Phuong Anh Nguyen, Jill Noorily, Matthew Flathers +7cs.CY cs.CL cs.IR
Online health information seeking is shifting from keyword search, where users consider a ranked list of links, to conversational systems that compose a single answer and curate its citations. Source evaluation therefore passes from user to platform, yet what these systems surface is poorly characterized. We audited three free consumer products (ChatGPT, Perplexity, Google AI Overview) on twenty English mental health questions under two prompt conditions, with a subset of three also translated into six further languages of varying resource tiers. We recorded 15,942 citations across 1,140 responses and 1,713 unique domains, then classified every citation with a nine-category organizational typology applied by a deterministic classifier validated against human coding. Citations were heavily concentrated: the ten most-cited domains accounted for 43.6% of English citations, and government, commercial health, and academic sources were closely matched at roughly 22% each. Platforms differed little in typical citation volume but sharply in consistency and in the source types they favored. Explicitly requesting sources shifted composition only modestly. Non-English queries surfaced fewer citations and were routed to language-appropriate resources at significantly lower rates. We release the typology, classifier, and annotated corpus as reusable instruments for auditing generative health search.
People share mental health diagnoses on social media, yet how such language becomes visible around their self-disclosure, and whether community engagement tracks it, remain unexamined across conditions. We analyze 89,605 Reddit posts from 739 users across eight conditions, removing each user's diagnosis disclosure and aligning their surrounding posts to that anchor. Within the pre-disclosure year, language-visible burden was highest in the month before disclosure for six conditions, earlier for post-traumatic stress disorder and furthest from it for borderline personality disorder, and remained visible afterward rather than resolving. The theme Seeking Clinical Explanations showed the largest early-to-late difference before disclosure in five conditions, yet engagement rarely tracked what users wrote: only 9 of 360 language--engagement correlations survived correction. Disclosure is therefore a waypoint in an unevenly visible process, and we offer implications for community practice and platform design where engagement metrics do not reflect clinical need.
Philipp Steigerwald, Nico Bienlein, Jennifer Burghardt +3cs.HC cs.CL
Rising global demand for mental health support creates significant service delivery challenges, with asynchronous email counselling serving as a crucial low-threshold channel for accessing care. This paper presents CAIA, a co-designed AI-based tool suite that demonstrates responsible AI integration into counselling practice through seven LLM-driven functions enhanced by retrieval-augmented generation. A field evaluation involved 34 professional counsellors conducting authentic sessions with trained student counsellees (36 threads, 321 messages, 1,257 AI outputs). User behaviour analysis confirms substantial adoption, revealing that professional autonomy and information accuracy are decisive for sustained acceptance, with counsellors particularly valuing interpretive functionalities that provide new perspectives and stimulate professional reflection.
Neil K. R. Sehgal, Dunigan Folk, Lyle Ungar +1cs.HC cs.AI
Large language models are increasingly used as private, always-available conversational systems, but little is known about how people with depressive symptoms use them. Building on CSCW work on disclosure and peer support, we examine ChatGPT as an emerging informal support infrastructure: private, persistent, responsive, and available outside ordinary hours. We analyze 187,093 ChatGPT conversations from 766 participants who completed the PHQ-8, comparing those below the moderate-symptom threshold (score of 10) with those at or above it. Higher-PHQ participants used ChatGPT more for mental-health, interpersonal, loneliness, self-focused, and support-seeking conversations, with pronounced late-night and recurring month-level patterns. Their language contained more first-person singular pronouns and absolutist terms. They more often engaged ChatGPT in high-disclosure contexts, but professional redirection was not higher. Language-based prediction was modest and insufficient for screening (AUROC 0.591). We argue these histories should not be treated as clinical screening data but as evidence LLMs are increasingly used as informal support infrastructure.
Matthew Flathers, Francesco Cipriani, John Torouscs.HC cs.CL cs.CY
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.
Henrique Ferraz de Arruda, Andreia Sofia Teixeira, Pranay Gundala Reddy +3cs.CY cs.CL cs.HC physics.soc-ph
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.