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Feb 24

MentalGLM Series: Explainable Large Language Models for Mental Health Analysis on Chinese Social Media

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.

  • 10 authors
·
Oct 14, 2024

Towards Interpretable Mental Health Analysis with Large Language Models

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.

  • 6 authors
·
Apr 6, 2023

A Wearable Device Dataset for Mental Health Assessment Using Laser Doppler Flowmetry and Fluorescence Spectroscopy Sensors

In this study, we introduce a novel method to predict mental health by building machine learning models for a non-invasive wearable device equipped with Laser Doppler Flowmetry (LDF) and Fluorescence Spectroscopy (FS) sensors. Besides, we present the corresponding dataset to predict mental health, e.g. depression, anxiety, and stress levels via the DAS-21 questionnaire. To our best knowledge, this is the world's largest and the most generalized dataset ever collected for both LDF and FS studies. The device captures cutaneous blood microcirculation parameters, and wavelet analysis of the LDF signal extracts key rhythmic oscillations. The dataset, collected from 132 volunteers aged 18-94 from 19 countries, explores relationships between physiological features, demographics, lifestyle habits, and health conditions. We employed a variety of machine learning methods to classify stress detection, in which LightGBM is identified as the most effective model for stress detection, achieving a ROC AUC of 0.7168 and a PR AUC of 0.8852. In addition, we also incorporated Explainable Artificial Intelligence (XAI) techniques into our analysis to investigate deeper insights into the model's predictions. Our results suggest that females, younger individuals and those with a higher Body Mass Index (BMI) or heart rate have a greater likelihood of experiencing mental health conditions like stress and anxiety. All related code and data are published online: https://github.com/leduckhai/Wearable_LDF-FS.

  • 10 authors
·
Feb 2, 2025

MentalLLaMA: Interpretable Mental Health Analysis on Social Media with Large Language Models

With the development of web technology, social media texts are becoming a rich source for automatic mental health analysis. As traditional discriminative methods bear the problem of low interpretability, the recent large language models have been explored for interpretable mental health analysis on social media, which aims to provide detailed explanations along with predictions. The results show that ChatGPT can generate approaching-human explanations for its correct classifications. However, LLMs still achieve unsatisfactory classification performance in a zero-shot/few-shot manner. Domain-specific finetuning is an effective solution, but faces 2 challenges: 1) lack of high-quality training data. 2) no open-source LLMs for interpretable mental health analysis were released to lower the finetuning cost. To alleviate these problems, we build the first multi-task and multi-source interpretable mental health instruction (IMHI) dataset on social media, with 105K data samples. The raw social media data are collected from 10 existing sources covering 8 mental health analysis tasks. We use expert-written few-shot prompts and collected labels to prompt ChatGPT and obtain explanations from its responses. To ensure the reliability of the explanations, we perform strict automatic and human evaluations on the correctness, consistency, and quality of generated data. Based on the IMHI dataset and LLaMA2 foundation models, we train MentalLLaMA, the first open-source LLM series for interpretable mental health analysis with instruction-following capability. We also evaluate the performance of MentalLLaMA on the IMHI evaluation benchmark with 10 test sets, where their correctness for making predictions and the quality of explanations are examined. The results show that MentalLLaMA approaches state-of-the-art discriminative methods in correctness and generates high-quality explanations.

  • 5 authors
·
Sep 24, 2023

Explainable Depression Symptom Detection in Social Media

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.

  • 3 authors
·
Oct 20, 2023

ReDSM5: A Reddit Dataset for DSM-5 Depression Detection

Depression is a pervasive mental health condition that affects hundreds of millions of individuals worldwide, yet many cases remain undiagnosed due to barriers in traditional clinical access and pervasive stigma. Social media platforms, and Reddit in particular, offer rich, user-generated narratives that can reveal early signs of depressive symptomatology. However, existing computational approaches often label entire posts simply as depressed or not depressed, without linking language to specific criteria from the DSM-5, the standard clinical framework for diagnosing depression. This limits both clinical relevance and interpretability. To address this gap, we introduce ReDSM5, a novel Reddit corpus comprising 1484 long-form posts, each exhaustively annotated at the sentence level by a licensed psychologist for the nine DSM-5 depression symptoms. For each label, the annotator also provides a concise clinical rationale grounded in DSM-5 methodology. We conduct an exploratory analysis of the collection, examining lexical, syntactic, and emotional patterns that characterize symptom expression in social media narratives. Compared to prior resources, ReDSM5 uniquely combines symptom-specific supervision with expert explanations, facilitating the development of models that not only detect depression but also generate human-interpretable reasoning. We establish baseline benchmarks for both multi-label symptom classification and explanation generation, providing reference results for future research on detection and interpretability.

  • 3 authors
·
Aug 5, 2025

WellDunn: On the Robustness and Explainability of Language Models and Large Language Models in Identifying Wellness Dimensions

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.

  • 6 authors
·
Jun 17, 2024

MentraSuite: Post-Training Large Language Models for Mental Health Reasoning and Assessment

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.

NextGenWhu CLAIN-WHU
·
Dec 10, 2025 2

Conceptualizing Suicidal Behavior: Utilizing Explanations of Predicted Outcomes to Analyze Longitudinal Social Media Data

The COVID-19 pandemic has escalated mental health crises worldwide, with social isolation and economic instability contributing to a rise in suicidal behavior. Suicide can result from social factors such as shame, abuse, abandonment, and mental health conditions like depression, Post-Traumatic Stress Disorder (PTSD), Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety disorders, and bipolar disorders. As these conditions develop, signs of suicidal ideation may manifest in social media interactions. Analyzing social media data using artificial intelligence (AI) techniques can help identify patterns of suicidal behavior, providing invaluable insights for suicide prevention agencies, professionals, and broader community awareness initiatives. Machine learning algorithms for this purpose require large volumes of accurately labeled data. Previous research has not fully explored the potential of incorporating explanations in analyzing and labeling longitudinal social media data. In this study, we employed a model explanation method, Layer Integrated Gradients, on top of a fine-tuned state-of-the-art language model, to assign each token from Reddit users' posts an attribution score for predicting suicidal ideation. By extracting and analyzing attributions of tokens from the data, we propose a methodology for preliminary screening of social media posts for suicidal ideation without using large language models during inference.

  • 8 authors
·
Dec 13, 2023

multiMentalRoBERTa: A Fine-tuned Multiclass Classifier for Mental Health Disorder

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.

  • 3 authors
·
Oct 31, 2025

Question-Answering Model for Schizophrenia Symptoms and Their Impact on Daily Life using Mental Health Forums 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.

  • 2 authors
·
Sep 30, 2023

From Classification to Clinical Insights: Towards Analyzing and Reasoning About Mobile and Behavioral Health Data With Large Language Models

Passively collected behavioral health data from ubiquitous sensors holds significant promise to provide mental health professionals insights from patient's daily lives; however, developing analysis tools to use this data in clinical practice requires addressing challenges of generalization across devices and weak or ambiguous correlations between the measured signals and an individual's mental health. To address these challenges, we take a novel approach that leverages large language models (LLMs) to synthesize clinically useful insights from multi-sensor data. We develop chain of thought prompting methods that use LLMs to generate reasoning about how trends in data such as step count and sleep relate to conditions like depression and anxiety. We first demonstrate binary depression classification with LLMs achieving accuracies of 61.1% which exceed the state of the art. While it is not robust for clinical use, this leads us to our key finding: even more impactful and valued than classification is a new human-AI collaboration approach in which clinician experts interactively query these tools and combine their domain expertise and context about the patient with AI generated reasoning to support clinical decision-making. We find models like GPT-4 correctly reference numerical data 75% of the time, and clinician participants express strong interest in using this approach to interpret self-tracking data.

  • 10 authors
·
Nov 21, 2023

MHQA: A Diverse, Knowledge Intensive Mental Health Question Answering Challenge for Language Models

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.

  • 7 authors
·
Feb 21, 2025

MHDash: An Online Platform for Benchmarking Mental Health-Aware AI Assistants

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.

  • 6 authors
·
Jan 30

Reasoning Is Not All You Need: Examining LLMs for Multi-Turn Mental Health Conversations

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.

  • 5 authors
·
May 26, 2025

Cognitive-Mental-LLM: Evaluating Reasoning in Large Language Models for Mental Health Prediction via Online Text

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.

  • 2 authors
·
Mar 13, 2025

Mental-LLM: Leveraging Large Language Models for Mental Health Prediction via Online Text Data

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.

  • 9 authors
·
Jul 26, 2023

MentalArena: Self-play Training of Language Models for Diagnosis and Treatment of Mental Health Disorders

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

  • 7 authors
·
Oct 9, 2024 2

Large Language Model for Mental Health: A Systematic Review

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.

  • 6 authors
·
Feb 19, 2024

Menta: A Small Language Model for On-Device Mental Health Prediction

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/

  • 9 authors
·
Dec 2, 2025

Depression Detection and Analysis using Large Language Models on Textual and Audio-Visual Modalities

Depression has proven to be a significant public health issue, profoundly affecting the psychological well-being of individuals. If it remains undiagnosed, depression can lead to severe health issues, which can manifest physically and even lead to suicide. Generally, Diagnosing depression or any other mental disorder involves conducting semi-structured interviews alongside supplementary questionnaires, including variants of the Patient Health Questionnaire (PHQ) by Clinicians and mental health professionals. This approach places significant reliance on the experience and judgment of trained physicians, making the diagnosis susceptible to personal biases. Given that the underlying mechanisms causing depression are still being actively researched, physicians often face challenges in diagnosing and treating the condition, particularly in its early stages of clinical presentation. Recently, significant strides have been made in Artificial neural computing to solve problems involving text, image, and speech in various domains. Our analysis has aimed to leverage these state-of-the-art (SOTA) models in our experiments to achieve optimal outcomes leveraging multiple modalities. The experiments were performed on the Extended Distress Analysis Interview Corpus Wizard of Oz dataset (E-DAIC) corpus presented in the Audio/Visual Emotion Challenge (AVEC) 2019 Challenge. The proposed solutions demonstrate better results achieved by Proprietary and Open-source Large Language Models (LLMs), which achieved a Root Mean Square Error (RMSE) score of 3.98 on Textual Modality, beating the AVEC 2019 challenge baseline results and current SOTA regression analysis architectures. Additionally, the proposed solution achieved an accuracy of 71.43% in the classification task. The paper also includes a novel audio-visual multi-modal network that predicts PHQ-8 scores with an RMSE of 6.51.

  • 6 authors
·
Jul 8, 2024

Beyond Empathy: Integrating Diagnostic and Therapeutic Reasoning with Large Language Models for Mental Health Counseling

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.

  • 8 authors
·
May 21, 2025

Artificial Intelligence in Mental Health and Well-Being: Evolution, Current Applications, Future Challenges, and Emerging Evidence

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.

  • 1 authors
·
Dec 13, 2024

Representation learning for improved interpretability and classification accuracy of clinical factors from EEG

Despite extensive standardization, diagnostic interviews for mental health disorders encompass substantial subjective judgment. Previous studies have demonstrated that EEG-based neural measures can function as reliable objective correlates of depression, or even predictors of depression and its course. However, their clinical utility has not been fully realized because of 1) the lack of automated ways to deal with the inherent noise associated with EEG data at scale, and 2) the lack of knowledge of which aspects of the EEG signal may be markers of a clinical disorder. Here we adapt an unsupervised pipeline from the recent deep representation learning literature to address these problems by 1) learning a disentangled representation using beta-VAE to denoise the signal, and 2) extracting interpretable features associated with a sparse set of clinical labels using a Symbol-Concept Association Network (SCAN). We demonstrate that our method is able to outperform the canonical hand-engineered baseline classification method on a number of factors, including participant age and depression diagnosis. Furthermore, our method recovers a representation that can be used to automatically extract denoised Event Related Potentials (ERPs) from novel, single EEG trajectories, and supports fast supervised re-mapping to various clinical labels, allowing clinicians to re-use a single EEG representation regardless of updates to the standardized diagnostic system. Finally, single factors of the learned disentangled representations often correspond to meaningful markers of clinical factors, as automatically detected by SCAN, allowing for human interpretability and post-hoc expert analysis of the recommendations made by the model.

  • 9 authors
·
Oct 28, 2020

MindEval: Benchmarking Language Models on Multi-turn Mental Health Support

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.

  • 6 authors
·
Nov 23, 2025

DAIC-WOZ: On the Validity of Using the Therapist's prompts in Automatic Depression Detection from Clinical Interviews

Automatic depression detection from conversational data has gained significant interest in recent years. The DAIC-WOZ dataset, interviews conducted by a human-controlled virtual agent, has been widely used for this task. Recent studies have reported enhanced performance when incorporating interviewer's prompts into the model. In this work, we hypothesize that this improvement might be mainly due to a bias present in these prompts, rather than the proposed architectures and methods. Through ablation experiments and qualitative analysis, we discover that models using interviewer's prompts learn to focus on a specific region of the interviews, where questions about past experiences with mental health issues are asked, and use them as discriminative shortcuts to detect depressed participants. In contrast, models using participant responses gather evidence from across the entire interview. Finally, to highlight the magnitude of this bias, we achieve a 0.90 F1 score by intentionally exploiting it, the highest result reported to date on this dataset using only textual information. Our findings underline the need for caution when incorporating interviewers' prompts into models, as they may inadvertently learn to exploit targeted prompts, rather than learning to characterize the language and behavior that are genuinely indicative of the patient's mental health condition.

  • 6 authors
·
Apr 22, 2024

Towards Efficient and Robust Linguistic Emotion Diagnosis for Mental Health via Multi-Agent Instruction Refinement

Linguistic expressions of emotions such as depression, anxiety, and trauma-related states are pervasive in clinical notes, counseling dialogues, and online mental health communities, and accurate recognition of these emotions is essential for clinical triage, risk assessment, and timely intervention. Although large language models (LLMs) have demonstrated strong generalization ability in emotion analysis tasks, their diagnostic reliability in high-stakes, context-intensive medical settings remains highly sensitive to prompt design. Moreover, existing methods face two key challenges: emotional comorbidity, in which multiple intertwined emotional states complicate prediction, and inefficient exploration of clinically relevant cues. To address these challenges, we propose APOLO (Automated Prompt Optimization for Linguistic Emotion Diagnosis), a framework that systematically explores a broader and finer-grained prompt space to improve diagnostic efficiency and robustness. APOLO formulates instruction refinement as a Partially Observable Markov Decision Process and adopts a multi-agent collaboration mechanism involving Planner, Teacher, Critic, Student, and Target roles. Within this closed-loop framework, the Planner defines an optimization trajectory, while the Teacher-Critic-Student agents iteratively refine prompts to enhance reasoning stability and effectiveness, and the Target agent determines whether to continue optimization based on performance evaluation. Experimental results show that APOLO consistently improves diagnostic accuracy and robustness across domain-specific and stratified benchmarks, demonstrating a scalable and generalizable paradigm for trustworthy LLM applications in mental healthcare.

  • 8 authors
·
Jan 19 2

Capturing social media expressions during the COVID-19 pandemic in Argentina and forecasting mental health and emotions

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.

  • 4 authors
·
Jan 12, 2021

Roleplaying with Structure: Synthetic Therapist-Client Conversation Generation from Questionnaires

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

  • 12 authors
·
Oct 29, 2025

Emergence of psychopathological computations in large language models

Can large language models (LLMs) implement computations of psychopathology? An effective approach to the question hinges on addressing two factors. First, for conceptual validity, we require a general and computational account of psychopathology that is applicable to computational entities without biological embodiment or subjective experience. Second, mechanisms underlying LLM behaviors need to be studied for better methodological validity. Thus, we establish a computational-theoretical framework to provide an account of psychopathology applicable to LLMs. To ground the theory for empirical analysis, we also propose a novel mechanistic interpretability method alongside a tailored empirical analytic framework. Based on the frameworks, we conduct experiments demonstrating three key claims: first, that distinct dysfunctional and problematic representational states are implemented in LLMs; second, that their activations can spread and self-sustain to trap LLMs; and third, that dynamic, cyclic structural causal models encoded in the LLMs underpin these patterns. In concert, the empirical results corroborate our hypothesis that network-theoretic computations of psychopathology have already emerged in LLMs. This suggests that certain LLM behaviors mirroring psychopathology may not be a superficial mimicry but a feature of their internal processing. Thus, our work alludes to the possibility of AI systems with psychopathological behaviors in the near future.

  • 8 authors
·
Apr 10, 2025

Psyche-R1: Towards Reliable Psychological LLMs through Unified Empathy, Expertise, and Reasoning

Amidst a shortage of qualified mental health professionals, the integration of large language models (LLMs) into psychological applications offers a promising way to alleviate the growing burden of mental health disorders. Recent reasoning-augmented LLMs have achieved remarkable performance in mathematics and programming, while research in the psychological domain has predominantly emphasized emotional support and empathetic dialogue, with limited attention to reasoning mechanisms that are beneficial to generating reliable responses. Therefore, in this paper, we propose Psyche-R1, the first Chinese psychological LLM that jointly integrates empathy, psychological expertise, and reasoning, built upon a novel data curation pipeline. Specifically, we design a comprehensive data synthesis pipeline that produces over 75k high-quality psychological questions paired with detailed rationales, generated through chain-of-thought (CoT) reasoning and iterative prompt-rationale optimization, along with 73k empathetic dialogues. Subsequently, we employ a hybrid training strategy wherein challenging samples are identified through a multi-LLM cross-selection strategy for group relative policy optimization (GRPO) to improve reasoning ability, while the remaining data is used for supervised fine-tuning (SFT) to enhance empathetic response generation and psychological domain knowledge. Extensive experiment results demonstrate the effectiveness of the Psyche-R1 across several psychological benchmarks, where our 7B Psyche-R1 achieves comparable results to 671B DeepSeek-R1.

  • 6 authors
·
Aug 14, 2025

PsyDraw: A Multi-Agent Multimodal System for Mental Health Screening in Left-Behind Children

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.

  • 8 authors
·
Dec 19, 2024

The Dead Salmons of AI Interpretability

In a striking neuroscience study, the authors placed a dead salmon in an MRI scanner and showed it images of humans in social situations. Astonishingly, standard analyses of the time reported brain regions predictive of social emotions. The explanation, of course, was not supernatural cognition but a cautionary tale about misapplied statistical inference. In AI interpretability, reports of similar ''dead salmon'' artifacts abound: feature attribution, probing, sparse auto-encoding, and even causal analyses can produce plausible-looking explanations for randomly initialized neural networks. In this work, we examine this phenomenon and argue for a pragmatic statistical-causal reframing: explanations of computational systems should be treated as parameters of a (statistical) model, inferred from computational traces. This perspective goes beyond simply measuring statistical variability of explanations due to finite sampling of input data; interpretability methods become statistical estimators, and findings should be tested against explicit and meaningful alternative computational hypotheses, with uncertainty quantified with respect to the postulated statistical model. It also highlights important theoretical issues, such as the identifiability of common interpretability queries, which we argue is critical to understand the field's susceptibility to false discoveries, poor generalizability, and high variance. More broadly, situating interpretability within the standard toolkit of statistical inference opens promising avenues for future work aimed at turning AI interpretability into a pragmatic and rigorous science.

  • 4 authors
·
Dec 21, 2025

MODMA dataset: a Multi-modal Open Dataset for Mental-disorder Analysis

According to the World Health Organization, the number of mental disorder patients, especially depression patients, has grown rapidly and become a leading contributor to the global burden of disease. However, the present common practice of depression diagnosis is based on interviews and clinical scales carried out by doctors, which is not only labor-consuming but also time-consuming. One important reason is due to the lack of physiological indicators for mental disorders. With the rising of tools such as data mining and artificial intelligence, using physiological data to explore new possible physiological indicators of mental disorder and creating new applications for mental disorder diagnosis has become a new research hot topic. However, good quality physiological data for mental disorder patients are hard to acquire. We present a multi-modal open dataset for mental-disorder analysis. The dataset includes EEG and audio data from clinically depressed patients and matching normal controls. All our patients were carefully diagnosed and selected by professional psychiatrists in hospitals. The EEG dataset includes not only data collected using traditional 128-electrodes mounted elastic cap, but also a novel wearable 3-electrode EEG collector for pervasive applications. The 128-electrodes EEG signals of 53 subjects were recorded as both in resting state and under stimulation; the 3-electrode EEG signals of 55 subjects were recorded in resting state; the audio data of 52 subjects were recorded during interviewing, reading, and picture description. We encourage other researchers in the field to use it for testing their methods of mental-disorder analysis.

  • 26 authors
·
Feb 20, 2020

A Zero-shot Explainable Doctor Ranking Framework with Large Language Models

Online medical service provides patients convenient access to doctors, but effectively ranking doctors based on specific medical needs remains challenging. Current ranking approaches typically lack the interpretability crucial for patient trust and informed decision-making. Additionally, the scarcity of standardized benchmarks and labeled data for supervised learning impedes progress in expertise-aware doctor ranking. To address these challenges, we propose an explainable ranking framework for doctor ranking powered by large language models in a zero-shot setting. Our framework dynamically generates disease-specific ranking criteria to guide the large language model in assessing doctor relevance with transparency and consistency. It further enhances interpretability by generating step-by-step rationales for its ranking decisions, improving the overall explainability of the information retrieval process. To support rigorous evaluation, we built and released DrRank, a novel expertise-driven dataset comprising 38 disease-treatment pairs and 4,325 doctor profiles. On this benchmark, our framework significantly outperforms the strongest baseline by +6.45 NDCG@10. Comprehensive analyses also show our framework is fair across disease types, patient gender, and geographic regions. Furthermore, verification by medical experts confirms the reliability and interpretability of our approach, reinforcing its potential for trustworthy, real-world doctor recommendation. To demonstrate its broader applicability, we validate our framework on two datasets from BEIR benchmark, where it again achieves superior performance. The code and associated data are available at: https://github.com/YangLab-BUPT/DrRank.

  • 3 authors
·
Mar 4, 2025

A Prescriptive Learning Analytics Framework: Beyond Predictive Modelling and onto Explainable AI with Prescriptive Analytics and ChatGPT

A significant body of recent research in the field of Learning Analytics has focused on leveraging machine learning approaches for predicting at-risk students in order to initiate timely interventions and thereby elevate retention and completion rates. The overarching feature of the majority of these research studies has been on the science of prediction only. The component of predictive analytics concerned with interpreting the internals of the models and explaining their predictions for individual cases to stakeholders has largely been neglected. Additionally, works that attempt to employ data-driven prescriptive analytics to automatically generate evidence-based remedial advice for at-risk learners are in their infancy. eXplainable AI is a field that has recently emerged providing cutting-edge tools which support transparent predictive analytics and techniques for generating tailored advice for at-risk students. This study proposes a novel framework that unifies both transparent machine learning as well as techniques for enabling prescriptive analytics, while integrating the latest advances in large language models. This work practically demonstrates the proposed framework using predictive models for identifying at-risk learners of programme non-completion. The study then further demonstrates how predictive modelling can be augmented with prescriptive analytics on two case studies in order to generate human-readable prescriptive feedback for those who are at risk using ChatGPT.

  • 1 authors
·
Aug 30, 2022

PsyGUARD: An Automated System for Suicide Detection and Risk Assessment in Psychological Counseling

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.

  • 3 authors
·
Sep 30, 2024

A Comprehensive Evaluation of Large Language Models on Mental Illnesses

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.

  • 5 authors
·
Sep 23, 2024

Comparing the Efficacy of GPT-4 and Chat-GPT in Mental Health Care: A Blind Assessment of Large Language Models for Psychological Support

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.

  • 1 authors
·
May 15, 2024

Rethinking Explainability as a Dialogue: A Practitioner's Perspective

As practitioners increasingly deploy machine learning models in critical domains such as health care, finance, and policy, it becomes vital to ensure that domain experts function effectively alongside these models. Explainability is one way to bridge the gap between human decision-makers and machine learning models. However, most of the existing work on explainability focuses on one-off, static explanations like feature importances or rule lists. These sorts of explanations may not be sufficient for many use cases that require dynamic, continuous discovery from stakeholders. In the literature, few works ask decision-makers about the utility of existing explanations and other desiderata they would like to see in an explanation going forward. In this work, we address this gap and carry out a study where we interview doctors, healthcare professionals, and policymakers about their needs and desires for explanations. Our study indicates that decision-makers would strongly prefer interactive explanations in the form of natural language dialogues. Domain experts wish to treat machine learning models as "another colleague", i.e., one who can be held accountable by asking why they made a particular decision through expressive and accessible natural language interactions. Considering these needs, we outline a set of five principles researchers should follow when designing interactive explanations as a starting place for future work. Further, we show why natural language dialogues satisfy these principles and are a desirable way to build interactive explanations. Next, we provide a design of a dialogue system for explainability and discuss the risks, trade-offs, and research opportunities of building these systems. Overall, we hope our work serves as a starting place for researchers and engineers to design interactive explainability systems.

  • 5 authors
·
Feb 3, 2022

Advancements in Machine Learning and Deep Learning for Early Detection and Management of Mental Health Disorder

For the early identification, diagnosis, and treatment of mental health illnesses, the integration of deep learning (DL) and machine learning (ML) has started playing a significant role. By evaluating complex data from imaging, genetics, and behavioral assessments, these technologies have the potential to significantly improve clinical outcomes. However, they also present unique challenges related to data integration and ethical issues. This survey reviews the development of ML and DL methods for the early diagnosis and treatment of mental health issues. It examines a range of applications, with a particular emphasis on behavioral assessments, genetic and biomarker analysis, and medical imaging for diagnosing diseases like depression, bipolar disorder, and schizophrenia. Predictive modeling for illness progression is further discussed, focusing on the role of risk prediction models and longitudinal studies. Key findings highlight how ML and DL can improve diagnostic accuracy and treatment outcomes while addressing methodological inconsistencies, data integration challenges, and ethical concerns. The study emphasizes the importance of building real-time monitoring systems for individualized treatment, enhancing data fusion techniques, and fostering interdisciplinary collaboration. Future research should focus on overcoming these obstacles to ensure the valuable and ethical application of ML and DL in mental health services.

  • 6 authors
·
Dec 8, 2024

When LLMs Meets Acoustic Landmarks: An Efficient Approach to Integrate Speech into Large Language Models for Depression Detection

Depression is a critical concern in global mental health, prompting extensive research into AI-based detection methods. Among various AI technologies, Large Language Models (LLMs) stand out for their versatility in mental healthcare applications. However, their primary limitation arises from their exclusive dependence on textual input, which constrains their overall capabilities. Furthermore, the utilization of LLMs in identifying and analyzing depressive states is still relatively untapped. In this paper, we present an innovative approach to integrating acoustic speech information into the LLMs framework for multimodal depression detection. We investigate an efficient method for depression detection by integrating speech signals into LLMs utilizing Acoustic Landmarks. By incorporating acoustic landmarks, which are specific to the pronunciation of spoken words, our method adds critical dimensions to text transcripts. This integration also provides insights into the unique speech patterns of individuals, revealing the potential mental states of individuals. Evaluations of the proposed approach on the DAIC-WOZ dataset reveal state-of-the-art results when compared with existing Audio-Text baselines. In addition, this approach is not only valuable for the detection of depression but also represents a new perspective in enhancing the ability of LLMs to comprehend and process speech signals.

  • 7 authors
·
Feb 17, 2024

Assessing Risks of Large Language Models in Mental Health Support: A Framework for Automated Clinical AI Red Teaming

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.

  • 5 authors
·
Feb 23 1

Tri-Modal Severity Fused Diagnosis across Depression and Post-traumatic Stress Disorders

Depression and post traumatic stress disorder (PTSD) often co-occur with connected symptoms, complicating automated assessment, which is often binary and disorder specific. Clinically useful diagnosis needs severity aware cross disorder estimates and decision support explanations. Our unified tri modal affective severity framework synchronizes and fuses interview text with sentence level transformer embeddings, audio with log Mel statistics with deltas, and facial signals with action units, gaze, head and pose descriptors to output graded severities for diagnosing both depression (PHQ-8; 5 classes) and PTSD (3 classes). Standardized features are fused via a calibrated late fusion classifier, yielding per disorder probabilities and feature-level attributions. This severity aware tri-modal affective fusion approach is demoed on multi disorder concurrent depression and PTSD assessment. Stratified cross validation on DAIC derived corpora outperforms unimodal/ablation baselines. The fused model matches the strongest unimodal baseline on accuracy and weighted F1, while improving decision curve utility and robustness under noisy or missing modalities. For PTSD specifically, fusion reduces regression error and improves class concordance. Errors cluster between adjacent severities; extreme classes are identified reliably. Ablations show text contributes most to depression severity, audio and facial cues are critical for PTSD, whereas attributions align with linguistic and behavioral markers. Our approach offers reproducible evaluation and clinician in the loop support for affective clinical decision making.

  • 3 authors
·
Oct 23, 2025

Thousand Voices of Trauma: A Large-Scale Synthetic Dataset for Modeling Prolonged Exposure Therapy Conversations

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.

  • 5 authors
·
Apr 16, 2025

MMFformer: Multimodal Fusion Transformer Network for Depression Detection

Depression is a serious mental health illness that significantly affects an individual's well-being and quality of life, making early detection crucial for adequate care and treatment. Detecting depression is often difficult, as it is based primarily on subjective evaluations during clinical interviews. Hence, the early diagnosis of depression, thanks to the content of social networks, has become a prominent research area. The extensive and diverse nature of user-generated information poses a significant challenge, limiting the accurate extraction of relevant temporal information and the effective fusion of data across multiple modalities. This paper introduces MMFformer, a multimodal depression detection network designed to retrieve depressive spatio-temporal high-level patterns from multimodal social media information. The transformer network with residual connections captures spatial features from videos, and a transformer encoder is exploited to design important temporal dynamics in audio. Moreover, the fusion architecture fused the extracted features through late and intermediate fusion strategies to find out the most relevant intermodal correlations among them. Finally, the proposed network is assessed on two large-scale depression detection datasets, and the results clearly reveal that it surpasses existing state-of-the-art approaches, improving the F1-Score by 13.92% for D-Vlog dataset and 7.74% for LMVD dataset. The code is made available publicly at https://github.com/rezwanh001/Large-Scale-Multimodal-Depression-Detection.

  • 6 authors
·
Aug 8, 2025

We Care: Multimodal Depression Detection and Knowledge Infused Mental Health Therapeutic Response Generation

The detection of depression through non-verbal cues has gained significant attention. Previous research predominantly centred on identifying depression within the confines of controlled laboratory environments, often with the supervision of psychologists or counsellors. Unfortunately, datasets generated in such controlled settings may struggle to account for individual behaviours in real-life situations. In response to this limitation, we present the Extended D-vlog dataset, encompassing a collection of 1, 261 YouTube vlogs. Additionally, the emergence of large language models (LLMs) like GPT3.5, and GPT4 has sparked interest in their potential they can act like mental health professionals. Yet, the readiness of these LLM models to be used in real-life settings is still a concern as they can give wrong responses that can harm the users. We introduce a virtual agent serving as an initial contact for mental health patients, offering Cognitive Behavioral Therapy (CBT)-based responses. It comprises two core functions: 1. Identifying depression in individuals, and 2. Delivering CBT-based therapeutic responses. Our Mistral model achieved impressive scores of 70.1% and 30.9% for distortion assessment and classification, along with a Bert score of 88.7%. Moreover, utilizing the TVLT model on our Multimodal Extended D-vlog Dataset yielded outstanding results, with an impressive F1-score of 67.8%

  • 2 authors
·
Jun 15, 2024

Toward Reliable Biomedical Hypothesis Generation: Evaluating Truthfulness and Hallucination in Large Language Models

Large language models (LLMs) have shown significant potential in scientific disciplines such as biomedicine, particularly in hypothesis generation, where they can analyze vast literature, identify patterns, and suggest research directions. However, a key challenge lies in evaluating the truthfulness of generated hypotheses, as verifying their accuracy often requires substantial time and resources. Additionally, the hallucination problem in LLMs can lead to the generation of hypotheses that appear plausible but are ultimately incorrect, undermining their reliability. To facilitate the systematic study of these challenges, we introduce TruthHypo, a benchmark for assessing the capabilities of LLMs in generating truthful biomedical hypotheses, and KnowHD, a knowledge-based hallucination detector to evaluate how well hypotheses are grounded in existing knowledge. Our results show that LLMs struggle to generate truthful hypotheses. By analyzing hallucinations in reasoning steps, we demonstrate that the groundedness scores provided by KnowHD serve as an effective metric for filtering truthful hypotheses from the diverse outputs of LLMs. Human evaluations further validate the utility of KnowHD in identifying truthful hypotheses and accelerating scientific discovery. Our data and source code are available at https://github.com/Teddy-XiongGZ/TruthHypo.

  • 8 authors
·
May 20, 2025 2

Automated speech- and text-based classification of neuropsychiatric conditions in a multidiagnostic setting

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

  • 11 authors
·
Jan 13, 2023

MedHalu: Hallucinations in Responses to Healthcare Queries by Large Language Models

The remarkable capabilities of large language models (LLMs) in language understanding and generation have not rendered them immune to hallucinations. LLMs can still generate plausible-sounding but factually incorrect or fabricated information. As LLM-empowered chatbots become popular, laypeople may frequently ask health-related queries and risk falling victim to these LLM hallucinations, resulting in various societal and healthcare implications. In this work, we conduct a pioneering study of hallucinations in LLM-generated responses to real-world healthcare queries from patients. We propose MedHalu, a carefully crafted first-of-its-kind medical hallucination dataset with a diverse range of health-related topics and the corresponding hallucinated responses from LLMs with labeled hallucination types and hallucinated text spans. We also introduce MedHaluDetect framework to evaluate capabilities of various LLMs in detecting hallucinations. We also employ three groups of evaluators -- medical experts, LLMs, and laypeople -- to study who are more vulnerable to these medical hallucinations. We find that LLMs are much worse than the experts. They also perform no better than laypeople and even worse in few cases in detecting hallucinations. To fill this gap, we propose expert-in-the-loop approach to improve hallucination detection through LLMs by infusing expert reasoning. We observe significant performance gains for all the LLMs with an average macro-F1 improvement of 6.3 percentage points for GPT-4.

  • 6 authors
·
Sep 28, 2024

When AI Takes the Couch: Psychometric Jailbreaks Reveal Internal Conflict in Frontier Models

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.

  • 5 authors
·
Dec 2, 2025 5

Through a Compressed Lens: Investigating the Impact of Quantization on LLM Explainability and Interpretability

Quantization methods are widely used to accelerate inference and streamline the deployment of large language models (LLMs). While prior research has extensively investigated the degradation of various LLM capabilities due to quantization, its effects on model explainability and interpretability, which are crucial for understanding decision-making processes, remain unexplored. To address this gap, we conduct comprehensive experiments using three common quantization techniques at distinct bit widths, in conjunction with two explainability methods, counterfactual examples and natural language explanations, as well as two interpretability approaches, knowledge memorization analysis and latent multi-hop reasoning analysis. We complement our analysis with a thorough user study, evaluating selected explainability methods. Our findings reveal that, depending on the configuration, quantization can significantly impact model explainability and interpretability. Notably, the direction of this effect is not consistent, as it strongly depends on (1) the quantization method, (2) the explainability or interpretability approach, and (3) the evaluation protocol. In some settings, human evaluation shows that quantization degrades explainability, while in others, it even leads to improvements. Our work serves as a cautionary tale, demonstrating that quantization can unpredictably affect model transparency. This insight has important implications for deploying LLMs in applications where transparency is a critical requirement.

  • 8 authors
·
May 20, 2025

What Makes Digital Support Effective? How Therapeutic Skills Affect Clinical Well-Being

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.

  • 7 authors
·
Dec 17, 2023

A Text Classification Framework for Simple and Effective Early Depression Detection Over Social Media Streams

With the rise of the Internet, there is a growing need to build intelligent systems that are capable of efficiently dealing with early risk detection (ERD) problems on social media, such as early depression detection, early rumor detection or identification of sexual predators. These systems, nowadays mostly based on machine learning techniques, must be able to deal with data streams since users provide their data over time. In addition, these systems must be able to decide when the processed data is sufficient to actually classify users. Moreover, since ERD tasks involve risky decisions by which people's lives could be affected, such systems must also be able to justify their decisions. However, most standard and state-of-the-art supervised machine learning models are not well suited to deal with this scenario. This is due to the fact that they either act as black boxes or do not support incremental classification/learning. In this paper we introduce SS3, a novel supervised learning model for text classification that naturally supports these aspects. SS3 was designed to be used as a general framework to deal with ERD problems. We evaluated our model on the CLEF's eRisk2017 pilot task on early depression detection. Most of the 30 contributions submitted to this competition used state-of-the-art methods. Experimental results show that our classifier was able to outperform these models and standard classifiers, despite being less computationally expensive and having the ability to explain its rationale.

  • 3 authors
·
May 18, 2019