Mental Health

In NLP, mental health conditions are often modeled as isolated phenomena, without interpersonal context. We use Reddit posts about long-distance relationships to capture both mental health distress and associated relational triggers. We introduce the Relational Stress and Psychiatry Corpus (RSPC) containing 1,799 Reddit posts annotated by psychiatrists for diagnostic categories, including the most prevalent mood disorders (anxiety and depression), relational stressor triggers, and indications of relationship phase. We benchmark seven fine-tuned transformer models and five large language models across multi-label disorder classification, relational trigger detection, and temporal phase prediction tasks. We find clear task-dependent differences between model families, with Claude-3-Haiku achieving the best disorder classification performance (Macro-F1 = 0.538) and GPT-4o obtaining the strongest relational trigger detection performance (Macro-F1 = 0.519), suggesting distinct model capabilities. We further find strong associations between anxiety disorders and chronic relational uncertainty. Overall, RSPC establishes a benchmark for NLP tasks that consider relational context and supports a shift from individual-centric to context-aware mental health modeling that captures the social and temporal dynamics of distress.

Large language models (LLMs) are increasingly being integrated into mental health support tools and other psychologically sensitive conversational applications. In such settings, behavioral stability and consistency are important for trustworthy human-AI interaction. However, semantically similar concerns can be presented through different contextual framings, potentially eliciting different model responses. Such framing-sensitive variability may challenge user expectations regarding system behavior and complicate the assessment of AI reliability. While prior studies have primarily examined such effects at the behavioral level, less is known about how framing-related variation is reflected in the internal representations of aligned language models. In this work, we investigate these effects using controlled matched prompts spanning multiple contextual framing conditions across several instruction-tuned model families. Across architectures, framing systematically alters interpretive response tendencies. Layer-wise probing analyses show that behavior-associated information remains decodable throughout transformer depth, with architecture-dependent variation in decoding strength. Moreover, held-out framing probes remained consistently above chance across architectures despite strong lexical baselines. Activation steering experiments further suggest that framing-associated representational directions can partially modulate downstream behavioral outcomes. Finally, these findings indicate that robustness to contextual variation may represent an important consideration when evaluating the consistency and trustworthiness of conversational AI systems deployed in mental-health-oriented interactions.

Automatic Speech Recognition (ASR) is increasingly used to document clinical encounters, yet its reliability in multilingual and demographically diverse Indian healthcare context remains largely unknown. In this study, we first conduct the systematic audit of ASR performance on real-world psychiatric interview data spanning Kannada, Hindi and Indian English, comparing eight state-of-the-art models including IndicWhisper, WhisperLargeV3, Sarvam, GoogleS2T, Gemma3n, OmniLingual, Vaani, and Gemini. Our results reveal substantial variability across models and languages, with some systems performing competitively in Indian English but failing in regional speech. We further fine-tune two of the best performing opensource models, i.e., Gemma3n and OmniLingual, using various methods. With this, we uncover systematic performance gaps tied to speaker role and gender, raising concerns about equitable deployment in clinical settings, which are further mitigated by fairness-aware fine-tuning. To this end, we propose SamaVaani, a unified debiasing technique that simultaneously improves ASR performance and improves fairness across demographic groups.

Patients increasingly seek medication information online, yet safety knowledge for psychiatric drugs is split between regulatory adverse-event records, which are authoritative but abstract, and patient narratives, which are experience-near but unvalidated. Integrating them without conflating evidence and anecdote is especially consequential in psychiatry, where poorly contextualised information can amplify fear, nocebo responses, and non-adherence. Here we develop a provenance-aware, knowledge-graph-based multi-agent framework unifying 466,525 Reddit posts, 60,782 WebMD reviews, and twenty years of U.S. FDA Adverse Event Reporting System records for nine antidepressants. A large-language-model entity-recognition pipeline benchmarked against physician annotations reached highest F1 scores of 0.969 for medications and 0.973 for conditions. The two community platforms were far more concordant with each other (overlap up to a Jaccard similarity of 0.905) than with regulatory reports, indicating that patient-generated data form a partly independent safety signal. For sertraline, many adverse events appeared in community sources hundreds of days before the corresponding FDA date. A Neo4j knowledge graph grounded in ATC-N, ICD-10, and MedDRA vocabularies preserves provenance, keeping every claim traceable and regulatory facts distinct from patient experience. These results establish source-aware integration as a route to more auditable psychiatric medication information, with usefulness and patient benefit to be tested prospectively.

Given the widespread prevalence of depression and its consequential impact on individuals and society, it is crucial to obtain objective measures for early diagnosis and intervention. As a multidisciplinary topic, these objective measures should be interpretable and accessible to health care professionals, ensuring effective collaboration and treatment planning in the realm of mental health care. Even though current automated depression diagnosis approaches improved over the last decade, a critical gap exists as they often lack affect-specificity and interpretability, limiting their practical application and potential impact on mental health care. In particular, interpretability from temporal activities from videos when deep models are used is not fully explored. In this study, we present a novel framework for analyzing Deep Neural Networks' decisions when trained on facial videos, specifically focusing on automatic depression severity diagnosis. By fine-tuning Deep Convolutional Neural Networks (DCNN) pre-trained on Action Recognition datasets on depression severity facial videos from AVEC depression dataset, our framework is able to interpret the model's saliency maps by examining face regions and temporal expression semantics. Our approach generates both visual and quantitative explanations for the model's decisions, providing greater insight into its reasoning. In addition to this interpretability, our video-based modeling has improved upon previous single-face benchmarks for visual depression diagnosis, resulting in enhanced predictive performance. Overall, our work demonstrates the successful development of a framework capable of generating hypotheses from a facial model's decisions while simultaneously improving depression's predictive capabilities.

One of the significant mental health issues affecting female sex workers (FSWs) is mental disorders, especially depression. Exposure to violence, stigma, and economic hardship further increases their psychological risk. Current machine learning (ML) models are typically ineffective at capturing the high-dimensional and complex risk patterns that exist in this marginalized group. This paper suggests a hybrid predictive model that merges an ensemble feature selection strategy using ANOVA and mutual information and Harris Hawks optimization-tuned logistic regression and represents a new application of swarm intelligence to predict mental health in vulnerable groups. The explainable AI (XAI) methods can be used to understand the factors of trauma associated with model predictions. When applied to a group of 3,005 FSWs, it can be seen that the proposed model is more effective than traditional classifiers, with an accuracy of 95.78%, an F1 score of 95.77%, and an AUC of 0.96, and identifying post-traumatic stress, client-related violence, and occupational factors as major contributors to depression. This work bridges the gaps between conventional and ML approaches to develop an XAI tool that enables vulnerable groups to receive early assistance, evidence-based targeted psychosocial care, and health planning.

General-purpose large language models (LLMs) are increasingly used for mental health-related conversations, yet safety guardrails remain inadequate and inconsistent across clinical conditions. This study evaluates eight proprietary LLMs across 16 DSM-5 conditions using four adversarial attack variants, introducing an eight-dimension harm taxonomy and a multi-dimensional evaluation framework. Results show that safeguards hold reliably only for suicide and self-harm, while conditions such as eating disorders, substance use disorder, and major depressive disorder exhibit failure rates of up to 100%. We argue that ethical design and deployment of these LLMs demand clearly defined harm categories across clinical conditions and implementation of safeguards accordingly. Until such safeguards are in place, these models pose significant risks to vulnerable populations, making their growing integration into publicly available settings (e.g., schools, search engines, and consumer chatbots) are particularly concerning.

Mental health assessment commonly relies on isolated screening instruments or data-driven models that often lack interpretability and multi-dimensional integration. Existing approaches frequently focus on individual indicators such as depression or anxiety while providing limited support for comprehensive and explainable decision-making. To address this limitation, this study proposes PsyBridge, a hybrid intelligent decision-support framework designed for multi-dimensional mental health assessment through the integration of clinically validated screening tools, cognitive evaluation, and personality profiling within a unified architecture. The proposed framework incorporates PHQ-9 and GAD-7 assessments alongside cognitive and behavioural indicators using a modular design and a weighted aggregation mechanism to generate interpretable mental health risk classifications and recommendations. To evaluate the framework, a semi-synthetic dataset consisting of 500 patient profiles representing varying severity levels was constructed based on clinically grounded score distributions. Experimental results demonstrate that PsyBridge achieves an overall accuracy of 0.84, outperforming standalone PHQ-9 and GAD-7 assessments while improving precision, recall, and F1-score. Sensitivity analysis and ablation studies further indicate that integrating cognitive and personality components contributes to more stable classification performance and reduces inconsistencies in moderate-risk prediction. The findings suggest that PsyBridge provides a scalable and interpretable approach for AI-assisted mental health decision support, particularly within digital healthcare and telehealth environments.

Pretrained text embeddings are increasingly used as representational maps, yet high category separability does not imply that their geometry recovers expert-defined structure. We study this problem in mental-health-related language, where symptom relations provide an external reference and online communities introduce strong domain, affective, stylistic, and discourse confounds. Using 28 Reddit communities, we compare pretrained and supervised fine-tuned Qwen3 embedding spaces at two scales (0.6B and 4B). We construct category prototypes, evaluate their representational dissimilarity matrices against an expert symptom matrix with representational similarity analysis, and complement this global test with prototype-based typicality and multi-baseline confound controls. Pretrained embeddings show measurable alignment with expert structure within the mental-health subset; fine-tuning strengthens this alignment most at the finest category level; and larger scale improves both zero-shot alignment and supervision-induced gains. Residual alignment remains substantial after controlling for VAD, LIWC, lexical style, and topic-distribution structure. These results suggest that LLM embeddings can recover expert-relevant category geometry, but this recovery is level-dependent and should be tested against explicit confounds rather than inferred from classification alone.

Mental illnesses among drug users are an increasing international issue, particularly in regions where early detection cannot be easily undertaken. The current literature tends to ignore the use of AI-based mental health analysis in drug users, and low quality of the class imbalance treatment, low interpretability, and optimal hyperparameter optimization can lower predictive quality and clinical utility. This study present a detailed, explainable machine learning (ML) model of multiclass mental health prediction, using a multidimensional data set of drug-affected persons. We combine hybrid PCA-Information Gain (PCA-IG) feature selection, Generative Adversarial Network (GAN)-based oversampling, and Dragonfly Algorithm (DA)-optimized XGBoost to address some of the limitations of existing methods. The suggested framework is effective to work with high-dimensional categorical data, address the issue of class imbalance, and improve predictive performance due to intelligent hyperparameter tuning. The experimental findings show that the XGBoost model optimized using the DA, in combination with GAN-based oversampling, has an accuracy of 94.17% and a weighted F1-score of 93.80%, which is better than the traditional and baseline models. The behavioral, lifestyle, and health factors, particularly sleep quality, physical health, and emotional regulation, are strongly predictive of mental health, with demographic factors having little impact, as seen through feature analysis. SHAP-based explainable AI provides easy-to-understand, instance-level information, enhancing interpretability and trust in models to be used in clinical settings. The results indicate that this framework has the potential to generate valid mental health forecasting tools, which would facilitate early intervention and enhance the treatment of drug-influenced people.

As mental health concerns continue to rise globally, social media has emerged as a vital space where individuals seek emotional support. While prior work on personalized emotional support has leveraged seekers' emotional states, personas, and situational context, these approaches primarily capture the seeker's current state, overlooking the formative experiences that shape present concerns. In this work, we propose MindTailor, a framework that generates personalized emotional support responses by constructing a case formulation from the seeker's post history and iteratively refining responses through collaborative critique among counselor agents grounded in distinct counseling strategies. To enable research on this history-aware task, we construct ReddiSupp, a dataset of 798 Reddit posts paired with seekers' prior post histories. Through LLM-as-a-Judge evaluation, expert human evaluation, and a user study with seekers, we demonstrate that MindTailor outperforms baselines across these evaluations, improving empathy, personalization, understanding, and achieving the highest overall preference.

As agentic systems tackle increasingly complex multi-step tasks, evaluating their trajectories presents a major bottleneck - human annotation of a single trajectory on popular agentic benchmarks can take hours, making it difficult to scale evaluations for measuring performance or curating training data. This has driven widespread reliance on automated approaches such as LLM-as-a-judge (LLMJ) to critique agents at the process and outcome-levels at scale, however, the soundness of LLMJ critiques often goes unmeasured. Here, we introduce Counsel, the first public dataset of meta-evaluations for agentic tasks. Counsel consists of process-level critiques from open-weight LLMJs on two agent benchmarks: tau-bench (customer support agents) and DA-Code (coding agents), and human meta-evaluations of these critiques. Human annotators label critiques on each flagged error as "spot on", "correct location but poor reasoning", or "should not have flagged", achieving reliable inter-annotator agreement (Krippendorff's alpha of 0.78). The resulting dataset stratifies LLMJ critiques by human alignment across both error location within a trajectory and reasoning quality, serving as valuable data to calibrate, improve, or train LLMJs for agents. Comparing open-weight judges, we find that more capable judge models and more reasoning effort both enabled improved human agreement, with the strongest judge reaching ~88% agreement on location and ~65% on reasoning. Counsel is generated using open-weight models and is permissively licensed for broad community use, which we hope will enable rigorous study and improved alignment of LLM-based evaluators for agentic systems.

Person-level psychological assessment requires aggregating meaning across many messages from the same individual, a task that document-level training objectives were not explicitly designed for. We present a systematic, empirical comparison between architecturally matched traditional (a) base-transformers and (b) document-tuned-transformers (further contrastively fine-tuned at the document-level, sometimes referred to as "sentence transformers") under otherwise identical conditions. Comparing layer-wise and overall performance across two longitudinal mental health and psychological datasets, we find document-tuned models demonstrated a consistent improvement over base representations (increase in Pearson r of 13.4%, p=.015). Robustness analyses revealed document-tuned models remained more accurate under perturbations to word deletion, synonym replacement, typo injection, and back translation. Further, hedged language (e.g., usually') was more characteristic of outcomes in document-tuned embeddings while abundance (e.g., lot') was more characteristic of base-transformers, suggesting document-tuned models may better capture uncertainty. These results suggest representation choice impacts mental health prediction, document-tuned models often being more adept.

Career anxiety and depression among university students present a growing challenge to mental health and academic achievement. This study proposes an Explainable AI (XAI) framework using multimodal data and Federated Learning (FL) to identify early indicators of career-related mental health problems in a privacy-preserving and culturally responsive manner. The framework combines structured behavioral data and facial emotion features from interview videos via an intermediate fusion neural network with attention mechanisms. Label smoothing was applied to improve model generalizability. FL was used across institutions to enable collaborative training without raw data sharing. Evaluation was conducted using the Student Mental Health Survey dataset from university students across Pakistan. Our model attained an F1-score of 89.12%, recall of 86.54%, accuracy of 92.08%, and precision of 91.88%. Using Integrated Gradients and SHAP, the model identified key behavioral markers of depression including avoidance of direct gaze, lower facial expressiveness, and social withdrawal, consistent with psychological theory. This research presents an interpretable, scalable, and context-sensitive AI system for mental health pre-diagnosis with potential integration into student support services globally.

AI and large language models (LLMs) have emerged as promising tools to address global mental health challenges. Despite the global nature of these challenges, there remains a critical shortage of high-quality datasets for training and evaluating such systems. To mitigate this gap, researchers increasingly generate synthetic clinical personas to simulate user data and test digital mental health support systems. However, most validated personas rely on English-centric contexts. This paper investigates whether similar persona-based methods can be used to generate multilingual mental health datasets. We modified nationality and language parameters in personas to generate clinical dialogues in Mandarin, Bengali, and Hindi. We then examined how different LLMs perform when evaluating the depression severity of these generated multilingual datasets against the baseline in English. Our findings indicate that just adding nationality and language parameters in personas might not be adequate, as it can introduce clinical inconsistency across languages. LLM judge models often exhibit inaccuracies in assessing depression severity in non-English texts, with performance varying across different models. This exposes the systemic limitations of applying English-centric personas to multilingual contexts. Ultimately, our work highlights the urgent need for culturally responsive data generation to ensure equitable mental health systems globally.

Family members caring for individuals with Alzheimer's disease and related dementias (AD/ADRD) provide the foundation of long-term care worldwide. In 2023, more than 11 million U.S. family and friends contributed 18 billion hours of unpaid care, often at the cost of their own physical and mental health. These informal caregivers -- also referred as the "invisible second patients" -- experience elevated rates of mental health problems. Yet research commonly reduces their complex psychosocial experiences to a single construct of caregiver burden, obscuring which specific needs are unmet or effectively supported. At the same time, digital and AI-enabled technologies are rapidly expanding, from smartphone apps and videoconferencing to sensor platforms and AI chatbots. However, the absence of shared frameworks across medicine, psychology, and technology research limits cumulative progress. This study introduces a Caregiver Mental Health and Technology Taxonomy that systematically links AD/ADRD caregiver needs with corresponding classes of technology-based interventions. Drawing from an interdisciplinary literature review and two qualitative studies with caregivers, the taxonomy identifies mismatches between caregiver priorities and existing technological support, highlights under-served domains such as relational strain and compassion fatigue, and proposes design directions for adaptive, responsive systems. The framework offers a shared vocabulary to guide clinicians, researchers, and technology designers in developing more person-centered and clinically grounded innovation in dementia care.

Dementia and depression are the most prevalent neuropsychiatric disorders in geriatric populations, and their overlapping symptoms pose major challenges for differential diagnosis. In this study, we investigate open-weights Large Language Models (LLMs) for predicting dementia and depression severity from speech samples collected during standardized history taking interviews with 154 German-speaking subjects. We introduce an observer-based Global Depression Scale (GDS-D) aligned with the established Global Deterioration Scale (GDS), enabling parallel global staging of affective and cognitive symptoms. We compare three LLMs (Mistral 3.1, DeepHermes, Qwen3) in two settings: (1) zero-shot prediction and (2) LLM-based feature extraction for Support Vector Regression, using human and pause-enriched transcripts. Results show that LLMs effectively predict depression severity in zero-shot settings (best MAE of 0.60), while dementia assessment benefits substantially from structured feature extraction (best MAE of 0.78), reducing errors by up to 35% over zero-shot baselines. Pause-enriched transcripts achieve competitive performance with human transcriptions, demonstrating the viability of fully automatic screening pipelines for differential neuropsychiatric assessment.

Depression is the leading cause of disability worldwide, and early detection of symptom change is essential for timely intervention. Validated instruments such as the Patient Health Questionnaire-9 (PHQ-9) support symptom monitoring at scale, but real-world completion rates are low, introducing response bias and systematic missingness. Passive approaches that infer severity from routinely generated data could close this gap. We address this by predicting PHQ-9 total scores directly from transcripts of conversations between users and an AI mental health application, requiring only conversation text and no additional clinical data. We fine-tune a Qwen3.5-27B backbone with a regression head, augment 3,111 ground-truth labels with pseudolabels generated by a reasoning model (Claude Opus) and iteratively trained intermediate models, for a combined dataset of 6,283 users. On a held-out test set of 842 users, our best model achieves MAE = 2.6, RMSE = 4.0, Pearson r = 0.80, and AUC = 0.91 at the PHQ-9 >= 10 clinical threshold. We also find AUC > 0.87 at every severity threshold from PHQ-9 >= 3 to PHQ-9 >= 24, demonstrating that the model captures depression severity across the full clinical spectrum. This work opens the door to passive, continuous symptom monitoring in AI mental health platforms, without requiring users to complete self-report measures.

Training psychotherapists in evidence-based interventions such as Acceptance and Commitment Therapy (ACT) requires repeated practice with meaningful feedback, yet opportunities for safe, standardized training are limited by ethical, logistical, and resource constraints. We introduce a system designed to support ACT-oriented psychotherapy training through spoken dialogue with an embodied virtual patient. The system uses large language models to simulate patient behavior conditioned on profiles derived from real therapy sessions and configurable clinical scenarios, while a separate automated evaluator provides turn-by-turn feedback on therapist responses based on established ACT fidelity criteria. Rather than aiming to replace supervision, the system is intended to support deliberate practice by enabling experimentation, reflection, and immediate feedback in low-risk settings. Expert evaluation with practicing psychologists confirmed high realism in patient behavior and demonstrated that immediate turn-by-turn ACT feedback increased therapists' awareness of intervention choices and enabled effective experimentation with alternative responses. Quantitative evaluation across 49 therapy transcripts identified GPT-4o-mini as the optimal feedback model, achieving the lowest mean absolute error (MAE = 6.12) in replicating human supervisor ACT fidelity ratings with statistically significant agreement. This work demonstrates the potential of fidelity-aware simulated patients as a scalable complement to psychotherapy training.

Cloze is an open-source web platform for conducting controlled, monitored studies of human-AI conversation in mental health research contexts. Consumer large language model (LLM) products such as ChatGPT, Claude, and Gemini are built for individual productivity, and offer researchers little experimental control, inconsistent data export, and no shared safety scaffolding that holds across providers. Cloze gives research teams a single environment in which they configure which models participants converse with, how the AI is instructed, how conversations are scheduled over time, and which safety constraints apply unconditionally, while every message is captured with full provenance (model version, prompt configuration, timing). The platform currently supports OpenAI, Anthropic, Google, and locally hosted open-weight models served through Ollama behind a unified interface, and runs in the cloud or fully on premises so that participant data need never leave an institution. Cloze is research infrastructure for building an evidence base on human-AI interaction in mental health contexts. It is not a therapeutic product.

Despite raising concerns about the mental health effects associated with the usage of TikTok, little is known about how related content is framed by creators and received by audiences. We collect the content of 28,341 TikTok videos and 80,130 comments from Mental Health Awareness Month (May) in 2023 and 2024 via the TikTok Research API, and study how the tone of awareness varies across topics and years. We characterize "tone" as the emotional and interpersonal framing of mental health discourse, operationalized through sentiment and toxicity measures. We extract topics from video text using BERTopic and log-odds keywords, then quantify topic-conditioned sentiment (XLM-T) and toxicity (Detoxify) separately for video transcriptions and comments. Sentiment captures the affective valence of content, while toxicity reflects the presence of harmful or abusive language. We find a stable set of recurring themes across years, spanning clinical conditions, emotional disclosure, self-care, and campaign-oriented content, with engagement highly skewed toward a small subset of topics. All sentiment and toxicity analyses are computed separately for video content and comments, allowing us to distinguish between content production and audience reception. Sentiment in videos is often negative for emotionally charged topics, while comments tend to shift toward more mixed or positive polarity, especially for suicide prevention. Toxicity is low in median overall, but exhibits longer-tailed outliers in comments than in videos that are more pronounced in comments and concentrated in specific topics (e.g., "Duet", "Suicide Prevention", and "Psychisch"). Overall, our results provide a topic-level decomposition of mental health discourse on TikTok during awareness-month campaigns.

Mental health problems such as anxiety, depression, and suicide remain urgent global challenges, where timely and accurate assessment is critical for effective intervention. Recently, large language models have been explored for mental health assessment. However, existing general-purpose post-training methods do not align with the cognitive processes of human assessment, which may lead to unreliable reasoning outcomes. To bridge this gap, we propose Cognitive Relative Policy Optimization (CRPO), a reinforcement learning framework tailored for the mental health domain. CRPO extends group relative policy optimization by integrating stage-dependent uncertainty modeling into the policy optimization process. Specifically, we introduce a stage-wise entropy regularization mechanism that encourages broad exploration in early reasoning phases and progressively enforces confident decision-making in later stages, mimicking the human cognitive shift from uncertainty to certainty. In addition, inspired by cognitive appraisal theory, we formalize cognitive reasoning stages, thereby guiding theory-grounded interpretable inference. Experiments on 8 mental health datasets show that CRPO achieves an average improvement of 10.4 percentage points in weighted F1-score over the best reinforcement learning baseline. Furthermore, the CRPO-trained model Mental-R1 demonstrates clear advantages compared with existing large language models on reasoning-intensive cases, suggesting that CRPO enhances reasoning capabilities for mental health assessment.

Detecting mental health disorders from Arabic social media text remains challenging due to dialectal variation, informal language, limited high-quality annotated resources, and severe class imbalance. While English mental health natural language processing (NLP) has progressed substantially, Arabic multi-class disorder classification remains insufficiently studied. This study proposes a two-phase framework for Arabic mental health text classification. In phase 1, three Arabic pre-trained language models, AraBERT, CAMeLBERT, and MARBERT, undergo Domain-Adaptive and Task-Adaptive Pretraining (DAPT and TAPT) using a large-scale corpus of unlabeled Arabic mental health tweets. The adapted models are evaluated under a unified protocol to identify the most effective backbone model. In phase 2, the selected model is assessed across four configurations combining single-stage and hierarchical two-stage classification architectures with full fine-tuning and Low-Rank Adaptation (LoRA). To support this study, we constructed a novel annotated Arabic mental health dataset comprising 50,670 tweets across six categories, with strong inter annotator agreement (Krippendorff's Alpha = 0.733, average pairwise agreement = 0.797). Experimental results show that the domain-adapted MARBERT (MentalMARBERT) achieves statistically significant improvements over baseline models in both accuracy and macro-F1. The hierarchical two-stage architecture combined with full fine-tuning achieves the best overall performance, reaching a macro-F1 of 0.861 and an accuracy of 0.877. These findings demonstrate the effectiveness of domain-specific adaptive pretraining and hierarchical classification for Arabic mental health disorder detection.

The escalating demand for mental healthcare, driven by rising societal stress, highlights the limitations of traditional psychiatric diagnostics. Conventional methods - relying primarily on clinical interviews and patient self-reports - are inherently vulnerable to subjective bias and the varying empirical judgment of practitioners. To address the need for quantitative evaluation, biological signal-based detection, including electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS), has emerged as a promising objective alternative. Such technology is particularly vital for identifying latent depressive states that may be unrecognized by the subjects themselves. Furthermore, in aging populations, the high comorbidity between depression and dementia necessitates early differentiation to prevent mutual symptom exacerbation and maintain Quality of Life (QoL). This pilot study of eleven healthy students establishes a framework for biological signal-based depression detection, serving as a foundational step toward automated, objective diagnostic tools for clinical use.

Automatic Depression Detection (ADD) from clinical interviews is a pivotal task in computational mental health, yet it remains challenging due to two critical obstacles: 1) difficulty in modeling complex but sparsely distributed depression clues within lengthy, multi-topic clinical interviews, leading to superficial and unreliable reasoning; 2) scarcity of labeled data due to clinical privacy, together with high cost of training and fine-tuning, limiting the deployment of supervised ADD systems. To jointly address these challenges, we propose Dep-LLM, a training-free framework that mirrors the step-by-step reasoning of clinical psychiatrists and operates entirely on frozen off-the-shelf foundation LLMs. Dep-LLM comprises three stages. First, a Chain-of-Thought (CoT) Depression Multi-factor Analysis module structurally decomposes the long dialogue into five clinically aligned themes and produces evidence-grounded rationales, effectively handling long-context dependencies. Second, we introduce Confidence Analysis and Modulation module that quantifies the epistemic reliability from token-level entropy of each rationale and applies an intra-label and inter-theme modulation that amplifies trustworthy signals while suppressing uncertain ones without extra training. Third, a Collaborative Multi-factor Prediction module dynamically integrates multi-factor signals weighted by confidence into the final diagnosis. Extensive experiments on the DAIC-WOZ and E-DAIC datasets demonstrate the effectiveness and generalizability of Dep-LLM: it surpasses zero-shot baseline on nearly all 21 foundation LLMs across 9 metrics such as accuracy, macro F1 and weighted-average F1, and further outperforms state-of-the-art supervised domain-specific LLMs as well as the latest closed-source commercial LLMs, while requiring no extra training.

Computational mental health research has predominantly centered on English-speaking populations, leaving Arabic-language discourse comparatively under-examined. We present an exploratory computational study of 8,147 tweets from 607 users classified by a GPT-4.1 personal-disclosure pipeline as likely lived-experience authors in three condition-specific Arabic-language X (formerly Twitter) Communities. We focus on discourse related to borderline personality disorder (BPD), bipolar disorder, and ADHD, and characterize community-associated linguistic patterns using a multi-domain cultural keyword framework. The results suggest that in this corpus, Bipolar tweets contain more religious and medical vocabulary, BPD tweets contain more relational, identity, and emotional-distress vocabulary, and ADHD tweets more often focus on practical symptoms and medication management. We treat these patterns as hypothesis-generating rather than confirmatory because the corpus is imbalanced across conditions, some subcorpora are temporally concentrated, and the keyword framework is an initial operationalization rather than a validated measurement instrument. The paper contributes a reusable LLM-assisted personal-disclosure pipeline and an exploratory cultural keyword framework for Arabic mental health discourse.

Speech-based mental health screening offers scalable depression detection, yet clinical deployment faces a significant barrier: users' privacy concerns about demographic information exposure. Current techniques struggle to resolve this conflict. Adversarial training often fails against unseen threats, whereas Differential Privacy tends to compromise diagnostic performance by injecting noise across all features. This paper presents InfoShield, which minimizes mutual information between speech representations and sensitive attributes while preserving depression classification accuracy. We identify that standard MINE estimators struggle with sequential speech due to temporal-static misalignment, and introduce TimeAwareMINE with cross-modal attention to align acoustic frames with attribute embeddings. Experiments on the Androids Corpus show InfoShield reduces gender inference from 92.6% to 55.5% and age inference from 55.7% to 30.3% with limited utility loss (6% F1 reduction), achieving F1=0.784 compared to prior SOTA's 0.723.

Large Language Models (LLMs) show promise in psychological counseling, yet existing benchmarks rely heavily on highly cooperative simulated clients. We observe a critical counselor-following phenomenon: these clients often rapidly shift from resistance to compliance after only a few turns, creating an illusion of therapeutic progress and inflating scores under current evaluation protocols through superficial empathy. To address this evaluation mismatch, we propose a Cognitive Behavioral Therapy (CBT)-grounded resistance-aware framework. We introduce CARS, a client simulator that explicitly models dynamic resistance via Cognitive Conceptualization Diagrams (CCDs). We present STREAMS, a dual-module framework that decouples strategic reasoning (Thinker) from response generation (Presenter) and optimizes it via reinforcement learning. We further propose EWTS-MI, an entropy-weighted metric for evaluating responsiveness under high-friction interactions. Experiments across resistant and non-resistant counseling settings validate our findings on evaluation mismatch and demonstrate the effectiveness of resistance-aware training for improving strategic robustness under challenging counseling interactions.

Large language models (LLMs) have shown growing potential for Cognitive Behavioral Therapy (CBT) counseling. However, most existing approaches still formulate counseling as a local response generation problem, focusing on empathetic replies within short, text-only, or single-session interactions. We argue that this formulation fundamentally mismatches the nature of real psychotherapy. In clinical CBT, therapy is a longitudinal process in which therapists continuously infer, update, and intervene on evolving therapeutic states across sessions. Realistic CBT further involves multimodal inference and delayed cross-session intervention effects, requiring models to capture longitudinal therapeutic state evolution under partial observability. We propose DMT-CBT, a framework for Dynamic Modeling of evolving Therapeutic states in CBT counseling. DMT-CBT maintains structured therapeutic states across sessions while incorporating multimodal behavioral grounding and tool-augmented intervention to support adaptive therapeutic reasoning. Based on this framework, we construct DMTCorpus, a synthetic multi-session multimodal CBT counseling dataset featuring evolving therapeutic states, image-grounded client behaviors, and cross-session intervention continuity. Experimental results show that DMT-CBT improves counseling fidelity and therapeutic alliance, produces more favorable longitudinal affective trajectories, and preserves therapeutic states more faithfully than post-hoc extraction approaches.

LLM chatbots increasingly serve as a first source of support for people in psychological distress, including those whose distress is entangled with delusional beliefs. Prior work on LLM mental-health safety largely evaluates general therapeutic quality or single-turn crisis detection, leaving unclear how models behave when distress is intertwined with delusion over sustained conversations. We address this gap with matched multi-turn simulations, across clinically grounded personas and six LLMs, that pair each delusional conversation with a distress-only control to isolate the effect of delusional framing. This reveals a recognition-intervention gap: models detect distress at comparable rates regardless of framing, yet sharply fail to act on it once distress is embedded in delusion, with safety interventions suppressed by up to 4.5x. The failure tracks accumulated acceptance of the user's premises rather than emotional validation. Worse, the intuitive fix of prompting models to assess user distress backfires under delusional framing; only delusion-aware prompting with explicit response guidance closes the gap, and even this depends on a delusion classifier that is itself unreliable on the most vulnerable models. Safe deployment therefore requires treating delusional framing as a distinct risk signal that overrides conversational accommodation.

Deep learning-based Major Depressive Disorder (MDD) detection using Electroencephalography (EEG) is fundamentally constrained by the "small-sample dilemma." Prevailing generative data augmentation methods not only incur heavy computational overhead but also risk introducing synthetic noise, thereby blurring classification boundaries. To challenge the traditional "data quantity first" convention, we propose a novel framework "Beyond Augmentation": Score-Guided Classification (SGC). SGC does not synthesize pseudo-samples; instead, it utilizes an unsupervised generative network architecture to model the structural and statistical anomaly degrees of samples, serving as the core "Pathological Prior". This prior, after robust normalization, is explicitly fused with deep feature representations, thereby precisely guiding the classifier's decision boundary. Furthermore, to dynamically adapt to varying channel configurations, we propose a Cross-Channel Spatial Adaptation module, utilizing a spatial mapping mechanism to effectively resolve the hardware heterogeneity of mismatched channels in multi-center datasets. Extensive experiments on the Mumtaz2016 and high-density MODMA datasets demonstrate the effectiveness and exceptional generalizability of our method under the challenging "zero data augmentation" setting and at "zero sample synthesis cost". Keywords: Electroencephalography (EEG), Depression Detection, Anomaly Score, Diffusion Models, Few-Shot Learning

Large language models (LLMs) show promise in generating supportive responses for mental health queries, but improving their usefulness, empathy, and safety often requires substantial compute, expert input, and labeled data. At the same time, deploying proprietary, cloud-based models for mental health-related interactions raises important privacy and data-governance concerns, given the sensitivities. To address this challenge, we introduce LLUMI setup that can be hosted in-house within protected environments. LLUMI consists of two complementary components: a generation model (GM), which drafts supportive responses to mental health queries, and an improvement model (IM), which revises an initial human-crafted response. We leverage feedback signals from Reddit mental health communities, using community endorsement patterns such as upvotes and downvotes to construct chosen-rejected response pairs for Supervised Fine Tuning (SFT) and Direct Preference Optimization (DPO). We further align LLUMI using human evaluation across five dimensions: readability, empathy, connection, actionability, and safety. Our results show that, despite relying on smaller open-source models rather than proprietary cloud-based GPT models, LLUMI achieves comparable performance across linguistic analyses and human evaluations. These findings suggest that open-source models, when trained with community-derived preference signals, can support high-quality mental health support assistance while offering a more privacy-preserving alternative for sensitive support contexts.

Recent advances in deep learning have enabled increasingly accurate electroencephalography (EEG)-based classification of Major Depressive Disorder (MDD), but the decision-making processes of high-capacity models remain difficult to interpret. This study investigates multiple post-hoc explainability methods applied to an InceptionTime architecture trained for EEG-based MDD detection. The analysis includes Shapley-based, gradient-based, and perturbation-based attribution approaches: DeepSHAP, Integrated Gradients, GradCAM, Occlusion, and Permutation Feature Importance. Explainability analysis was performed within a subject-level stratified 5-fold cross-validation framework using global attribution aggregation across EEG segments and subjects. The evaluated methods revealed partially convergent attribution patterns, with recurring emphasis on frontal, temporal, and posterior EEG regions, particularly in the right hemisphere. Quantitative comparison demonstrated substantial agreement between gradient- and perturbation-based approaches, while DeepSHAP produced comparatively distinct attribution distributions. At the same time, variability between explainability methods highlighted the influence of methodological assumptions on the resulting explanations. Overall, the results suggest that different post-hoc explainability approaches capture partially overlapping relevance structures in EEG-based deep learning models for depression detection. Although the observed attribution patterns are broadly consistent with several previous EEG studies of MDD, the analysis should be interpreted as exploratory rather than evidence of definitive neurophysiological biomarkers or clinical applicability. The study highlights both the usefulness and limitations of post-hoc explainability for interpreting black-box EEG classifiers in psychiatric applications.

A central puzzle for the behavioural sciences and for human-facing artificial intelligence is the persistence of within-person variability. The same individual, presented with the same observable input, produces different outcomes on different occasions, and different individuals produce divergent outcomes that no observable covariate fully predicts. We argue that this variability belongs in the dynamic latent state of the person, and that human outcomes are controllable in a precise and operational sense through interventions that target the state and its weighting at the moment a decision is being formed. We define a state as the time-indexed weighting vector over the dimensions that govern how an individual's biology, physiology, and neuropsychology process the next event into a decision and an outcome. The relationship between state, decision, and outcome is causal rather than correlational. The weighting vector is dynamic at sub-daily timescales. The conscious channel through which outcomes are reportable is a narrow attentional bottleneck whose contents are themselves state-dependent. Taken together, these claims imply that the outcome of a given event is controllable, conditionally, on the state-trajectory at the time of intervention. We motivate the framework with six strands of established evidence (causal inference, predictive processing, allostasis, attentional bottleneck, chronobiology, computational psychiatry) and a 24-month observational base from a deployed behavioural platform spanning more than 200,000 consented users across four occupational personas (research period 2023 to 2026). We derive seven testable predictions, list six operational requirements for state-aware systems, and discuss implications for digital health, education, AI personalisation, and personal agency.

Crisis Responders (CRs) rapidly assess thousands of youth SMS conversations each year to identify mental health concerns and guide support. Yet youth distress is increasingly expressed through evolving and context-specific language that often does not fit fixed-label taxonomies. This work analyzed 703,975 de-identified Kids Help Phone conversations (2018-2023) and expanded KHP's 19-label issue taxonomy into a 39-label hierarchical schema. We then introduce Keyphrase Generative Representation (KGR), a constrained LLM generating concise, conversation-specific keyphrases, evaluated across 129 conversations and 387 expert annotations. The expanded taxonomy achieved expert consensus reliability, with an accuracy of 0.96, and expert review found that 81% of keyphrases accurately reflected content and 74% improved clarity. KGR surfaced identity-linked themes absent from the fixed taxonomy, including immigration problems and caregiver burden, and supported a topic-retrieval workflow that increased accuracy from 0.25 to 0.70 (+0.45) over the manual analyst process. KGR marks a shift toward hybrid, interpretable generative representations that extend crisis response beyond static taxonomies to surface emerging and culturally grounded patterns of youth distress.

Large language models (LLMs) are increasingly being used for emotional support. They are also being developed for formal therapy purposes. However, LLMs like ChaptGPT or Llama are often developed with content moderation guardrails that prevent them from discussing sensitive subjects with users for both liability and safety purposes, and this inability to broach these subjects may affect their capacity as therapists. In this study, we perform an algorithm audit on three state-of-the-art moderation systems (OpenAI's moderation endpoint, Meta's Llama Guard, and Google's Shield Gemma) to investigate the extent to which these systems flag the content of real-life therapy sessions as undesirable. Our results raise implications for the limitations that users and organizations may encounter when designing LLMs to play the part of a therapist.

Cognitive distortions, distorted patterns of thinking, have been increasingly studied in computational mental health research. Although they are related to many, if not all, mental health disorders, most existing studies focus primarily on depression. In this work, we explore distortion profiles across multiple mental health conditions. We analyzed a large Reddit-based dataset containing posts from nine self-reported mental health groups as well as a control group using both an n-gram-based method and a fine-tuned transformer model for detecting cognitive distortions. Mental health groups, both when pooled together and when examined individually, showed higher prevalence of cognitive distortions compared to the control group, with the effect sizes ranging from small to moderate. When comparing distortion profiles across conditions, we observed largely similar patterns, although some groups exhibited overall higher levels of distortions than others. These findings suggest that relatively simple lexical approaches can be useful for exploratory analyses of group-level trends in large-scale mental health text data.

Speech monologues recorded in naturalistic settings provide opportunities to characterize mental illness phenomenology and detect symptom exacerbation. Large language models (LLMs) offer new possibilities for automating this process, as they require annotated data primarily for evaluation rather than training. In this paper, we present a novel automated, multi-agent LLM pipeline for the fine-grained, multi-label extraction of language suggestive of delusional beliefs, associated affective responses, and behavioral responses from transcripts of naturalistic audio diaries collected from people with moderate persecutory ideation. Evaluating an ensemble of three foundation models, we demonstrate that detailed diagnostic prompt instructions successfully reduce false positives for delusional theme classification, but also constrain the interpretation of affective or behavioral responses. Furthermore, comparing multi-agent adjudication frameworks shows that complex conversational debate between agents diminishes accuracy on clinically ambiguous text by inducing premature consensus. Instead, majority voting establishes robust performance (Micro F1 of 0.872 and 0.779 for delusion detection and classification respectively). This work provides a validated and scalable pipeline for the automated detection and characterization of content suggesting delusional beliefs in naturalistic speech.

Speech and language technologies offer valuable opportunities for supporting mental health assessment through objective and interpretable cues. We present a systematic feature-based analysis framework leveraging perceptually grounded acoustic and linguistic characteristics, including prosody, vocal quality, semantic coherence, syntactic structure, and sarcasm. Using statistical analysis and interpretable machine learning (XGBoost with SHAP and LIME), we examine associations between speech features and validated symptom measures of depression, anxiety, and ADHD. Evaluated on both controlled benchmark datasets (StressID, DAIC-WOZ, Androids, EATD) and a real-world clinical dataset, the framework reveals stable and consistent relationships between symptom severity and vocal irregularities (e.g., shimmer, jitter), lexical-syntactic patterns, and affective tone. An ablation study conducted across all datasets further identifies the most informative feature groups. This work explores a transparent and clinically interpretable approach to speech-based mental health analysis.

Existing language model applications struggle to meet the demand for emotionally oriented support, primarily due to their inability to maintain deep, persistent context across sessions. This report introduces Psych LM, an iOS application that validates the thesis that, for such applications, the surrounding architecture is paramount. Psych LM runs a local, on-device language model within a purpose-built, local-first runtime designed for behavioral and life-coaching applications. The system achieves the practical effect of a near-infinite context window through an automated, user-inspectable memory corpus that converts conversations into structured memory cards, including facts, goals, and events, and dynamically injects them into the prompt via semantic and vector search. As such, the system can be defined as an active-learning, retrieval-augmented generative, on-device architecture. This architecture delivers four primary contributions: a local-first design where privacy is a core property; a detailed description of the memory corpus for persistent context of key user information; a deterministic orchestration layer that provides a stable behavioral spine independent of the model's internal state; and a benchmark framework focused on evaluating the integrated system's reliability under realistic operating conditions. The R and D process confirms that complex, context-aware interaction can be reliably achieved under the strict constraints of a mobile environment by prioritizing architectural control and resource management over simple model size.

We describe our submission to the CLPsych2026 Shared Task on capturing and characterizing mental health changes through social media timeline dynamics. To infer the dominant self-states in posts (Tasks 1.1 and 1.2), we ensemble in-context learning of three open-weight large language models using majority voting. For predicting moments of change in a timeline (Task2), we train supervised classifiers on features derived from Task1.1 predictions. To summarize the patterns of mood dynamics and their progression over time within a timeline (Task 3.1), we augment in-context example labels predicted by upstream systems (Tasks 1.1, 1.2, and 2), yielding performance gains over zero-shot and unaugmented in-context learning baselines. Our submission ranked first on Task1.1, fourth on Task1.2, fourth on Task2, and third on Task~3.1.\footnote{The source code for the experiments is available at https://github.com/amirzia/clpsych26-cuny

Diagnosing Major Depressive Disorder (MDD) from functional magnetic resonance imaging (fMRI) using functional connectivity (FC) analysis requires large amounts of labeled data that are scarce in clinical settings. Existing augmentation methods synthesize FC matrices, which compress fMRI recordings into static pairwise summaries and discard temporal information. We propose fMRI-Diffusion, a framework that synthesizes region-of-interest (ROI)-level fMRI time series rather than FC matrices. A Temporal Transformer serves as the denoising network within a denoising diffusion probabilistic model, treating each time point as a token to capture temporal dependencies through self-attention. A supervised pretraining strategy initializes the Transformer with task-relevant representations before diffusion training, and FC matrices are derived from the synthesized time series for classification. Experiments on the REST-meta-MDD dataset show that augmenting training data with synthetic time series consistently improves diagnostic accuracy across ten classifiers, six parcellation atlases, and three acquisition sites. The method outperforms five recent FC-based synthesis approaches, with accuracy gains of up to 3.7 percentage points over the strongest baseline. Ablation studies confirm the contributions of both the Transformer-based denoiser and the pretraining strategy. Distributional fidelity metrics remain below 0.06 across all conditions, indicating close agreement between real and synthetic distributions. These findings suggest that synthesizing fMRI time series before FC computation preserves temporal information lost in matrix-level augmentation and provides a practical strategy for MDD diagnosis under limited data.

As demand for mental health care outpaces clinician-delivered assessment, scalable screening tools are increasingly needed. Large language models (LLMs) may identify psychiatric risk from patient narratives, but their reliability across diagnoses, demographic subgroups, and evidence-use patterns remains uncertain. We introduce a SCID-anchored benchmark of 555 semi-structured experiential interviews paired with diagnostic reference labels for anxiety disorder, major depressive disorder, post-traumatic stress disorder, and any current mental health disorder. Using zero-shot task-specific prompting, we evaluated five state-of-the-art LLMs and examined whether false-negative errors reflected missed psychiatric evidence or differential weighting of symptom, functional-impairment, and protective-context cues. Performance varied across tasks and models, with accuracy ranging from 0.49 to 0.86 and Matthews correlation coefficients from 0.16 to 0.38. GPT-4.1 Mini and GPT-5 Mini showed the most consistent disorder-specific accuracy. Subgroup analyses found higher depression-classification accuracy among male than female participants, no consistent age-related pattern, and modest non-uniform variation across race strata. Evidence-integration analyses showed that false-negative anxiety and PTSD classifications often contained explicit symptom evidence but were accompanied by preserved functioning, coping ability, or social support. Functional-impairment evidence shifted model outputs toward positive classifications, whereas protective-context evidence shifted outputs away. These findings suggest that LLMs may support scalable psychiatric screening, but their tendency to discount symptom evidence in the presence of preserved functioning or protective context requires careful validation before clinical deployment.

We present DreamerNLplus, a hybrid framework for modeling mental health dynamics from social media timelines in the CLPsych 2026 shared task. Our system addresses three tasks: psychological state modeling, temporal change detection, and sequence-level summarization. For Task 1, we combine LLM-based data augmentation, DeBERTa classification, and Random Forest regression for structured state prediction. For Task 2, we use few-shot prompting with a locally deployed Llama 3.1 model to detect Switch and Escalation events using short-term temporal context. For Task 3.1, we explore both a deterministic rule-based summarization pipeline and a few-shot LLM-based approach, ranking \textbf{2nd} officially. Our RAG-based method achieves strong performance in Task 3.2, ranking \textbf{1st} for Improvement and \textbf{3rd} for Deterioration, demonstrating its ability to capture recurrent psychological change patterns across timelines. Our analysis reveals key challenges, including the mismatch between classification and regression performance, the difficulty of modeling temporal transitions, and the disagreement between semantic and similarity-based evaluation metrics. These findings highlight the complexity of modeling mental health dynamics and motivate future work on unified evaluation frameworks. We share our code and prompts at https://github.com/4dpicture/CLPsych2026

We introduce a novel Longitudinal Focused Attention Meditation Electroencephalography (L-FAME) dataset and an accompanying benchmark, designed to foster research into the neural effects of various meditation practices and the evolution of these effects over a six-week training period. The dataset contains EEG recordings and psychological assessments from 74 healthy college participants, collected at two distinct time points: pre-intervention and post-intervention. Participants were randomly assigned to one of three distinct meditation groups: two mantra-based techniques (SA-TA-NA-MA and Hare Krishna) and one Breath Focus practice. Leveraging this unique longitudinal and comparative dataset, we propose a benchmark suite comprising three distinct classification tasks: (1) cognitive state decoding to distinguish between resting and meditation states, (2) fine-grained classification of the specific meditation techniques, and (3) cross-session adaptation to evaluate model generalization across the longitudinal time gap. We provide comprehensive baseline results for these tasks utilizing a range of classical machine learning algorithms and deep learning architectures. The complete dataset, preprocessing pipelines, and benchmark evaluation code will be publicly released, offering a valuable resource and a standardized framework for the development and comparison of new analytical methods in computational meditation research and EEG-based machine learning. The dataset is available at https://huggingface.co/datasets/L-FAME-Dataset-Benchmark/L-FAME

Text-based counseling provides a valuable source of information for assessing depression severity. We study prediction of the total score on the eight-item Patient Health Questionnaire (PHQ-8), a self-report measure of depression severity, from counseling transcripts. Clinical-based methods rely mainly on large language model (LLM) inference to obtain structured session-level assessments, but these assessments provide limited information about which utterances support each score. Training-based methods train predictors directly on sentences or their semantic embeddings and preserve local conversational detail, but must learn clinical structure from limited labeled transcripts. Integrating a small set of clinical feature scores with a long sequence of high-dimensional utterance representations is challenging, as simple fusion can overemphasize dialogue evidence and fail to link clinical features to supporting utterances. Combining structured clinical assessments with sentence-level semantics, we propose EmoTrack, which jointly encodes clinical feature scores and utterance representations to predict the total PHQ-8 score. For longitudinal assessment across successive sessions, the model can also incorporate a compressed representation of the preceding session as optional memory. On the real-world DAIC-WOZ benchmark, EmoTrack reduces mean absolute error from 2.8234 to 2.4708 relative to the strongest evaluated baseline. Across five settings covering single-session estimation, cross-dataset transfer without adaptation, and longitudinal assessment, it reduces normalized aggregate error by approximately 6.1% relative to the strongest baseline.

In recent years, large language models have shown substantial potential in psychological support tasks. However, existing psychological counseling data mostly rely on single-turn question answering or short multi-turn dialogues, making it difficult to characterize how college students' psychological distress accumulates, interacts, and gradually evolves over long periods within campus life events. To address this issue, this paper proposes Psy-Chronicle, a structured data-generation framework for synthesizing long-horizon campus psychological counseling dialogues. We generate a semester-spanning temporal stress event graph to model the chronological order and evolutionary dependencies among campus stress events. Through interactive simulation between a student agent and a counselor agent, together with a structured memory integration mechanism, Psy-Chronicle generates long-horizon dialogues with continuity across counseling sessions. Based on Psy-Chronicle, we construct and open-source CPCD, a Chinese long-horizon dialogue dataset for college psychological counseling, containing 100 student profiles, 90,000 counseling dialogues. We further build CPCD-Bench to evaluate models' long-horizon campus counseling capabilities from three dimensions: session-level response, long-horizon memory recall, and temporal-causal reasoning. Experimental results show that CPCD effectively improves session-level response generation and long-horizon memory recall for models with the same base architecture. Meanwhile, improvements in temporal-causal reasoning remain limited, indicating that event-chain organization and causal explanation are key challenges in long-horizon psychological counseling modeling. The related code and data are available at: https://github.com/EdwinUSTB/Psy-Chronicle

Longitudinal passive sensing enables continuous health prediction, yet models often fail under cross-dataset distribution shifts. Traditional ML overfits cohort-specific artifacts, while Large Language Models (LLMs) struggle to reason reliably over long, heterogeneous time-series. We introduce TimeSRL, a two-stage LLM framework that routes predictions through an explicit semantic bottleneck. The model first abstracts raw signals into high-level natural language, then predicts behavioral outcomes from these abstractions alone. This forces the model to reason over semantic concepts that we argue generalize better than raw numbers. We optimize this process end-to-end using Group Relative Policy Optimization (GRPO) with Reinforcement Learning from Verifiable Rewards (RLVR), learning outcome-aligned abstractions without gold intermediate annotations. Instantiated on mental-health prediction, TimeSRL achieves state-of-the-art performance on a benchmark designed to stress-test cross-cohort generalization under a rigorous leave-one-dataset-out (LOSO) protocol, reducing mean absolute error (MAE) over strong non-LLM ML and LLM baselines by 3.1--10.1% and 9.5--44.1% for anxiety, and 3.2--9.6% and 27.4--57.6% for depression (all $p$s<0.05). TimeSRL significantly outperforms prior methods in cross-benchmark transfer across different sensing pipelines, rivaling its own within-domain performance without target-domain fine-tuning. These results demonstrate that semantic abstractions are reusable and point to a new direction for generalizable behavior modeling via RL-tuned LLMs.

Mental health has become a global priority, leading to a massive administrative burden in the coding of clinical diagnoses. This study proposes the automation of psychiatric diagnostic analysis by mapping free-text descriptions to the International Classification of Diseases (ICD) using Natural Language Processing (NLP) and Machine Learning (ML) techniques. Utilizing a specialized dataset of 145,513 Spanish psychiatric descriptions, various text representation paradigms were evaluated, ranging from classical frequency-based models (BoW, TF-IDF) to state-of-the-art Large Language Models (LLMs) such as e5_large, BioLORD, and Llama-3-8B. Results indicate that transformer-based embeddings consistently outperform traditional methods by capturing implicit semantic cues and nuanced medical terminology. The e5_large model, through end-to-end fine-tuning, achieved the highest performance with a $F1_{micro}$ score of 0.866. This research demonstrates that adapting LLMs to specific clinical nomenclature is essential for overcoming the challenges of ``long-tail'' label distributions and the inherent ambiguity of psychiatric discourse.

This paper reflects on twenty years of building NLP resources and research infrastructure for Arabic, a language spoken by hundreds of millions yet historically underserved relative to languages such as English or Chinese. The first decade focused on foundational linguistic infrastructure; the second shifted toward computational social science, social media analysis, and socially oriented applications. Rather than cataloguing outputs, the paper examines what the experience of building them revealed. Three counterintuitive lessons emerge: building datasets is as much a social process as a technical one; communities formed around shared tasks often matter more than the tasks themselves; and moving from language resources to computational social science exposes challenges that traditional NLP training does not address. We discuss three failures: a depression detection corpus that never reached clinical practice, a period of spreading across too many shared tasks without sufficient depth, and a long-standing assumption that Modern Standard Arabic infrastructure would transfer cleanly to dialectal tasks. These experiences suggest that the hardest problems in developing NLP for underserved communities are not linguistic but social, institutional, and epistemic, and require competencies the field rarely teaches.

Social media text data are often used to train Machine Learning (ML) models to identify users exhibiting high-risk mental health behaviors. However, sharing this sensitive data poses privacy risks and limits the growth of benchmark datasets. We comprehensively evaluate whether privacy-preserving ML techniques can enable safer data sharing while preserving performance. Specifically, we apply federated learning (FL) and Differentially Private FL for two widely-studied mental health prediction tasks: depression detection on X (Twitter) and suicide crisis detection on Reddit. We simulate realistic data-sharing scenarios by treating each user as a client in a non-IID setting, evaluating across different client fractions, aggregation strategies, and privacy budgets. While FL achieves comparable performance to centralized training (centralized F1 = 85.63; best FL model F1 = 83.16) on depression identification, we find that Differentially Private FL has a large performance-privacy trade-off (up to F1 = 27.01 drop) even with low levels of noise (epsilon = 50). This is due to the distortion of highly informative yet sparse mental health linguistic markers related to mental health, like health topics and emotion words. This research empirically demonstrates the potential and limitations of current privacy preservation techniques for mental health inference tasks.

Cancer survivors face elevated rates of depression, anxiety, and general emotional distress, yet the precise moments they most need support are often the moments when self-report is sparse, a phenomenon we term the diary paradox. Passive smartphone sensing offers a continuous, unobtrusive alternative, but prior sensing-based affect prediction has been limited by an accuracy ceiling, suggesting a bottleneck not only in available data, but in how behavioral signals are interpreted. We present PULSE, a system that shifts from fixed feature pipelines to agentic sensing investigation: LLM agents equipped with eight purpose-built tools autonomously query smartphone sensing data, compare current behavior against personalized baselines, and calibrate inferences through retrieval-augmented population-level comparisons. Rather than receiving pre-formatted feature summaries, agents decide which modalities to inspect, how far back to look, and how deeply to investigate, mirroring hypothesis-driven clinical reasoning. We evaluate PULSE through a 2*2 factorial design crossing reasoning architecture (structured vs. agentic) with data modality (sensing-only vs. with diary) on 50 cancer survivors from a longitudinal study of cancer survivors. Agentic reasoning is the primary driver of performance: agentic multimodal agent achieves balanced accuracy of 0.743 for emotion regulation desire with diary and sensing data, while agentic agents predict intervention availability at 0.713 with passive sensing data only. These results suggest that agentic investigation may be a cornerstone for unlocking the clinical value of passive sensing, advancing the feasibility of proactive just-in-time mental health support.

Cognitive behavioural therapy is widely used to help patients understand and manage psychological distress. It is often delivered through spoken conversation, where therapists attend not only to what patients say, but also to how they say it, because these cues can help therapists decide how to respond and adapt treatment. Progress in building AI systems for CBT remains largely limited to text, partly because most available datasets are text based and shareable spoken CBT data are scarce under ethical and privacy constraints. This creates a blind spot because text based models and evaluations cannot capture the mismatch between the transcript and the patient's voice, even though therapists often rely on this mismatch to understand patient distress. We introduce CBT-Audio, a dataset for evaluating patient distress estimation from spoken CBT sessions with audio language models. CBT-Audio contains 1,802 patient turns from 96 publicly available CBT recordings, with turn-level distress labels validated on an experts-annotated subset. We evaluate 10 open source audio language models under three input conditions, where models receive only patient audio, only the transcript, or both audio and transcript. Our results show that audio can provide useful information beyond text, especially when combined with transcripts. Adding audio to transcript input improves distress estimation over using the transcript alone in 8 of 10 model families, with significant gains in 4, and case studies show the clearest benefit when verbal content and vocal delivery diverge. CBT-Audio makes spoken patient behaviour measurable for AI evaluation in CBT-related tasks and supports future work on audio language models for mental health interaction.

Large language models (LLMs) are increasingly used in the mental health domain, yet it remains unclear how well they capture related biomedical knowledge and how reliably they apply it to clinically salient structured judgments. Here, we present a knowledge-graph (KG)-grounded benchmark for assessing LLMs on mental-health entity recognition, relation judgment, and two-hop reasoning. The benchmark is derived from PrimeKG and comprises nine task families with KG-supported answers and controlled negative options. Experiments across 15 closed- and open-source LLMs reveal a persistent recognition-to-judgment gap: leading models achieve near-ceiling performance on entity typing and on the small relation-typing subset, yet they still struggle with relation prediction and two-hop reasoning. Additionally, short KG-derived snippets benefit some models but degrade performance for others. Moreover, output-format reliability can substantially influence measured performance under constrained multiple-choice settings, highlighting the critical role of response validity in benchmark-based evaluation. MHGraphBench should therefore be interpreted as evaluating agreement with a curated mental-health slice of PrimeKG under a constrained multiple-choice interface, rather than as a direct assessment of real-world clinical safety.

Every day, users generate digital traces (e.g., social media posts, chats, and online interactions) that are inherently timestamped and may reflect aspects of their mental state. These traces can be organized into temporal trajectories that capture how a user's mental health signals evolve, including phases of improvement, deterioration, or stability. In this work, we propose an explainable framework for detecting and analyzing depression-related status shifts in user digital traces. The approach combines multiple BERT-based models to extract complementary signals across different dimensions (e.g., sentiment, emotion, and depression severity). Such signals are then aggregated over time to construct user-level trajectories that are analyzed to identify meaningful change points. To enhance interpretability, the framework integrates a large language model to generate concise and human-readable reports that describe the evolution of mental-health signals and highlight key transitions. We evaluate the framework on two social media datasets. Results show that the approach produces more coherent and informative summaries than direct LLM-based reporting, achieving higher coverage of user history, stronger temporal coherence, and improved sensitivity to change points. An ablation study confirms the contribution of each component, particularly temporal modeling and segmentation. Overall, the method provides an interpretable view of mental health signals over time, supporting research and decision making without aiming at clinical diagnosis.

This paper audits benchmark evaluation in clinical-interview depression detection through four complementary probes across DAIC/E-DAIC, CMDC, ANDROIDS, MODMA, and PDCH. First, we re-evaluate E-DAIC under strict subject-disjoint leave-one-subject-out cross-validation. A lightweight hybrid text-plus-LLM-score model reaches macro-F1 = 0.723 - the highest reported under this protocol, to our knowledge - providing a conservative out-of-fold reference point that does not depend on the privileged official holdout. Second, we test whether the E-DAIC official split supports fine-grained leaderboard rankings by sweeping 96 model configurations across modality bundles, pooling strategies, and learners. Development-side cross-validation and official-test rankings align only moderately: the best cross-validation configuration ranks twentieth on the official test, the official-test winner ranks forty-first by cross-validation, top-3 overlap is zero, and the apparent winner is rank-1 in only 32.3% of subject bootstraps. Third, we externally validate strong public CMDC and ANDROIDS baselines that achieve near-ceiling in-domain performance. Zero-shot transfer to external corpora is substantially weaker. Finally, we stress-test E-DAIC text and audio models using paired symptom-dense versus symptom-light interview slices defined by an SRDS-based annotator. Text scores rise sharply on symptom-dense slices, whereas audio scores remain nearly flat; the text-minus-audio gap is positive across all five seeds.

Chatbot usage has increased, including in fields for which they were never developed for--notably mental health support. To that end, we introduce Validations of Ethical and Responsible AI in Mental Health (VERA-MH), a novel clinically-validated evaluation for safety of chatbots in the context of mental health support. The first iteration of VERA-MH focuses on Suicidal Ideation (SI) risks, by assessing how well chatbots can responds to users that might be in crisis. VERA-MH is comprised of three steps: conversation simulation, conversation judging and model rating. First, to simulate conversations with the chatbot under evaluation, another chatbot is tasked with role-playing users based on specific personas. Such user personas have been developed under clinical guidance, to make sure that, among others, multiple risk factors, demographic characteristics and disclosure factors were represented. In the judging step, a second support model is used as an LLM-as-a-Judge, together with a clinically-developed rubric. The rubric is structured as a flow, with a single Yes/No question asked each time, to improve answers' consistency and highlight models' failure modes. In the last stage, results of each conversation are aggregated to present the final evaluation of the chatbot. Together with the framework, we present the result of the evaluations for four leading LLM providers.

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.

We propose a game-theoretic framework for adaptive multi-agent intelligent systems. Unlike classical game theory, which often treats strategies as primitive objects chosen by perfectly rational agents, the proposed framework provides a mathematical foundation for studying equilibrium in NeuroAI and can be viewed as an extension of game theory under relaxed assumptions, including partial observability, bounded computation, and uncertainty. At its core, Multilevel Interactive Equilibrium (MIE) generalizes the classical Nash equilibrium to intelligent systems with internal computation. Rather than being defined solely at the level of observable behavior, equilibrium emerges when neural learning dynamics, cognitive representations, and behavioral strategies mutually stabilize between interacting agents. This framework applies uniformly to interactions between two biological brains, two artificial agents, or hybrid human-AI systems. We discuss applications of multilevel game theory to human-autonomous vehicle driving, human-machine interaction, human-large language model (LLM) interaction, and computational psychiatry. We also outline experimental strategies and computational methods for estimating MIE and discuss challenges and prospects for future research.

Psychological support hotlines provide critical support for individuals experiencing mental health emergencies, yet current assessments largely rely on human operators whose judgments may vary with professional experience and are constrained by limited staffing resources. This paper proposes a large language model (LLM)-based framework for automated crisis level classification, a key indicator that supports many downstream tasks and improves the overall quality of hotline services. To better capture emotional signals in spoken conversations, we introduce a paralinguistic injection method that inserts identified non-verbal emotional cues into speech transcripts, enabling LLM-based reasoning to incorporate critical acoustic nuances. In addition, we propose a reasoning-enhanced training strategy that trains the model to generate diagnostic reasoning chains as an auxiliary task, which serves as a regulariser to improve classification performance. Combined with data augmentation, our final system achieves a macro F1-score of 0.802 and an accuracy of 0.805 on the three-class classification task under 5-fold cross-validation.