A Scoping Review of AI-Driven Digital Interventions in Mental Health Care: Mapping Applications Across Screening, Support, Monitoring, Prevention, and Clinical Education

The rising global prevalence of mental health conditions, together with longstanding barriers in traditional healthcare, such as limited resources, high cost, stigma, and privacy concerns, has created an urgent need for accessible and scalable support. Large Language Models (LLMs) have emerged as a transformative technology with strong potential to democratize mental health support through advanced natural language understanding and generation. However, the rapidly expanding, fragmented body of work in this area lacks a coherent evolutionary narrative, making it difficult to contextualize current progress and identify future directions. This survey addresses this gap by organizing and analyzing the literature around a central thesis: the role of LLMs in mental health is evolving through three distinct, increasingly sophisticated phases. We trace this trajectory from Phase I, in which LLMs act primarily as passive Information Tools and Pattern Recognizers for assessment; through Phase II, where they function as Empathetic Conversationalists for in-the-moment, stateless interactions; to the current frontier, Phase III, which seeks Longitudinal, Personalized Companions implemented as stateful cognitive agents. To support this framework, we systematically review core technologies, agent architectures (Profile, Memory, Reasoning, and Planning), and the critical infrastructure of datasets and benchmarks, highlighting how their evolution underpins this developmental path. Viewing the field through this developmental lens, we provide a comprehensive synthesis of existing work, an insightful narrative of its trajectory, and a clear roadmap for future innovation in responsible, effective, and human-centered AI for mental healthcare. A curated collection of the resources reviewed in this survey is available at our project repository: https://github.com/Emo-gml/Awesome-Mental-Health-LLMs.

Mental health disorders affect millions worldwide, and healthcare systems are increasingly overwhelmed by the volume of clinical data generated from electronic records, telemedicine platforms, and population-level screening programs. At the same time, the emergence of novel AI-based approaches in healthcare calls for intelligent frameworks capable of processing domain-specific unstructured clinical information while adapting to patient-specific needs. This paper proposes an agentic framework for building robust LLM-based pipelines, where each stage is encapsulated as a LangChain agent governed by explicit policies and proxy-guided evaluation. Stages are incrementally locked once validated, ensuring that later adaptations cannot overwrite configurations without demonstrated improvement. The proposed framework evolves from feature-level exploration, through proxy-based tuning and freeze/rollback mechanisms, to full orchestration by an Orchestrator Agent that coordinates preprocessing, retrieval, selection, diversity, threshold optimization, and decoding. A proof-of-concept in transcript-based depression detection demonstrates that the framework converges to stable configurations, such as cosine similarity, dynamic Top-k, and threshold 0.75, while controlling evaluation costs and avoiding regressions. These results highlight the potential of agentic AI to enable population-level mental health screening over large clinical datasets, addressing critical challenges in trustworthiness, reproducibility, and adaptability required in healthcare environments.

Campus well-being underpins academic success, yet many universities lack effective methods for monitoring satisfaction and detecting mental health risks. This dissertation addresses these gaps through prevention (improving feedback collection) and intervention (advancing mental health detection), unified under an integrated framework. For prevention, we developed TigerGPT, a personalized survey chatbot leveraging LLMs to engage users in context-aware conversations grounded in conversational design and engagement theory, achieving 75% usability and 81% satisfaction. To address its limitations in repetitiveness and response depth, we introduced AURA, a reinforcement-learning framework that adapts follow-up question types (validate, specify, reflect, probe) within a session using an LSDE quality signal (Length, Self-disclosure, Emotion, Specificity), initialized from 96 prior conversations. AURA achieved +0.12 mean quality gain (p=0.044, d=0.66), with 63% fewer specification prompts and 10x more validation behavior. For intervention, we examine Expressive Narrative Stories (ENS) for mental health screening, showing BERT(128) captures nuanced linguistic features without keyword cues, while conventional classifiers depend heavily on explicit mental health terms. We then developed PsychoGPT, an LLM built on DSM-5 and PHQ-8 guidelines that performs initial distress classification, symptom-level scoring, and reconciliation with external ratings for explainable assessment. To reduce hallucinations, we proposed Stacked Multi-Model Reasoning (SMMR), layering expert models where early layers handle localized subtasks and later layers reconcile findings, outperforming single-model solutions on DAIC-WOZ in accuracy, F1, and PHQ-8 scoring. Finally, a cohesive framework unifies these tools, enabling adaptive survey insights to flow directly into specialized mental health detection models.