomy of six crisis categories; (2) a dataset of over 2,000 inputs from 12 mental health datasets, classified into these categories; and (3) a clinical response assessment protocol. We also use LLMs to identify crisis inputs and audit five models for response safety and appropriateness. First, we built a clinical-informed crisis taxonomy and evaluation protocol. Next, we curated 2,252 relevant examples from over 239,000 user inputs, then tested three LLMs for automatic classification. In addition, we evaluated five models for the appropriateness of their responses to a user's crisis, graded on a 5-point Likert scale from harmful (1) to appropriate (5). While some models respond reliably to explicit crises, risks still exist. Many outputs, especially in self-harm and suicidal categories, are inappropriate or unsafe. Different models perform variably; some, like gpt-5-nano and deepseek-v3.2-exp, have low harm rates, but others, such as gpt-4o-mini and grok-4-fast, generate more unsafe responses. All models struggle with indirect signals, default replies, and context misalignment. These results highlight the urgent need for better safeguards, crisis detection, and context-aware responses in LLMs. They also show that alignment and safety practices, beyond scale, are crucial for reliable crisis support. Our taxonomy, datasets, and evaluation methods support ongoing AI mental health research, aiming to reduce harm and protect vulnerable users.

Emotional support is a crucial ability for many conversation scenarios, including social interactions, mental health support, and customer service chats. Following reasonable procedures and using various support skills can help to effectively provide support. However, due to the lack of a well-designed task and corpora of effective emotional support conversations, research on building emotional support into dialog systems remains untouched. In this paper, we define the Emotional Support Conversation (ESC) task and propose an ESC Framework, which is grounded on the Helping Skills Theory. We construct an Emotion Support Conversation dataset (ESConv) with rich annotation (especially support strategy) in a help-seeker and supporter mode. To ensure a corpus of high-quality conversations that provide examples of effective emotional support, we take extensive effort to design training tutorials for supporters and several mechanisms for quality control during data collection. Finally, we evaluate state-of-the-art dialog models with respect to the ability to provide emotional support. Our results show the importance of support strategies in providing effective emotional support and the utility of ESConv in training more emotional support systems.

Demand for mental health support through AI chatbots is surging, though current systems present several limitations, like sycophancy or overvalidation, and reinforcement of maladaptive beliefs. A core obstacle to the creation of better systems is the scarcity of benchmarks that capture the complexity of real therapeutic interactions. Most existing benchmarks either only test clinical knowledge through multiple-choice questions or assess single responses in isolation. To bridge this gap, we present MindEval, a framework designed in collaboration with Ph.D-level Licensed Clinical Psychologists for automatically evaluating language models in realistic, multi-turn mental health therapy conversations. Through patient simulation and automatic evaluation with LLMs, our framework balances resistance to gaming with reproducibility via its fully automated, model-agnostic design. We begin by quantitatively validating the realism of our simulated patients against human-generated text and by demonstrating strong correlations between automatic and human expert judgments. Then, we evaluate 12 state-of-the-art LLMs and show that all models struggle, scoring below 4 out of 6, on average, with particular weaknesses in problematic AI-specific patterns of communication. Notably, reasoning capabilities and model scale do not guarantee better performance, and systems deteriorate with longer interactions or when supporting patients with severe symptoms. We release all code, prompts, and human evaluation data.

There has been an increasing research interest in developing specialized dialogue systems that can offer mental health support. However, gathering large-scale and real-life multi-turn conversations for mental health support poses challenges due to the sensitivity of personal information, as well as the time and cost involved. To address these issues, we introduce the SMILE approach, an inclusive language expansion technique that employs ChatGPT to extend public single-turn dialogues into multi-turn ones. Our research first presents a preliminary exploratory study that validates the effectiveness of the SMILE approach. Furthermore, we conduct a comprehensive and systematic contrastive analysis of datasets generated with and without the SMILE approach, demonstrating that the SMILE method results in a large-scale, diverse, and close-to-real-life multi-turn mental health support conversation corpus, including dialog topics, lexical and semantic features. Finally, we use the collected corpus (SMILECHAT) to develop a more effective dialogue system that offers emotional support and constructive suggestions in multi-turn conversations for mental health support.

As mental health issues globally escalate, there is a tremendous need for advanced digital support systems. We introduce MentalAgora, a novel framework employing large language models enhanced by interaction between multiple agents for tailored mental health support. This framework operates through three stages: strategic debating, tailored counselor creation, and response generation, enabling the dynamic customization of responses based on individual user preferences and therapeutic needs. We conduct experiments utilizing a high-quality evaluation dataset TherapyTalk crafted with mental health professionals, shwoing that MentalAgora generates expert-aligned and user preference-enhanced responses. Our evaluations, including experiments and user studies, demonstrate that MentalAgora aligns with professional standards and effectively meets user preferences, setting a new benchmark for digital mental health interventions.

The advancement of AI systems for mental health support is hindered by limited access to therapeutic conversation data, particularly for trauma treatment. We present Thousand Voices of Trauma, a synthetic benchmark dataset of 3,000 therapy conversations based on Prolonged Exposure therapy protocols for Post-traumatic Stress Disorder (PTSD). The dataset comprises 500 unique cases, each explored through six conversational perspectives that mirror the progression of therapy from initial anxiety to peak distress to emotional processing. We incorporated diverse demographic profiles (ages 18-80, M=49.3, 49.4% male, 44.4% female, 6.2% non-binary), 20 trauma types, and 10 trauma-related behaviors using deterministic and probabilistic generation methods. Analysis reveals realistic distributions of trauma types (witnessing violence 10.6%, bullying 10.2%) and symptoms (nightmares 23.4%, substance abuse 20.8%). Clinical experts validated the dataset's therapeutic fidelity, highlighting its emotional depth while suggesting refinements for greater authenticity. We also developed an emotional trajectory benchmark with standardized metrics for evaluating model responses. This privacy-preserving dataset addresses critical gaps in trauma-focused mental health data, offering a valuable resource for advancing both patient-facing applications and clinician training tools.

Virtual counselors powered by large language models (LLMs) aim to create interactive support systems that effectively assist clients struggling with mental health challenges. To replicate counselor-client conversations, researchers have built an online mental health platform that allows professional counselors to provide clients with text-based counseling services for about an hour per session. Notwithstanding its effectiveness, challenges exist as human annotation is time-consuming, cost-intensive, privacy-protected, and not scalable. To address this issue and investigate the applicability of LLMs in psychological counseling conversation simulation, we propose a framework that employs two LLMs via role-playing for simulating counselor-client interactions. Our framework involves two LLMs, one acting as a client equipped with a specific and real-life user profile and the other playing the role of an experienced counselor, generating professional responses using integrative therapy techniques. We implement both the counselor and the client by zero-shot prompting the GPT-4 model. In order to assess the effectiveness of LLMs in simulating counselor-client interactions and understand the disparities between LLM- and human-generated conversations, we evaluate the synthetic data from various perspectives. We begin by assessing the client's performance through automatic evaluations. Next, we analyze and compare the disparities between dialogues generated by the LLM and those generated by professional counselors. Furthermore, we conduct extensive experiments to thoroughly examine the performance of our LLM-based counselor trained with synthetic interactive dialogues by benchmarking against state-of-the-art models for mental health.

Online mental health support communities have grown in recent years for providing accessible mental and emotional health support through volunteer counselors. Despite millions of people participating in chat support on these platforms, the clinical effectiveness of these communities on mental health symptoms remains unknown. Furthermore, although volunteers receive some training based on established therapeutic skills studied in face-to-face environments such as active listening and motivational interviewing, it remains understudied how the usage of these skills in this online context affects people's mental health status. In our work, we collaborate with one of the largest online peer support platforms and use both natural language processing and machine learning techniques to measure how one-on-one support chats affect depression and anxiety symptoms. We measure how the techniques and characteristics of support providers, such as using affirmation, empathy, and past experience on the platform, affect support-seekers' mental health changes. We find that online peer support chats improve both depression and anxiety symptoms with a statistically significant but relatively small effect size. Additionally, support providers' techniques such as emphasizing the autonomy of the client lead to better mental health outcomes. However, we also found that some behaviors (e.g. persuading) are actually harmful to depression and anxiety outcomes. Our work provides key understanding for mental health care in the online setting and designing training systems for online support providers.

This paper introduces DeepPsy-Agent, an innovative psychological support system that combines the three-stage helping theory in psychology with deep learning techniques. The system consists of two core components: (1) a multi-stage response-capable dialogue model (deeppsy-chat), which enhances reasoning capabilities through stage-awareness and deep-thinking analysis to generate high-quality responses; and (2) a real-time stage transition detection model that identifies contextual shifts to guide the dialogue towards more effective intervention stages. Based on 30,000 real psychological hotline conversations, we employ AI-simulated dialogues and expert re-annotation strategies to construct a high-quality multi-turn dialogue dataset. Experimental results demonstrate that DeepPsy-Agent outperforms general-purpose large language models (LLMs) in key metrics such as problem exposure completeness, cognitive restructuring success rate, and action adoption rate. Ablation studies further validate the effectiveness of stage-awareness and deep-thinking modules, showing that stage information contributes 42.3\% to performance, while the deep-thinking module increases root-cause identification by 58.3\% and reduces ineffective suggestions by 72.1\%. This system addresses critical challenges in AI-based psychological support through dynamic dialogue management and deep reasoning, advancing intelligent mental health services.

Unlike empathetic dialogues, the system in emotional support conversations (ESC) is expected to not only convey empathy for comforting the help-seeker, but also proactively assist in exploring and addressing their problems during the conversation. In this work, we study the problem of mixed-initiative ESC where the user and system can both take the initiative in leading the conversation. Specifically, we conduct a novel analysis on mixed-initiative ESC systems with a tailor-designed schema that divides utterances into different types with speaker roles and initiative types. Four emotional support metrics are proposed to evaluate the mixed-initiative interactions. The analysis reveals the necessity and challenges of building mixed-initiative ESC systems. In the light of this, we propose a knowledge-enhanced mixed-initiative framework (KEMI) for ESC, which retrieves actual case knowledge from a large-scale mental health knowledge graph for generating mixed-initiative responses. Experimental results on two ESC datasets show the superiority of KEMI in both content-preserving evaluation and mixed initiative related analyses.

Online Mental Health Communities (OMHCs) provide crucial peer and expert support, yet many posts remain unanswered due to missing support attributes that signal the need for help. We present a novel framework that identifies these gaps and prompts users to enrich their posts, thereby improving engagement. To support this, we introduce REDDME, a new dataset of 4,760 posts from mental health subreddits annotated for the span and intensity of three key support attributes: event what happened?, effect what did the user experience?, and requirement what support they need?. Next, we devise a hierarchical taxonomy, CueTaxo, of support attributes for controlled question generation. Further, we propose MH-COPILOT, a reinforcement learning-based system that integrates (a) contextual attribute-span identification, (b) support attribute intensity classification, (c) controlled question generation via a hierarchical taxonomy, and (d) a verifier for reward modeling. Our model dynamically assesses posts for the presence/absence of support attributes, and generates targeted prompts to elicit missing information. Empirical results across four notable language models demonstrate significant improvements in attribute elicitation and user engagement. A human evaluation further validates the model's effectiveness in real-world OMHC settings.

As awareness of mental health issues grows, online counseling support services are becoming increasingly prevalent worldwide. Detecting whether users express suicidal ideation in text-based counseling services is crucial for identifying and prioritizing at-risk individuals. However, the lack of domain-specific systems to facilitate fine-grained suicide detection and corresponding risk assessment in online counseling poses a significant challenge for automated crisis intervention aimed at suicide prevention. In this paper, we propose PsyGUARD, an automated system for detecting suicide ideation and assessing risk in psychological counseling. To achieve this, we first develop a detailed taxonomy for detecting suicide ideation based on foundational theories. We then curate a large-scale, high-quality dataset called PsySUICIDE for suicide detection. To evaluate the capabilities of automated systems in fine-grained suicide detection, we establish a range of baselines. Subsequently, to assist automated services in providing safe, helpful, and tailored responses for further assessment, we propose to build a suite of risk assessment frameworks. Our study not only provides an insightful analysis of the effectiveness of automated risk assessment systems based on fine-grained suicide detection but also highlights their potential to improve mental health services on online counseling platforms. Code, data, and models are available at https://github.com/qiuhuachuan/PsyGUARD.

Conversational agents are increasingly used to address emotional needs on top of information needs. One use case of increasing interest are counselling-style mental health and behaviour change interventions, with large language model (LLM)-based approaches becoming more popular. Research in this context so far has been largely system-focused, foregoing the aspect of user behaviour and the impact this can have on LLM-generated texts. To address this issue, we share a dataset containing text-based user interactions related to behaviour change with two GPT-4-based conversational agents collected in a preregistered user study. This dataset includes conversation data, user language analysis, perception measures, and user feedback for LLM-generated turns, and can offer valuable insights to inform the design of such systems based on real interactions.

Effective mental health support is crucial for alleviating psychological distress. While large language model (LLM)-based assistants have shown promise in mental health interventions, existing research often defines "effective" support primarily in terms of empathetic acknowledgments, overlooking other essential dimensions such as informational guidance, community validation, and tangible coping strategies. To address this limitation and better understand what constitutes effective support, we introduce RedditESS, a novel real-world dataset derived from Reddit posts, including supportive comments and original posters' follow-up responses. Grounded in established social science theories, we develop an ensemble labeling mechanism to annotate supportive comments as effective or not and perform qualitative assessments to ensure the reliability of the annotations. Additionally, we demonstrate the practical utility of RedditESS by using it to guide LLM alignment toward generating more context-sensitive and genuinely helpful supportive responses. By broadening the understanding of effective support, our study paves the way for advanced AI-driven mental health interventions.

Large language models (LLMs) chatbots like ChatGPT are increasingly used for mental health support. They offer accessible, therapeutic support but also raise concerns about misinformation, over-reliance, and risks in high-stakes contexts of mental health. We crowdsource large-scale users' posts from six major social media platforms to examine how people discuss their interactions with LLM chatbots across different mental health conditions. Through an LLM-assisted pipeline grounded in Value-Sensitive Design (VSD), we mapped the relationships across user-reported sentiments, mental health conditions, perspectives, and values. Our results reveal that the use of LLM chatbots is condition-specific. Users with neurodivergent conditions (e.g., ADHD, ASD) report strong positive sentiments and instrumental or appraisal support, whereas higher-risk disorders (e.g., schizophrenia, bipolar disorder) show more negative sentiments. We further uncover how user perspectives co-occur with underlying values, such as identity, autonomy, and privacy. Finally, we discuss shifting from "one-size-fits-all" chatbot design toward condition-specific, value-sensitive LLM design.

Current mental-health conversational systems are usually based on fixed, generic dialogue patterns. This paper proposes an adaptive framework based on large language models that aims to personalize therapeutic interaction according to a user's psychological state, quantified with the Acceptance of Illness Scale (AIS). The framework defines three specialized agents, L, M, and H, each linked to a different level of illness acceptance, and adjusts conversational behavior over time using continuous feedback signals. The AIS-stratified architecture is treated as a diegetic prototype placed in a plausible near-future setting and examined through the method of design fiction. By embedding the architecture in narrative scenarios, the study explores how such agents might influence access to care and therapeutic relationship. The goal is to show how clinically informed personalization, technical feasibility, and speculative scenario analysis can together inform the responsible design of LLM-based companions for mental-health support.

Student mental health is a sensitive issue that necessitates special attention. A primary concern is the student-to-counselor ratio, which surpasses the recommended standard of 250:1 in most universities. This imbalance results in extended waiting periods for in-person consultations, which cause suboptimal treatment. Significant efforts have been directed toward developing mental health dialogue systems utilizing the existing open-source mental health-related datasets. However, currently available datasets either discuss general topics or various strategies that may not be viable for direct application due to numerous ethical constraints inherent in this research domain. To address this issue, this paper introduces a specialized mental health dataset that emphasizes the active listening strategy employed in conversation for counseling, also named as ConvCounsel. This dataset comprises both speech and text data, which can facilitate the development of a reliable pipeline for mental health dialogue systems. To demonstrate the utility of the proposed dataset, this paper also presents the NYCUKA, a spoken mental health dialogue system that is designed by using the ConvCounsel dataset. The results show the merit of using this dataset.

According to the World Health Organization (WHO), suicide was the fourth leading cause of death in the world for individuals aged 15 to 29 in 2019. Given the rapid increase in mental health issues, providing psychological support is both crucial and urgent. In this paper: (1) we propose S\'olo Esc\'uchame, the first open-source Spanish emotional assistance chatbot, based on LLaMA-2-7b-Chat. (2) We introduced the HEAR (Hispanic Emotional Accompaniment Responses) dataset, compiled from multiple English sources translated into Spanish, as well as generic data generated using ChatGPT-3.5-Turbo. Finally, (3) we propose an evaluation metric based on two semi-automatic assessment methods. Our system outperforms a range of state-of-the-art models in providing psychological assistance in Spanish. Our models and datasets are publicly available to facilitate reproducibility.

The growing demand for mental health support has highlighted the importance of conversational agents as human supporters worldwide and in China. These agents could increase availability and reduce the relative costs of mental health support. The provided support can be divided into two main types: cognitive and emotional support. Existing work on this topic mainly focuses on constructing agents that adopt Cognitive Behavioral Therapy (CBT) principles. Such agents operate based on pre-defined templates and exercises to provide cognitive support. However, research on emotional support using such agents is limited. In addition, most of the constructed agents operate in English, highlighting the importance of conducting such studies in China. In this study, we analyze the effectiveness of Emohaa in reducing symptoms of mental distress. Emohaa is a conversational agent that provides cognitive support through CBT-based exercises and guided conversations. It also emotionally supports users by enabling them to vent their desired emotional problems. The study included 134 participants, split into three groups: Emohaa (CBT-based), Emohaa (Full), and control. Experimental results demonstrated that compared to the control group, participants who used Emohaa experienced considerably more significant improvements in symptoms of mental distress. We also found that adding the emotional support agent had a complementary effect on such improvements, mainly depression and insomnia. Based on the obtained results and participants' satisfaction with the platform, we concluded that Emohaa is a practical and effective tool for reducing mental distress.

Artificial Intelligence (AI) is a broad field that is upturning mental health care in many ways, from addressing anxiety, depression, and stress to increasing access, personalization of treatment, and real-time monitoring that enhances patient outcomes. The current paper discusses the evolution, present application, and future challenges in the field of AI for mental health and well-being. From the early chatbot models, such as ELIZA, to modern machine learning systems, the integration of AI in mental health has grown rapidly to augment traditional treatment and open innovative solutions. AI-driven tools provide continuous support, offering personalized interventions and addressing issues such as treatment access and patient stigma. AI also enables early diagnosis through the analysis of complex datasets, including speech patterns and social media behavior, to detect early signs of conditions like depression and Post-Traumatic Stress Disorder (PTSD). Ethical challenges persist, however, most notably around privacy, data security, and algorithmic bias. With AI at the core of mental health care, there is a dire need to develop strong ethical frameworks that ensure patient rights are protected, access is equitable, and transparency is maintained in AI applications. Going forward, the role of AI in mental health will continue to evolve, and continued research and policy development will be needed to meet the diverse needs of patients while mitigating associated risks.

Global rates of mental health concerns are rising and there is increasing realization that existing models of mental healthcare will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health-related tasks. In this review, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs application to mental health and encourage adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. Especially critical is ensuring that mental health LLMs are fine-tuned for mental health, enhance mental health equity, adhere to ethical standards, and that people, including those with lived experience with mental health concerns, are involved in all stages from development through deployment. Prioritizing these efforts will minimize potential harms to mental health and maximize the likelihood that LLMs will positively impact mental health globally.

People experiencing severe distress increasingly use Large Language Model (LLM) chatbots as mental health support tools. Discussions on social media have described how engagements were lifesaving for some, but evidence suggests that general-purpose LLM chatbots also have notable risks that could endanger the welfare of users if not designed responsibly. In this study, we investigate the lived experiences of people who have used LLM chatbots for mental health support. We build on interviews with 21 individuals from globally diverse backgrounds to analyze how users create unique support roles for their chatbots, fill in gaps in everyday care, and navigate associated cultural limitations when seeking support from chatbots. We ground our analysis in psychotherapy literature around effective support, and introduce the concept of therapeutic alignment, or aligning AI with therapeutic values for mental health contexts. Our study offers recommendations for how designers can approach the ethical and effective use of LLM chatbots and other AI mental health support tools in mental health care.

The Mental Health Question Answer (MHQA) task requires the seeker and supporter to complete the support process in one-turn dialogue. Given the richness of help-seeker posts, supporters must thoroughly understand the content and provide logical, comprehensive, and well-structured responses. Previous works in MHQA mostly focus on single-agent approaches based on the cognitive element of Cognitive Behavioral Therapy (CBT), but they overlook the interactions among various CBT elements, such as emotion and cognition. This limitation hinders the models' ability to thoroughly understand the distress of help-seekers. To address this, we propose a framework named Multi-Agent Deductive Planning (MADP), which is based on the interactions between the various psychological elements of CBT. This method guides Large Language Models (LLMs) to achieve a deeper understanding of the seeker's context and provide more personalized assistance based on individual circumstances. Furthermore, we construct a new dataset based on the MADP framework and use it to fine-tune LLMs, resulting in a specialized model named MADP-LLM. We conduct extensive experiments, including comparisons with multiple LLMs, human evaluations, and automatic evaluations, to validate the effectiveness of the MADP framework and MADP-LLM.

Large language models (LLMs) have received much attention and shown their potential in digital health, while their application in mental health is subject to ongoing debate. This systematic review aims to summarize and characterize the use of LLMs in mental health by investigating the strengths and limitations of the latest work in LLMs and discusses the challenges and opportunities for early screening, digital interventions, and other clinical applications in mental health. Following PRISMA guidelines, we examined English articles from PubMed, DBLP Computer Science Bibliography, and IEEE Xplore, published between 1 January 2017, and 1 September 2023, focusing on mental health and LLMs. The review analyzed 32 articles, including mental health analysis using social media datasets (n=13), mental health chatbots (n=10), and other mental health applications (n=9). Findings reveal LLMs' effectiveness in mental health issue detection and the enhancement of telepsychological services through personalised healthcare. Nonetheless, risks like text inconsistencies, hallucinatory content, and the lack of an ethical framework raise concerns about their clinical use. Despite these challenges, the advancement of LLMs underscores their potential as innovative clinical tools, necessitating further research and development. The review emphasizes that LLMs should complement, not replace, professional mental health services.

Mobile mental health applications are seen as a promising way to fulfill the growing need for mental health care. Although there are more than ten thousand mental health apps available on app marketplaces, such as Google Play and Apple App Store, many of them are not evidence-based, or have been minimally evaluated or regulated. The real-life experience and concerns of the app users are largely unknown. To address this knowledge gap, we analyzed 2159 user reviews from 117 Android apps and 2764 user reviews from 76 iOS apps. Our findings include the critiques around inconsistent moderation standards and lack of transparency. App-embedded social features and chatbots were criticized for providing little support during crises. We provide research and design implications for future mental health app developers, discuss the necessity of developing a comprehensive and centralized app development guideline, and the opportunities of incorporating existing AI technology in mental health chatbots.

Mental health disorders are a global crisis. While various datasets exist for detecting such disorders, there remains a critical gap in identifying individuals actively seeking help. This paper introduces a novel dataset, M-Help, specifically designed to detect help-seeking behavior on social media. The dataset goes beyond traditional labels by identifying not only help-seeking activity but also specific mental health disorders and their underlying causes, such as relationship challenges or financial stressors. AI models trained on M-Help can address three key tasks: identifying help-seekers, diagnosing mental health conditions, and uncovering the root causes of issues.

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

Mental health disorders affect hundreds of millions globally, and the Web now serves as a primary medium for accessing support, information, and assessment. Large language models (LLMs) offer scalable and accessible assistance, yet their deployment in mental-health settings remains risky when their reasoning is incomplete, inconsistent, or ungrounded. Existing psychological LLMs emphasize emotional understanding or knowledge recall but overlook the step-wise, clinically aligned reasoning required for appraisal, diagnosis, intervention planning, abstraction, and verification. To address these issues, we introduce MentraSuite, a unified framework for advancing reliable mental-health reasoning. We propose MentraBench, a comprehensive benchmark spanning five core reasoning aspects, six tasks, and 13 datasets, evaluating both task performance and reasoning quality across five dimensions: conciseness, coherence, hallucination avoidance, task understanding, and internal consistency. We further present Mindora, a post-trained model optimized through a hybrid SFT-RL framework with an inconsistency-detection reward to enforce faithful and coherent reasoning. To support training, we construct high-quality trajectories using a novel reasoning trajectory generation strategy, that strategically filters difficult samples and applies a structured, consistency-oriented rewriting process to produce concise, readable, and well-balanced trajectories. Across 20 evaluated LLMs, Mindora achieves the highest average performance on MentraBench and shows remarkable performances in reasoning reliability, demonstrating its effectiveness for complex mental-health scenarios.

Due to the lack of human resources for mental health support, there is an increasing demand for employing conversational agents for support. Recent work has demonstrated the effectiveness of dialogue models in providing emotional support. As previous studies have demonstrated that seekers' persona is an important factor for effective support, we investigate whether there are benefits to modeling such information in dialogue models for support. In this paper, our empirical analysis verifies that persona has an important impact on emotional support. Therefore, we propose a framework for dynamically inferring and modeling seekers' persona. We first train a model for inferring the seeker's persona from the conversation history. Accordingly, we propose PAL, a model that leverages persona information and, in conjunction with our strategy-based controllable generation method, provides personalized emotional support. Automatic and manual evaluations demonstrate that PAL achieves state-of-the-art results, outperforming the baselines on the studied benchmark. Our code and data are publicly available at https://github.com/chengjl19/PAL.

The limited availability of psychologists necessitates efficient identification of individuals requiring urgent mental healthcare. This study explores the use of Natural Language Processing (NLP) pipelines to analyze text data from online mental health forums used for consultations. By analyzing forum posts, these pipelines can flag users who may require immediate professional attention. A crucial challenge in this domain is data privacy and scarcity. To address this, we propose utilizing readily available curricular texts used in institutes specializing in mental health for pre-training the NLP pipelines. This helps us mimic the training process of a psychologist. Our work presents CASE-BERT that flags potential mental health disorders based on forum text. CASE-BERT demonstrates superior performance compared to existing methods, achieving an f1 score of 0.91 for Depression and 0.88 for Anxiety, two of the most commonly reported mental health disorders. Our code is publicly available.

Mental health conditions affect hundreds of millions globally, yet early detection remains limited. While large language models (LLMs) have shown promise in mental health applications, their size and computational demands hinder practical deployment. Small language models (SLMs) offer a lightweight alternative, but their use for social media--based mental health prediction remains largely underexplored. In this study, we introduce Menta, the first optimized SLM fine-tuned specifically for multi-task mental health prediction from social media data. Menta is jointly trained across six classification tasks using a LoRA-based framework, a cross-dataset strategy, and a balanced accuracy--oriented loss. Evaluated against nine state-of-the-art SLM baselines, Menta achieves an average improvement of 15.2\% across tasks covering depression, stress, and suicidality compared with the best-performing non--fine-tuned SLMs. It also achieves higher accuracy on depression and stress classification tasks compared to 13B-parameter LLMs, while being approximately 3.25x smaller. Moreover, we demonstrate real-time, on-device deployment of Menta on an iPhone 15 Pro Max, requiring only approximately 3GB RAM. Supported by a comprehensive benchmark against existing SLMs and LLMs, Menta highlights the potential for scalable, privacy-preserving mental health monitoring. Code is available at: https://xxue752-nz.github.io/menta-project/

Users of social platforms often perceive these sites as supportive spaces to post about their mental health issues. Those conversations contain important traces about individuals' health risks. Recently, researchers have exploited this online information to construct mental health detection models, which aim to identify users at risk on platforms like Twitter, Reddit or Facebook. Most of these models are centred on achieving good classification results, ignoring the explainability and interpretability of the decisions. Recent research has pointed out the importance of using clinical markers, such as the use of symptoms, to improve trust in the computational models by health professionals. In this paper, we propose using transformer-based architectures to detect and explain the appearance of depressive symptom markers in the users' writings. We present two approaches: i) train a model to classify, and another one to explain the classifier's decision separately and ii) unify the two tasks simultaneously using a single model. Additionally, for this latter manner, we also investigated the performance of recent conversational LLMs when using in-context learning. Our natural language explanations enable clinicians to interpret the models' decisions based on validated symptoms, enhancing trust in the automated process. We evaluate our approach using recent symptom-based datasets, employing both offline and expert-in-the-loop metrics to assess the quality of the explanations generated by our models. The experimental results show that it is possible to achieve good classification results while generating interpretable symptom-based explanations.

Large Language Models (LLMs) are increasingly utilized for mental health support; however, current safety benchmarks often fail to detect the complex, longitudinal risks inherent in therapeutic dialogue. We introduce an evaluation framework that pairs AI psychotherapists with simulated patient agents equipped with dynamic cognitive-affective models and assesses therapy session simulations against a comprehensive quality of care and risk ontology. We apply this framework to a high-impact test case, Alcohol Use Disorder, evaluating six AI agents (including ChatGPT, Gemini, and Character.AI) against a clinically-validated cohort of 15 patient personas representing diverse clinical phenotypes. Our large-scale simulation (N=369 sessions) reveals critical safety gaps in the use of AI for mental health support. We identify specific iatrogenic risks, including the validation of patient delusions ("AI Psychosis") and failure to de-escalate suicide risk. Finally, we validate an interactive data visualization dashboard with diverse stakeholders, including AI engineers and red teamers, mental health professionals, and policy experts (N=9), demonstrating that this framework effectively enables stakeholders to audit the "black box" of AI psychotherapy. These findings underscore the critical safety risks of AI-provided mental health support and the necessity of simulation-based clinical red teaming before deployment.

Left-behind children (LBCs), numbering over 66 million in China, face severe mental health challenges due to parental migration for work. Early screening and identification of at-risk LBCs is crucial, yet challenging due to the severe shortage of mental health professionals, especially in rural areas. While the House-Tree-Person (HTP) test shows higher child participation rates, its requirement for expert interpretation limits its application in resource-scarce regions. To address this challenge, we propose PsyDraw, a multi-agent system based on Multimodal Large Language Models that assists mental health professionals in analyzing HTP drawings. The system employs specialized agents for feature extraction and psychological interpretation, operating in two stages: comprehensive feature analysis and professional report generation. Evaluation of HTP drawings from 290 primary school students reveals that 71.03% of the analyzes achieved High Consistency with professional evaluations, 26.21% Moderate Consistency and only 2.41% Low Consistency. The system identified 31.03% of cases requiring professional attention, demonstrating its effectiveness as a preliminary screening tool. Currently deployed in pilot schools, \method shows promise in supporting mental health professionals, particularly in resource-limited areas, while maintaining high professional standards in psychological assessment.

Objective: This study aims to develop and validate an evaluation framework to ensure the safety and reliability of mental health chatbots, which are increasingly popular due to their accessibility, human-like interactions, and context-aware support. Materials and Methods: We created an evaluation framework with 100 benchmark questions and ideal responses, and five guideline questions for chatbot responses. This framework, validated by mental health experts, was tested on a GPT-3.5-turbo-based chatbot. Automated evaluation methods explored included large language model (LLM)-based scoring, an agentic approach using real-time data, and embedding models to compare chatbot responses against ground truth standards. Results: The results highlight the importance of guidelines and ground truth for improving LLM evaluation accuracy. The agentic method, dynamically accessing reliable information, demonstrated the best alignment with human assessments. Adherence to a standardized, expert-validated framework significantly enhanced chatbot response safety and reliability. Discussion: Our findings emphasize the need for comprehensive, expert-tailored safety evaluation metrics for mental health chatbots. While LLMs have significant potential, careful implementation is necessary to mitigate risks. The superior performance of the agentic approach underscores the importance of real-time data access in enhancing chatbot reliability. Conclusion: The study validated an evaluation framework for mental health chatbots, proving its effectiveness in improving safety and reliability. Future work should extend evaluations to accuracy, bias, empathy, and privacy to ensure holistic assessment and responsible integration into healthcare. Standardized evaluations will build trust among users and professionals, facilitating broader adoption and improved mental health support through technology.

With the increasing prevalence of mental health conditions worldwide, AI-powered chatbots and conversational agents have emerged as accessible tools to support mental health. However, deploying Large Language Models (LLMs) in mental healthcare applications raises significant privacy concerns, especially regarding regulations like HIPAA and GDPR. In this work, we propose FedMentalCare, a privacy-preserving framework that leverages Federated Learning (FL) combined with Low-Rank Adaptation (LoRA) to fine-tune LLMs for mental health analysis. We investigate the performance impact of varying client data volumes and model architectures (e.g., MobileBERT and MiniLM) in FL environments. Our framework demonstrates a scalable, privacy-aware approach for deploying LLMs in real-world mental healthcare scenarios, addressing data security and computational efficiency challenges.

This paper presents ChatCounselor, a large language model (LLM) solution designed to provide mental health support. Unlike generic chatbots, ChatCounselor is distinguished by its foundation in real conversations between consulting clients and professional psychologists, enabling it to possess specialized knowledge and counseling skills in the field of psychology. The training dataset, Psych8k, was constructed from 260 in-depth interviews, each spanning an hour. To assess the quality of counseling responses, the counseling Bench was devised. Leveraging GPT-4 and meticulously crafted prompts based on seven metrics of psychological counseling assessment, the model underwent evaluation using a set of real-world counseling questions. Impressively, ChatCounselor surpasses existing open-source models in the counseling Bench and approaches the performance level of ChatGPT, showcasing the remarkable enhancement in model capability attained through high-quality domain-specific data.

In recent years, there is strong emphasis on mining medical data using machine learning techniques. A common problem is to obtain a noiseless set of textual documents, with a relevant content for the research question, and developing a Question Answering (QA) model for a specific medical field. The purpose of this paper is to present a new methodology for building a medical dataset and obtain a QA model for analysis of symptoms and impact on daily life for a specific disease domain. The ``Mental Health'' forum was used, a forum dedicated to people suffering from schizophrenia and different mental disorders. Relevant posts of active users, who regularly participate, were extrapolated providing a new method of obtaining low-bias content and without privacy issues. Furthermore, it is shown how to pre-process the dataset to convert it into a QA dataset. The Bidirectional Encoder Representations from Transformers (BERT), DistilBERT, RoBERTa, and BioBERT models were fine-tuned and evaluated via F1-Score, Exact Match, Precision and Recall. Accurate empirical experiments demonstrated the effectiveness of the proposed method for obtaining an accurate dataset for QA model implementation. By fine-tuning the BioBERT QA model, we achieved an F1 score of 0.885, showing a considerable improvement and outperforming the state-of-the-art model for mental disorders domain.

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

Mental distress like depression and anxiety contribute to the largest proportion of the global burden of diseases. Automated diagnosis systems of such disorders, empowered by recent innovations in Artificial Intelligence, can pave the way to reduce the sufferings of the affected individuals. Development of such systems requires information-rich and balanced corpora. In this work, we introduce a novel mental distress analysis audio dataset DEPAC, labeled based on established thresholds on depression and anxiety standard screening tools. This large dataset comprises multiple speech tasks per individual, as well as relevant demographic information. Alongside, we present a feature set consisting of hand-curated acoustic and linguistic features, which were found effective in identifying signs of mental illnesses in human speech. Finally, we justify the quality and effectiveness of our proposed audio corpus and feature set in predicting depression severity by comparing the performance of baseline machine learning models built on this dataset with baseline models trained on other well-known depression corpora.

Limited access to mental healthcare, extended wait times, and increasing capabilities of Large Language Models (LLMs) has led individuals to turn to LLMs for fulfilling their mental health needs. However, examining the multi-turn mental health conversation capabilities of LLMs remains under-explored. Existing evaluation frameworks typically focus on diagnostic accuracy and win-rates and often overlook alignment with patient-specific goals, values, and personalities required for meaningful conversations. To address this, we introduce MedAgent, a novel framework for synthetically generating realistic, multi-turn mental health sensemaking conversations and use it to create the Mental Health Sensemaking Dialogue (MHSD) dataset, comprising over 2,200 patient-LLM conversations. Additionally, we present MultiSenseEval, a holistic framework to evaluate the multi-turn conversation abilities of LLMs in healthcare settings using human-centric criteria. Our findings reveal that frontier reasoning models yield below-par performance for patient-centric communication and struggle at advanced diagnostic capabilities with average score of 31%. Additionally, we observed variation in model performance based on patient's persona and performance drop with increasing turns in the conversation. Our work provides a comprehensive synthetic data generation framework, a dataset and evaluation framework for assessing LLMs in multi-turn mental health conversations.

The classification of mental health is challenging for a variety of reasons. For one, there is overlap between the mental health issues. In addition, the signs of mental health issues depend on the context of the situation, making classification difficult. Although fine-tuning transformers has improved the performance for mental health classification, standard cross-entropy training tends to create entangled feature spaces and fails to utilize all the information the transformers contain. We present a new framework that focuses on representations to improve mental health classification. This is done using two methods. First, layer-attentive residual aggregation which works on residual connections to to weigh and fuse representations from all transformer layers while maintaining high-level semantics. Second, supervised contrastive feature learning uses temperature-scaled supervised contrastive learning with progressive weighting to increase the geometric margin between confusable mental health problems and decrease class overlap by restructuring the feature space. With a score of 74.36\%, the proposed method is the best performing on the SWMH benchmark and outperforms models that are domain-specialized, such as MentalBERT and MentalRoBERTa by margins of (3.25\% - 2.2\%) and 2.41 recall points over the highest achieving model. These findings show that domain-adaptive pretraining for mental health text classification can be surpassed by carefully designed representation geometry and layer-aware residual integration, which also provide enhanced interpretability through learnt layer importance.

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.

Mental health is a critical issue in modern society, and mental disorders could sometimes turn to suicidal ideation without adequate treatment. Early detection of mental disorders and suicidal ideation from social content provides a potential way for effective social intervention. Recent advances in pretrained contextualized language representations have promoted the development of several domain-specific pretrained models and facilitated several downstream applications. However, there are no existing pretrained language models for mental healthcare. This paper trains and release two pretrained masked language models, i.e., MentalBERT and MentalRoBERTa, to benefit machine learning for the mental healthcare research community. Besides, we evaluate our trained domain-specific models and several variants of pretrained language models on several mental disorder detection benchmarks and demonstrate that language representations pretrained in the target domain improve the performance of mental health detection tasks.

Mental health is a significant and growing public health concern. As language usage can be leveraged to obtain crucial insights into mental health conditions, there is a need for large-scale, labeled, mental health-related datasets of users who have been diagnosed with one or more of such conditions. In this paper, we investigate the creation of high-precision patterns to identify self-reported diagnoses of nine different mental health conditions, and obtain high-quality labeled data without the need for manual labelling. We introduce the SMHD (Self-reported Mental Health Diagnoses) dataset and make it available. SMHD is a novel large dataset of social media posts from users with one or multiple mental health conditions along with matched control users. We examine distinctions in users' language, as measured by linguistic and psychological variables. We further explore text classification methods to identify individuals with mental conditions through their language.

Mental health remains a challenging problem all over the world, with issues like depression, anxiety becoming increasingly common. Large Language Models (LLMs) have seen a vast application in healthcare, specifically in answering medical questions. However, there is a lack of standard benchmarking datasets for question answering (QA) in mental health. Our work presents a novel multiple choice dataset, MHQA (Mental Health Question Answering), for benchmarking Language models (LMs). Previous mental health datasets have focused primarily on text classification into specific labels or disorders. MHQA, on the other hand, presents question-answering for mental health focused on four key domains: anxiety, depression, trauma, and obsessive/compulsive issues, with diverse question types, namely, factoid, diagnostic, prognostic, and preventive. We use PubMed abstracts as the primary source for QA. We develop a rigorous pipeline for LLM-based identification of information from abstracts based on various selection criteria and converting it into QA pairs. Further, valid QA pairs are extracted based on post-hoc validation criteria. Overall, our MHQA dataset consists of 2,475 expert-verified gold standard instances called MHQA-gold and ~56.1k pairs pseudo labeled using external medical references. We report F1 scores on different LLMs along with few-shot and supervised fine-tuning experiments, further discussing the insights for the scores.

We introduce MentalChat16K, an English benchmark dataset combining a synthetic mental health counseling dataset and a dataset of anonymized transcripts from interventions between Behavioral Health Coaches and Caregivers of patients in palliative or hospice care. Covering a diverse range of conditions like depression, anxiety, and grief, this curated dataset is designed to facilitate the development and evaluation of large language models for conversational mental health assistance. By providing a high-quality resource tailored to this critical domain, MentalChat16K aims to advance research on empathetic, personalized AI solutions to improve access to mental health support services. The dataset prioritizes patient privacy, ethical considerations, and responsible data usage. MentalChat16K presents a valuable opportunity for the research community to innovate AI technologies that can positively impact mental well-being. The dataset is available at https://huggingface.co/datasets/ShenLab/MentalChat16K and the code and documentation are hosted on GitHub at https://github.com/ChiaPatricia/MentalChat16K.

The recent advancements in artificial intelligence highlight the potential of language models in psychological health support. While models trained on data from mental health service platform have achieved preliminary success, challenges persist in areas such as data scarcity, quality, and ensuring a solid foundation in psychological techniques. To address these challenges, this study introduces a novel approach to enhance the precision and efficacy of psychological support through large language models. Specifically, we design a specific prompt derived from principles of Cognitive Behavioral Therapy (CBT) and have generated the CBT QA dataset, specifically for Chinese psychological health Q&A based on CBT structured intervention strategies. Unlike previous methods, our dataset emphasizes professional and structured response. Utilizing this dataset, we fine-tuned the large language model, giving birth to CBT-LLM, the large-scale language model specifically designed for Cognitive Behavioral Therapy techniques. Empirical evaluations demonstrate that CBT-LLM excels in generating structured, professional, and highly relevant responses in psychological health support tasks, showcasing its practicality and quality. The model is available on Hugging Face: https://huggingface.co/Hongbin37/CBT-LLM.

The latest large language models (LLMs) such as ChatGPT, exhibit strong capabilities in automated mental health analysis. However, existing relevant studies bear several limitations, including inadequate evaluations, lack of prompting strategies, and ignorance of exploring LLMs for explainability. To bridge these gaps, we comprehensively evaluate the mental health analysis and emotional reasoning ability of LLMs on 11 datasets across 5 tasks. We explore the effects of different prompting strategies with unsupervised and distantly supervised emotional information. Based on these prompts, we explore LLMs for interpretable mental health analysis by instructing them to generate explanations for each of their decisions. We convey strict human evaluations to assess the quality of the generated explanations, leading to a novel dataset with 163 human-assessed explanations. We benchmark existing automatic evaluation metrics on this dataset to guide future related works. According to the results, ChatGPT shows strong in-context learning ability but still has a significant gap with advanced task-specific methods. Careful prompt engineering with emotional cues and expert-written few-shot examples can also effectively improve performance on mental health analysis. In addition, ChatGPT generates explanations that approach human performance, showing its great potential in explainable mental health analysis.

Simulating human clients in mental health counseling is crucial for training and evaluating counselors (both human or simulated) in a scalable manner. Nevertheless, past research on client simulation did not focus on complex conversation tasks such as mental health counseling. In these tasks, the challenge is to ensure that the client's actions (i.e., interactions with the counselor) are consistent with with its stipulated profiles and negative behavior settings. In this paper, we propose a novel framework that supports consistent client simulation for mental health counseling. Our framework tracks the mental state of a simulated client, controls its state transitions, and generates for each state behaviors consistent with the client's motivation, beliefs, preferred plan to change, and receptivity. By varying the client profile and receptivity, we demonstrate that consistent simulated clients for different counseling scenarios can be effectively created. Both our automatic and expert evaluations on the generated counseling sessions also show that our client simulation method achieves higher consistency than previous methods.

Mental health has attracted substantial attention in recent years and LLM can be an effective technology for alleviating this problem owing to its capability in text understanding and dialogue. However, existing research in this domain often suffers from limitations, such as training on datasets lacking crucial prior knowledge and evidence, and the absence of comprehensive evaluation methods. In this paper, we propose a specialized psychological large language model (LLM), named PsycoLLM, trained on a proposed high-quality psychological dataset, including single-turn QA, multi-turn dialogues enriched with prior knowledge and knowledge-based QA. Additionally, to compare the performance of PsycoLLM with other LLMs, we develop a comprehensive psychological benchmark based on authoritative psychological counseling examinations in China, which includes assessments of professional ethics, theoretical proficiency, and case analysis. The experimental results on the benchmark illustrates the effectiveness of PsycoLLM, which demonstrates superior performance compared to other LLMs.

Language Models (LMs) are being proposed for mental health applications where the heightened risk of adverse outcomes means predictive performance may not be a sufficient litmus test of a model's utility in clinical practice. A model that can be trusted for practice should have a correspondence between explanation and clinical determination, yet no prior research has examined the attention fidelity of these models and their effect on ground truth explanations. We introduce an evaluation design that focuses on the robustness and explainability of LMs in identifying Wellness Dimensions (WDs). We focus on two existing mental health and well-being datasets: (a) Multi-label Classification-based MultiWD, and (b) WellXplain for evaluating attention mechanism veracity against expert-labeled explanations. The labels are based on Halbert Dunn's theory of wellness, which gives grounding to our evaluation. We reveal four surprising results about LMs/LLMs: (1) Despite their human-like capabilities, GPT-3.5/4 lag behind RoBERTa, and MedAlpaca, a fine-tuned LLM on WellXplain fails to deliver any remarkable improvements in performance or explanations. (2) Re-examining LMs' predictions based on a confidence-oriented loss function reveals a significant performance drop. (3) Across all LMs/LLMs, the alignment between attention and explanations remains low, with LLMs scoring a dismal 0.0. (4) Most mental health-specific LMs/LLMs overlook domain-specific knowledge and undervalue explanations, causing these discrepancies. This study highlights the need for further research into their consistency and explanations in mental health and well-being.

Wider access to therapeutic care is one of the biggest challenges in mental health treatment. Due to institutional barriers, some people seeking mental health support have turned to large language models (LLMs) for personalized therapy, even though these models are largely unsanctioned and untested. We investigate the potential and limitations of using LLMs as providers of evidence-based therapy by using mixed methods clinical metrics. Using HELPERT, a prompt run on a large language model using the same process and training as a comparative group of peer counselors, we replicated publicly accessible mental health conversations rooted in Cognitive Behavioral Therapy (CBT) to compare session dynamics and counselor's CBT-based behaviors between original peer support sessions and their reconstructed HELPERT sessions. Two licensed, CBT-trained clinical psychologists evaluated the sessions using the Cognitive Therapy Rating Scale and provided qualitative feedback. Our findings show that the peer sessions are characterized by empathy, small talk, therapeutic alliance, and shared experiences but often exhibit therapist drift. Conversely, HELPERT reconstructed sessions exhibit minimal therapist drift and higher adherence to CBT methods but display a lack of collaboration, empathy, and cultural understanding. Through CTRS ratings and psychologists' feedback, we highlight the importance of human-AI collaboration for scalable mental health. Our work outlines the ethical implication of imparting human-like subjective qualities to LLMs in therapeutic settings, particularly the risk of deceptive empathy, which may lead to unrealistic patient expectations and potential harm.

Large language models (LLMs) hold significant potential for mental health support, capable of generating empathetic responses and simulating therapeutic conversations. However, existing LLM-based approaches often lack the clinical grounding necessary for real-world psychological counseling, particularly in explicit diagnostic reasoning aligned with standards like the DSM/ICD and incorporating diverse therapeutic modalities beyond basic empathy or single strategies. To address these critical limitations, we propose PsyLLM, the first large language model designed to systematically integrate both diagnostic and therapeutic reasoning for mental health counseling. To develop the PsyLLM, we propose a novel automated data synthesis pipeline. This pipeline processes real-world mental health posts, generates multi-turn dialogue structures, and leverages LLMs guided by international diagnostic standards (e.g., DSM/ICD) and multiple therapeutic frameworks (e.g., CBT, ACT, psychodynamic) to simulate detailed clinical reasoning processes. Rigorous multi-dimensional filtering ensures the generation of high-quality, clinically aligned dialogue data. In addition, we introduce a new benchmark and evaluation protocol, assessing counseling quality across four key dimensions: comprehensiveness, professionalism, authenticity, and safety. Our experiments demonstrate that PsyLLM significantly outperforms state-of-the-art baseline models on this benchmark.

Purpose. We present an approach for forecasting mental health conditions and emotions of a given population during the COVID-19 pandemic in Argentina based on language expressions used in social media. This approach permits anticipating high prevalence periods in short- to medium-term time horizons. Design. Mental health conditions and emotions are captured via markers, which link social media contents with lexicons. First, we build descriptive timelines for decision makers to monitor the evolution of markers, and their correlation with crisis events. Second, we model the timelines as time series, and support their forecasting, which in turn serve to identify high prevalence points for the estimated markers. Findings. Results showed that different time series forecasting strategies offer different capabilities. In the best scenario, the emergence of high prevalence periods of emotions and mental health disorders can be satisfactorily predicted with a neural network strategy, even when limited data is available in early stages of a crisis (e.g., 7 days). Originality. Although there have been efforts in the literature to predict mental states of individuals, the analysis of mental health at the collective level has received scarce attention. We take a step forward by proposing a forecasting approach for analyzing the mental health of a given population (or group of individuals) at a larger scale. Practical implications. We believe that this work contributes to a better understanding of how psychological processes related to crisis manifest in social media, being a valuable asset for the design, implementation and monitoring of health prevention and communication policies.

Great research interests have been attracted to devise AI services that are able to provide mental health support. However, the lack of corpora is a main obstacle to this research, particularly in Chinese language. In this paper, we propose PsyQA, a Chinese dataset of psychological health support in the form of question and answer pair. PsyQA is crawled from a Chinese mental health service platform, and contains 22K questions and 56K long and well-structured answers. Based on the psychological counseling theories, we annotate a portion of answer texts with typical strategies for providing support, and further present in-depth analysis of both lexical features and strategy patterns in the counseling answers. We also evaluate the performance of generating counseling answers with the generative pretrained models. Results show that utilizing strategies enhances the fluency and helpfulness of generated answers, but there is still a large space for future research.

Emotional support dialogue systems aim to reduce help-seekers' distress and help them overcome challenges. While human valuesx2013core beliefs that shape an individual's prioritiesx2013are increasingly emphasized in contemporary psychological therapy for their role in fostering internal transformation and long-term emotional well-being, their integration into emotional support systems remains underexplored. To bridge this gap, we present a value-driven method for training emotional support dialogue systems designed to reinforce positive values in seekers. Notably, our model identifies which values to reinforce at each turn and how to do so, by leveraging online support conversations from Reddit. We evaluate the method across support skills, seekers' emotional intensity, and value reinforcement. Our method consistently outperforms various baselines, effectively exploring and eliciting values from seekers. Additionally, leveraging crowd knowledge from Reddit significantly enhances its effectiveness. Therapists highlighted its ability to validate seekers' challenges and emphasize positive aspects of their situationsx2013both crucial elements of value reinforcement. Our work, being the first to integrate value reinforcement into emotional support systems, demonstrates its promise and establishes a foundation for future research.

As mental health care systems worldwide struggle to meet demand, there is increasing focus on using language models to infer neuropsychiatric conditions or psychopathological traits from language production. Yet, so far, this research has only delivered solutions with limited clinical applicability, due to insufficient consideration of ethical questions crucial to ensuring the synergy between possible applications and model design. To accelerate progress towards clinically applicable models, our paper charts the ethical landscape of research on language-based inference of psychopathology and provides a practical tool for researchers to navigate it. We identify seven core ethical principles that should guide model development and deployment in this domain, translate them into ELLIPS, an ethical toolkit operationalizing these principles into questions that can guide researchers' choices with respect to data selection, architectures, evaluation, and model deployment, and provide a case study exemplifying its use. With this, we aim to facilitate the emergence of model technology with concrete potential for real-world applicability.

The rapid evolution of Large Language Models (LLMs) offers promising potential to alleviate the global scarcity of mental health professionals. However, LLMs' alignment with essential mental health counseling competencies remains understudied. We introduce CounselingBench, a novel NCMHCE-based benchmark evaluating LLMs across five key mental health counseling competencies. Testing 22 general-purpose and medical-finetuned LLMs, we find frontier models exceed minimum thresholds but fall short of expert-level performance, with significant variations: they excel in Intake, Assessment & Diagnosis yet struggle with Core Counseling Attributes and Professional Practice & Ethics. Medical LLMs surprisingly underperform generalist models accuracy-wise, while at the same time producing slightly higher-quality justifications but making more context-related errors. Our findings highlight the complexities of developing AI systems for mental health counseling, particularly for competencies requiring empathy and contextual understanding. We found that frontier LLMs perform at a level exceeding the minimal required level of aptitude for all key mental health counseling competencies, but fall short of expert-level performance, and that current medical LLMs do not significantly improve upon generalist models in mental health counseling competencies. This underscores the critical need for specialized, mental health counseling-specific fine-tuned LLMs that rigorously aligns with core competencies combined with appropriate human supervision before any responsible real-world deployment can be considered.

As the prevalence of mental health challenges, social media has emerged as a key platform for individuals to express their emotions.Deep learning tends to be a promising solution for analyzing mental health on social media. However, black box models are often inflexible when switching between tasks, and their results typically lack explanations. With the rise of large language models (LLMs), their flexibility has introduced new approaches to the field. Also due to the generative nature, they can be prompted to explain decision-making processes. However, their performance on complex psychological analysis still lags behind deep learning. In this paper, we introduce the first multi-task Chinese Social Media Interpretable Mental Health Instructions (C-IMHI) dataset, consisting of 9K samples, which has been quality-controlled and manually validated. We also propose MentalGLM series models, the first open-source LLMs designed for explainable mental health analysis targeting Chinese social media, trained on a corpus of 50K instructions. The proposed models were evaluated on three downstream tasks and achieved better or comparable performance compared to deep learning models, generalized LLMs, and task fine-tuned LLMs. We validated a portion of the generated decision explanations with experts, showing promising results. We also evaluated the proposed models on a clinical dataset, where they outperformed other LLMs, indicating their potential applicability in the clinical field. Our models show strong performance, validated across tasks and perspectives. The decision explanations enhance usability and facilitate better understanding and practical application of the models. Both the constructed dataset and the models are publicly available via: https://github.com/zwzzzQAQ/MentalGLM.

Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.

The early detection of mental health disorders from social media text is critical for enabling timely support, risk assessment, and referral to appropriate resources. This work introduces multiMentalRoBERTa, a fine-tuned RoBERTa model designed for multiclass classification of common mental health conditions, including stress, anxiety, depression, post-traumatic stress disorder (PTSD), suicidal ideation, and neutral discourse. Drawing on multiple curated datasets, data exploration is conducted to analyze class overlaps, revealing strong correlations between depression and suicidal ideation as well as anxiety and PTSD, while stress emerges as a broad, overlapping category. Comparative experiments with traditional machine learning methods, domain-specific transformers, and prompting-based large language models demonstrate that multiMentalRoBERTa achieves superior performance, with macro F1-scores of 0.839 in the six-class setup and 0.870 in the five-class setup (excluding stress), outperforming both fine-tuned MentalBERT and baseline classifiers. Beyond predictive accuracy, explainability methods, including Layer Integrated Gradients and KeyBERT, are applied to identify lexical cues that drive classification, with a particular focus on distinguishing depression from suicidal ideation. The findings emphasize the effectiveness of fine-tuned transformers for reliable and interpretable detection in sensitive contexts, while also underscoring the importance of fairness, bias mitigation, and human-in-the-loop safety protocols. Overall, multiMentalRoBERTa is presented as a lightweight, robust, and deployable solution for enhancing support in mental health platforms.

Empathy is critical for effective mental health support, especially when addressing Long Counseling Texts (LCTs). However, existing Large Language Models (LLMs) often generate replies that are semantically fluent but lack the structured reasoning necessary for genuine psychological support, particularly in a Chinese context. To bridge this gap, we introduce Empathy-R1, a novel framework that integrates a Chain-of-Empathy (CoE) reasoning process with Reinforcement Learning (RL) to enhance response quality for LCTs. Inspired by cognitive-behavioral therapy, our CoE paradigm guides the model to sequentially reason about a help-seeker's emotions, causes, and intentions, making its thinking process both transparent and interpretable. Our framework is empowered by a new large-scale Chinese dataset, Empathy-QA, and a two-stage training process. First, Supervised Fine-Tuning instills the CoE's reasoning structure. Subsequently, RL, guided by a dedicated reward model, refines the therapeutic relevance and contextual appropriateness of the final responses. Experiments show that Empathy-R1 achieves strong performance on key automatic metrics. More importantly, human evaluations confirm its superiority, showing a clear preference over strong baselines and achieving a Win@1 rate of 44.30% on our new benchmark. By enabling interpretable and contextually nuanced responses, Empathy-R1 represents a significant advancement in developing responsible and genuinely beneficial AI for mental health support.

The delayed access to specialized psychiatric assessments and care for patients at risk of suicidal tendencies in emergency departments creates a notable gap in timely intervention, hindering the provision of adequate mental health support during critical situations. To address this, we present a non-invasive, speech-based approach for automatic suicide risk assessment. For our study, we have collected a novel dataset of speech recordings from 20 patients from which we extract three sets of features, including wav2vec, interpretable speech and acoustic features, and deep learning-based spectral representations. We proceed by conducting a binary classification to assess suicide risk in a leave-one-subject-out fashion. Our most effective speech model achieves a balanced accuracy of 66.2,%. Moreover, we show that integrating our speech model with a series of patients' metadata, such as the history of suicide attempts or access to firearms, improves the overall result. The metadata integration yields a balanced accuracy of 94.4,%, marking an absolute improvement of 28.2,%, demonstrating the efficacy of our proposed approaches for automatic suicide risk assessment in emergency medicine.

In mental health counseling, a variety of earlier studies have focused on dialogue modeling. However, most of these studies give limited to no emphasis on the quality of interaction between a patient and a therapist. The therapeutic bond between a patient and a therapist directly correlates with effective mental health counseling. It involves developing the patient's trust on the therapist over the course of counseling. To assess the therapeutic bond in counseling, we introduce trust as a therapist-assistive metric. Our definition of trust involves patients' willingness and openness to express themselves and, consequently, receive better care. We conceptualize it as a dynamic trajectory observable through textual interactions during the counseling. To facilitate trust modeling, we present MENTAL-TRUST, a novel counseling dataset comprising manual annotation of 212 counseling sessions with first-of-its-kind seven expert-verified ordinal trust levels. We project our problem statement as an ordinal classification task for trust quantification and propose a new benchmark, TrustBench, comprising a suite of classical and state-of-the-art language models on MENTAL-TRUST. We evaluate the performance across a suite of metrics and lay out an exhaustive set of findings. Our study aims to unfold how trust evolves in therapeutic interactions.

Large Language Models (LLMs) have shown promise in various domains, including healthcare, with significant potential to transform mental health applications by enabling scalable and accessible solutions. This study aims to provide a comprehensive evaluation of 33 LLMs, ranging from 2 billion to 405+ billion parameters, in performing key mental health tasks using social media data across six datasets. To our knowledge, this represents the largest-scale systematic evaluation of modern LLMs for mental health applications. Models such as GPT-4, Llama 3, Claude, Gemma, Gemini, and Phi-3 were assessed for their zero-shot (ZS) and few-shot (FS) capabilities across three tasks: binary disorder detection, disorder severity evaluation, and psychiatric knowledge assessment. Key findings revealed that models like GPT-4 and Llama 3 exhibited superior performance in binary disorder detection, achieving accuracies up to 85% on certain datasets, while FS learning notably enhanced disorder severity evaluations, reducing the Mean Absolute Error (MAE) by 1.3 points for the Phi-3-mini model. Recent models, such as Llama 3.1 405b, demonstrated exceptional psychiatric knowledge assessment accuracy at 91.2%, while prompt engineering played a crucial role in improving performance across tasks. However, the ethical constraints imposed by many LLM providers limit their ability to respond to sensitive queries, hampering comprehensive performance evaluations. This work highlights both the capabilities and limitations of LLMs in mental health contexts, offering valuable insights for future applications in psychiatry.

The development of AI for mental health is hindered by a lack of authentic therapy dialogues, due to strict privacy regulations and the fact that clinical sessions were historically rarely recorded. We present an LLM-driven pipeline that generates synthetic counseling dialogues based on structured client profiles and psychological questionnaires. Grounded on the principles of Cognitive Behavioral Therapy (CBT), our method creates synthetic therapeutic conversations for clinical disorders such as anxiety and depression. Our framework, SQPsych (Structured Questionnaire-based Psychotherapy), converts structured psychological input into natural language dialogues through therapist-client simulations. Due to data governance policies and privacy restrictions prohibiting the transmission of clinical questionnaire data to third-party services, previous methodologies relying on proprietary models are infeasible in our setting. We address this limitation by generating a high-quality corpus using open-weight LLMs, validated through human expert evaluation and LLM-based assessments. Our SQPsychLLM models fine-tuned on SQPsychConv achieve strong performance on counseling benchmarks, surpassing baselines in key therapeutic skills. Our findings highlight the potential of synthetic data to enable scalable, data-secure, and clinically informed AI for mental health support. We will release our code, models, and corpus at https://ai-mh.github.io/SQPsych

Should a large language model (LLM) be used as a therapist? In this paper, we investigate the use of LLMs to *replace* mental health providers, a use case promoted in the tech startup and research space. We conduct a mapping review of therapy guides used by major medical institutions to identify crucial aspects of therapeutic relationships, such as the importance of a therapeutic alliance between therapist and client. We then assess the ability of LLMs to reproduce and adhere to these aspects of therapeutic relationships by conducting several experiments investigating the responses of current LLMs, such as `gpt-4o`. Contrary to best practices in the medical community, LLMs 1) express stigma toward those with mental health conditions and 2) respond inappropriately to certain common (and critical) conditions in naturalistic therapy settings -- e.g., LLMs encourage clients' delusional thinking, likely due to their sycophancy. This occurs even with larger and newer LLMs, indicating that current safety practices may not address these gaps. Furthermore, we note foundational and practical barriers to the adoption of LLMs as therapists, such as that a therapeutic alliance requires human characteristics (e.g., identity and stakes). For these reasons, we conclude that LLMs should not replace therapists, and we discuss alternative roles for LLMs in clinical therapy.

In this paper, we propose Evebot, an innovative, sequence to sequence (Seq2seq) based, fully generative conversational system for the diagnosis of negative emotions and prevention of depression through positively suggestive responses. The system consists of an assembly of deep-learning based models, including Bi-LSTM based model for detecting negative emotions of users and obtaining psychological counselling related corpus for training the chatbot, anti-language sequence to sequence neural network, and maximum mutual information (MMI) model. As adolescents are reluctant to show their negative emotions in physical interaction, traditional methods of emotion analysis and comforting methods may not work. Therefore, this system puts emphasis on using virtual platform to detect signs of depression or anxiety, channel adolescents' stress and mood, and thus prevent the emergence of mental illness. We launched the integrated chatbot system onto an online platform for real-world campus applications. Through a one-month user study, we observe better results in the increase in positivity than other public chatbots in the control group.

As generative artificial intelligence (GAI) enters the mental health landscape, questions arise about how individuals weigh AI tools against human therapists. Drawing on the Health Belief Model (HBM), this study examined belief-based predictors of intention to use GAI and therapists across two populations: a university sample (N = 1,155) and a nationally representative adult sample (N = 651). Using repeated-measures ANOVA and LASSO regression, we found that therapists were consistently valued for emotional, relational, and personalization benefits, while GAI was favored for accessibility and affordability. Yet structural advantages alone did not predict adoption; emotional benefit and personalization emerged as decisive factors. Adoption patterns diverged across groups: students treated GAI as a complement, whereas national adults approached it as a substitute. Concerns about privacy and reliability constrained GAI use in both groups. These findings extend HBM to multi-modality contexts and highlight design implications for trustworthy, emotionally resonant digital mental health tools.

Large Language Models (LLMs) have demonstrated potential in predicting mental health outcomes from online text, yet traditional classification methods often lack interpretability and robustness. This study evaluates structured reasoning techniques-Chain-of-Thought (CoT), Self-Consistency (SC-CoT), and Tree-of-Thought (ToT)-to improve classification accuracy across multiple mental health datasets sourced from Reddit. We analyze reasoning-driven prompting strategies, including Zero-shot CoT and Few-shot CoT, using key performance metrics such as Balanced Accuracy, F1 score, and Sensitivity/Specificity. Our findings indicate that reasoning-enhanced techniques improve classification performance over direct prediction, particularly in complex cases. Compared to baselines such as Zero Shot non-CoT Prompting, and fine-tuned pre-trained transformers such as BERT and Mental-RoBerta, and fine-tuned Open Source LLMs such as Mental Alpaca and Mental-Flan-T5, reasoning-driven LLMs yield notable gains on datasets like Dreaddit (+0.52\% over M-LLM, +0.82\% over BERT) and SDCNL (+4.67\% over M-LLM, +2.17\% over BERT). However, performance declines in Depression Severity, and CSSRS predictions suggest dataset-specific limitations, likely due to our using a more extensive test set. Among prompting strategies, Few-shot CoT consistently outperforms others, reinforcing the effectiveness of reasoning-driven LLMs. Nonetheless, dataset variability highlights challenges in model reliability and interpretability. This study provides a comprehensive benchmark of reasoning-based LLM techniques for mental health text classification. It offers insights into their potential for scalable clinical applications while identifying key challenges for future improvements.

The deployment of large language models (LLMs) in mental health and other sensitive domains raises urgent questions about ethical reasoning, fairness, and responsible alignment. Yet, existing benchmarks for moral and clinical decision-making do not adequately capture the unique ethical dilemmas encountered in mental health practice, where confidentiality, autonomy, beneficence, and bias frequently intersect. To address this gap, we introduce Ethical Reasoning in Mental Health (EthicsMH), a pilot dataset of 125 scenarios designed to evaluate how AI systems navigate ethically charged situations in therapeutic and psychiatric contexts. Each scenario is enriched with structured fields, including multiple decision options, expert-aligned reasoning, expected model behavior, real-world impact, and multi-stakeholder viewpoints. This structure enables evaluation not only of decision accuracy but also of explanation quality and alignment with professional norms. Although modest in scale and developed with model-assisted generation, EthicsMH establishes a task framework that bridges AI ethics and mental health decision-making. By releasing this dataset, we aim to provide a seed resource that can be expanded through community and expert contributions, fostering the development of AI systems capable of responsibly handling some of society's most delicate decisions.

Advances in large language models (LLMs) have empowered a variety of applications. However, there is still a significant gap in research when it comes to understanding and enhancing the capabilities of LLMs in the field of mental health. In this work, we present the first comprehensive evaluation of multiple LLMs, including Alpaca, Alpaca-LoRA, FLAN-T5, GPT-3.5, and GPT-4, on various mental health prediction tasks via online text data. We conduct a broad range of experiments, covering zero-shot prompting, few-shot prompting, and instruction fine-tuning. The results indicate a promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for the mental health tasks. More importantly, our experiments show that instruction finetuning can significantly boost the performance of LLMs for all tasks simultaneously. Our best-finetuned models, Mental-Alpaca and Mental-FLAN-T5, outperform the best prompt design of GPT-3.5 (25 and 15 times bigger) by 10.9% on balanced accuracy and the best of GPT-4 (250 and 150 times bigger) by 4.8%. They further perform on par with the state-of-the-art task-specific language model. We also conduct an exploratory case study on LLMs' capability on the mental health reasoning tasks, illustrating the promising capability of certain models such as GPT-4. We summarize our findings into a set of action guidelines for potential methods to enhance LLMs' capability for mental health tasks. Meanwhile, we also emphasize the important limitations before achieving deployability in real-world mental health settings, such as known racial and gender bias. We highlight the important ethical risks accompanying this line of research.

The increasing prevalence of mental health disorders globally highlights the urgent need for effective digital screening methods that can be used in multilingual contexts. Most existing studies, however, focus on English data, overlooking critical mental health signals that may be present in non-English texts. To address this important gap, we present the first survey on the detection of mental health disorders using multilingual social media data. We investigate the cultural nuances that influence online language patterns and self-disclosure behaviors, and how these factors can impact the performance of NLP tools. Additionally, we provide a comprehensive list of multilingual data collections that can be used for developing NLP models for mental health screening. Our findings can inform the design of effective multilingual mental health screening tools that can meet the needs of diverse populations, ultimately improving mental health outcomes on a global scale.

In our modern, fast-paced, and interconnected world, the importance of mental well-being has grown into a matter of great urgency. However, traditional methods such as Emotional Support Conversations (ESC) face challenges in effectively addressing a diverse range of individual personalities. In response, we introduce the Social Support Conversation (S2Conv) framework. It comprises a series of support agents and the interpersonal matching mechanism, linking individuals with persona-compatible virtual supporters. Utilizing persona decomposition based on the MBTI (Myers-Briggs Type Indicator), we have created the MBTI-1024 Bank, a group that of virtual characters with distinct profiles. Through improved role-playing prompts with behavior preset and dynamic memory, we facilitate the development of the MBTI-S2Conv dataset, which contains conversations between the characters in the MBTI-1024 Bank. Building upon these foundations, we present CharacterChat, a comprehensive S2Conv system, which includes a conversational model driven by personas and memories, along with an interpersonal matching plugin model that dispatches the optimal supporters from the MBTI-1024 Bank for individuals with specific personas. Empirical results indicate the remarkable efficacy of CharacterChat in providing personalized social support and highlight the substantial advantages derived from interpersonal matching. The source code is available in https://github.com/morecry/CharacterChat.

People often utilise online media (e.g., Facebook, Reddit) as a platform to express their psychological distress and seek support. State-of-the-art NLP techniques demonstrate strong potential to automatically detect mental health issues from text. Research suggests that mental health issues are reflected in emotions (e.g., sadness) indicated in a person's choice of language. Therefore, we developed a novel emotion-annotated mental health corpus (EmoMent), consisting of 2802 Facebook posts (14845 sentences) extracted from two South Asian countries - Sri Lanka and India. Three clinical psychology postgraduates were involved in annotating these posts into eight categories, including 'mental illness' (e.g., depression) and emotions (e.g., 'sadness', 'anger'). EmoMent corpus achieved 'very good' inter-annotator agreement of 98.3% (i.e. % with two or more agreement) and Fleiss' Kappa of 0.82. Our RoBERTa based models achieved an F1 score of 0.76 and a macro-averaged F1 score of 0.77 for the first task (i.e. predicting a mental health condition from a post) and the second task (i.e. extent of association of relevant posts with the categories defined in our taxonomy), respectively.