AI Chatbots for Mental Health: Values and Harms from Lived Experiences of Depression

Recent advancements in LLMs enable chatbots to interact with individuals on a range of queries, including sensitive mental health contexts. Despite uncertainties about their effectiveness and reliability, the development of LLMs in these areas is growing, potentially leading to harms. To better identify and mitigate these harms, it is critical to understand how the values of people with lived experiences relate to the harms. In this study, we developed a technology probe, a GPT-4o based chatbot called Zenny, enabling participants to engage with depression self-management scenarios informed by previous research. We used Zenny to interview 17 individuals with lived experiences of depression. Our thematic analysis revealed key values: informational support, emotional support, personalization, privacy, and crisis management. This work explores the relationship between lived experience values, potential harms, and design recommendations for mental health AI chatbots, aiming to enhance self-management support while minimizing risks.

Interpersonal Theory of Suicide as a Lens to Examine Suicidal Ideation in Online Spaces

Suicide is a critical global public health issue, with millions experiencing suicidal ideation (SI) each year. Online spaces enable individuals to express SI and seek peer support. While prior research has revealed the potential of detecting SI using machine learning and natural language analysis, a key limitation is the lack of a theoretical framework to understand the underlying factors affecting high-risk suicidal intent. To bridge this gap, we adopted the Interpersonal Theory of Suicide (IPTS) as an analytic lens to analyze 59,607 posts from Reddit's r/SuicideWatch, categorizing them into SI dimensions (Loneliness, Lack of Reciprocal Love, Self Hate, and Liability) and risk factors (Thwarted Belongingness, Perceived Burdensomeness, and Acquired Capability of Suicide). We found that high-risk SI posts express planning and attempts, methods and tools, and weaknesses and pain. In addition, we also examined the language of supportive responses through psycholinguistic and content analyses to find that individuals respond differently to different stages of Suicidal Ideation (SI) posts. Finally, we explored the role of AI chatbots in providing effective supportive responses to suicidal ideation posts. We found that although AI improved structural coherence, expert evaluations highlight persistent shortcomings in providing dynamic, personalized, and deeply empathetic support. These findings underscore the need for careful reflection and deeper understanding in both the development and consideration of AI-driven interventions for effective mental health support.