mental health app developers

Abstract: People increasingly use general-purpose chatbots such as ChatGPT, Claude, and Gemini for mental health and emotional support. We report a multi-stage longitudinal qualitative study of 18 U.S. adults, conducted from April to December 2025, combining initial interviews, a four-week diary study, focus groups, and exit interviews. We find that socioemotional use often emerged gradually out of practical use and when other forms of support were unavailable. Participants developed routines and boundaries around chatbot use, which were disrupted by model updates, evolving public discourse about AI harms, and changes in personal circumstances. We demonstrate how longitudinal study captures factors beyond the human-AI dyad, and argue that HCI researchers and designers should account for users' histories with their chatbots and broader care ecologies when evaluating AI systems over time and introducing updates that may disrupt established sources of support.

Abstract: With the existing digital mental health tools specifically developed for Western settings, Pakistani students are exposed to a uniquely compounded stress situation in their university that includes academic, financial, familial, and relational stressors, which have become a serious concern for academic and psychological development of students in Pakistani universities. This paper introduces a new, AI-driven and culturally sensitive stress detection and wellness support system that is tailored to the context of Pakistani university students. The system is based on a machine learning model called Random Forest which is trained using a validated student stress data set of 1100 responses on 20 features from psychological, physiological, academic, environmental and social aspects, with an accuracy of 89.09% and a macro F1-score of 0.89, in three stress severity levels. The classification outputs are passed on to an open-source large language model through OpenRouter API, where an appropriately crafted system prompt, culturally aware, gives the model a conversation about wellness, in English, Urdu and Roman Urdu. The second most predictive stress factor in this population identified by feature importance analysis was teacher-student relationship, which is a culturally important stress factor highlighting the need for region-aware mental health systems. Future research will involve primary data collection from students at various academic levels of Pakistani Universities with the validated DASS-21 instrument focusing on the students who are moving from FSc to undergraduate studies, which is a time of being psychologically vulnerable which is under-researched.

Abstract: Existing emotional support conversation systems mainly focus on one-on-one seeker-supporter interactions and individual emotional states, leaving interpersonal relations in multi-party scenarios underexplored. In this work, we introduce relation-aware emotional support conversation, a new task that evaluates whether LLMs can capture and utilize the evolving dynamics of relationships to offer more effective emotional support. We construct RESCUE (Relation-aware Emotional Support Conversation Understanding and Evaluation Benchmark) from real couple and family interview conversations, containing 191 samples, 7,079 annotated turns, and 1,064.8 minutes of video. Based on rich annotations of socio-emotional and support-related dynamics, RESCUE defines six tasks that evaluate two core capabilities required for relation-aware emotional support: Relational Understanding and Relation-Sensitive Support. Experiments with ten LLMs show that current models perform relatively well on tasks relying on local emotional or intervention cues, but struggle with relation-intensive tasks such as relation pattern prediction, viewpoint prediction, and support strategy prediction. These findings reveal the limitations of current LLMs in modeling interpersonal relations and making relation-sensitive support decisions.

Abstract: Assessing suicide risk from social media text is a small-data, high-stakes setting requiring not only severity prediction but also supporting evidence and clinically relevant risk and protective factors. Yet common NLP techniques, including model scaling, synthetic data, loss reweighting, ensembling, and threshold tuning, are often applied without testing whether their gains hold up under severe class imbalance, coupled outputs, and limited author-level data. We study 1,635 clinician-annotated posts and audit 31 pre-specified techniques from 7 methodological families through roughly 300 controlled experiments on author-disjoint partitions. We found no prior audit of this playbook in this regime. The findings guide a task-grounded system for three outputs: 4-level suicide risk, evidence spans, and 24 clinical risk and protective factors. Only 5 of 31 comparisons produced reliable gains. We reformulate factor prediction as entailment between each post and its codebook definitions, using an architecturally diverse ensemble with class-balanced training and score rescaling. Risk predictions condition a 7-model evidence tagger ensemble; evidence restricts symbolic risk rules; and a difficult risk class is routed separately. The factor predictor remains independent because risk evidence provides no additional factor signal. We also correct a mismatch between validation scores used for threshold fitting and test-time ensemble scores through deployment-consistent calibration, yielding the largest improvement to the factor system. The final system achieves 0.8203 for risk, 0.7953 for evidence, and 0.7045 macro-F1 for factors, with a 0.7781 composite, ranking third among 53 teams. We call the underlying principle task-conditioned technique selection: retain techniques only when task-specific knowledge, structure, or empirical evidence justifies them.

Abstract: AI chatbots are increasingly used for companionship, emotional support, and personal self-disclosure; however, how social engagement with these systems unfolds over time and shapes users' well-being remains unclear. To address this, we conducted a two-wave longitudinal study of CharacterAI users, surveying 1,182 participants at baseline and 439 after a mean follow-up of 12 months. We examined how social engagement with AI companions evolves and how these longitudinal engagement patterns may influence well-being through two hypothesized pathways: sustained social engagement over time and the displacement of human social interaction. We found that interaction intensity, companionship use, and self-disclosure all showed substantial continuity over time. Greater interaction intensity at baseline predicted greater subsequent interaction intensity, companionship use, and self-disclosure. Consistent with the longitudinal engagement pathway, sustained social engagement across these dimensions was consistently associated with lower well-being. Results further support the social displacement pathway, indicating that these links were mainly explained by lower in-person social interaction. These findings highlight the importance of designing AI companions that support human social relationships without displacing them