IntroductionGlobally, children and adolescents exposed to Adverse Childhood Experiences (ACEs) face an increased risk of developing mental health disorders. The prevalence of these mental disorders is further amplified by the lack of access to specialised mental health treatment especially in low resource settings. There is an urgent need for scalable mental health interventions that can effectively address the needs of these vulnerable populations. Non-specialist-delivered interventions, such as PROACT (Psychoeducation, Relaxation, Problem-solving, Activation, and Cognitive Coping Therapy), represent a promising scalable approach that could help bridge the existing mental health treatment gap in low-resource settings.ObjectivesThis study aimed to assess changes in depression, anxiety, and post-traumatic stress symptoms among children and adolescents exposed to adverse childhood experiences following participation in the PROACT intervention delivered by trained social workers in Nairobi, Kenya.MethodologyMixed-methods pre-post study design was employed. Twenty purposively selected sites across Nairobi County each contributed one social worker (N = 20), who received training to deliver the intervention. A total of 40 children participated and received 4–6 PROACT sessions. Quantitative data were analysed using STATA version 17. Paired t-tests were used to compare baseline and endline scores, while mixed-effects linear regression models with participant ID as a random effect were fitted to estimate changes in outcomes over time and account for repeated measures. Statistically significant improvements were observed across all mental health outcomes. Mean anxiety scores decreased from 6.2 at baseline to 2.7 at endline (mean difference: −3.5; 95% CI: −4.7 to −2.2; p < 0.001), while mean depression scores decreased from 6.4 to 2.9 (mean difference: −3.6; 95% CI: −4.9 to −2.3; p < 0.001). Mean PTSD scores decreased from 16.7 (95% CI: 12.8–20.5) at baseline to 7.3 (95% CI: 4.4–10.1) at endline (mean difference: −9.4; 95% CI: −14.6 to −9.3; p < 0.001). Mixed-effects linear regression analyses corroborated these findings, demonstrating significant reductions in PTSD (β = −9.44), anxiety (β = −3.48), and depression (β = −3.59) symptoms (all p < 0.001).ConclusionThe PROACT intervention was feasible and acceptable when delivered by social workers in Nairobi primary healthcare facilities and was associated with improvements in mental health outcomes among children and adolescents. These findings highlight the potential of task-sharing approaches to expand access to mental healthcare in low- and middle-income countries (LMICs) and warrant further evaluation in controlled studies.
Child Mind Institute Launches Research Initiative To Inform Safer AI Systems for Youth
New project will develop tools to study youth mental health during AI chatbot use
New York, NY — Today, the Child Mind Institute announced a new research initiative, launched with support from the OpenAI Foundation, to build the research infrastructure needed to measure and better understand youth mental health while using AI chatbots and over time. The effort aims to identify valid markers that can inform the design and testing of safer AI systems.
Millions of children in the United States are struggling with mental health or learning challenges, yet there continues to be a dire shortage of qualified mental health professionals. That, along with stigma and misinformation about mental health, is pushing young people to explore using readily available, often free AI tools for support, including general-purpose chatbots, digital companions, or “therapy bots.”
Novel and emerging digital technologies are shaping mental health faster than the pace of science and the development of evidence-based care can keep up. This new initiative will help advance research studying the impact of these tools and better support youth mental health.
“As the leading nonprofit dedicated to improving youth mental health through science, education, and care, the Child Mind Institute is well positioned to help tackle the key issues affecting the well-being of young people, including technology and the proliferation of AI. It is our belief that with appropriate safeguards and evidence, digital tools may complement care from trained clinicians,” said Harold S. Koplewicz, MD, president and medical director at the Child Mind Institute. “We are excited about filling a gap that currently exists in the research of AI tools and to work toward creating a safer online experience for youth around the globe.”
Using clinical assessments, digital journals, de-identified AI chat histories, real-time behavioral measures, and existing youth mental health datasets, the Child Mind Institute will build an infrastructure to better understand interactions between youth users and AI conversational platforms. With the goal of strengthening our understanding of the mental state in AI chatbot interactions, this initial one-year project will enable the research team to identify and begin scaling the signals needed to meaningfully assess and monitor youth mental health alongside their use of AI tools.
The Child Mind Institute has long been committed to advancing technologies that make mental health research and care more precise, measurable, and connected to real-world settings. Grounded in science and focused on impact, the organization brings together scientific rigor, clinical expertise, and product development experience to build digital tools that accelerate research, improve care, and expand access without compromising safety, quality, or accountability.
“Many of our youth are turning to AI chatbots for important areas of their lives — and mental health is no exception. It is our responsibility to more holistically comprehend the impact of these tools on mental health, both in the long and short term,” said Michael P. Milham, MD, PhD, chief science officer at the Child Mind Institute. “Digital platforms provide an opportunity to rethink the way we conduct mental health research, but they also introduce new challenges and risks. It is critical to better understand the relationship between AI use and youth mental health, and to examine whether, and under what conditions, AI tools can strengthen evidence-based care, support clinician training, and expand access to high-quality mental health services.”
This research initiative is being independently developed and solely executed by the Child Mind Institute. To ensure the safety and security of all study participants, it will be conducted with strong privacy protections, informed consent, ethical oversight, and careful data governance. The project will be co-designed by its principal investigators, Gregory Kiar, PhD, Arno Klein, PhD, and Dr. Milham, who bring expertise in computational methods, digital measurement, clinical science, and youth mental health. Consistent with the Child Mind Institute’s open science philosophy, all data will be shared to help fuel discovery across the field.
About the Child Mind Institute
The Child Mind Institute is an independent nonprofit organization dedicated to transforming the lives of children and families struggling with mental health and learning disorders. Through cutting-edge research, evidence-based clinical care, and public education, the Child Mind Institute builds open science platforms and digital tools to accelerate discovery and improve youth mental health worldwide.
For press questions, contact cmiscience@ssmandl.com or mediaoffice@childmind.org.
The post Child Mind Institute Launches Research Initiative To Inform Safer AI Systems for Youth appeared first on Child Mind Institute.
A conceptual multi-agent architecture for mental health triage in post-conflict Arabic-speaking populations: a theoretical proposition and staged validation argument
Syria’s protracted conflict has produced a mental health crisis of extraordinary scale, with post-traumatic stress, depression, and anxiety estimated at several times global baselines, set against fewer than 0.37 psychiatrists per 100,000 people. Existing AI mental health tools have been developed and evaluated primarily for English-speaking, non-humanitarian populations, and their transfer to this setting is constrained by three simultaneous structural deficiencies—extreme clinical scarcity, Arabic natural-language-processing underperformance for dialect, and cultural misalignment with Syrian idioms of distress—which we term the Triple Gap. This article is a conceptual contribution in the Hypothesis and Theory genre, and its central claim is theoretical rather than technical: that AI-assisted mental-health triage at a safety floor adequate for crisis relevant care in this setting is conditional on the joint satisfaction of three constraints—linguistic adequacy for the local dialect, cultural validity for local idioms of distress and help-seeking, and bounded clinical responsibility through human oversight. These constraints interact, so that a system satisfying fewer than all three is expected to fail in clinically consequential rather than random ways. As one possible design response to this proposition—neither the only one nor a validated one—we describe a conceptual multi-agent architecture aligned with the WHO mhGAP task-shifting model: a four-stage pipeline (screening, risk stratification, routing, follow-up) constrained by a cross-cutting cultural-adaptation layer, augmented by candidate verification mechanisms with explicit abstention, and governed by human oversight in which clinical responsibility rests with a licensed clinician. The proposal is a hybrid clinical decision support hypothesis, not an autonomous system. Because no Syrian Arabic clinical corpus yet exists, the conversational components of the design cannot presently be evaluated; we therefore set out a staged sequencing argument for future work in which the construction of a Syrian Arabic Mental Health Evaluation Corpus (SAMHEC) is the first and rate-limiting condition. We present no prototype, no corpus, and no clinical, cultural, or safety evaluation, and we make no claim of clinical validity, safety, or readiness for deployment. The contribution is the integration of multi-agent triage with task-shifting and cultural adaptation into a single conditional argument whose adequacy can be established only through the staged empirical work we describe.
Group Treatment for Self-harming Adolescents and Their Parents: a Randomized Controlled Trial
Conditions: Self-Harm; Self-Harm, Deliberate; Self-harm Behavior; Non-Suicidal Self Injury; Non-suicidal Self-injury (NSSI)
Interventions: Behavioral: Emotion Regulation Group Therapy for Self-harming Adolescents, ERA; Behavioral: Functional habits for mental health, FUNK
Sponsors: Karolinska Institutet; Västra Götalandsregionen; Region Stockholm
Not yet recruiting
Interventions: Behavioral: Emotion Regulation Group Therapy for Self-harming Adolescents, ERA; Behavioral: Functional habits for mental health, FUNK
Sponsors: Karolinska Institutet; Västra Götalandsregionen; Region Stockholm
Not yet recruiting
Deprexis for Veteran Depression: Open-Label Pilot Trial Examining Feasibility, Acceptability, and Preliminary Efficacy
Background: Depression carries the highest burden of mental health–related disability in the United States. Approximately 13% of military veterans report elevated rates of depression. Despite the availability of evidence-based treatments for depression, nearly 50% of veterans in need of mental health care remain untreated. Internet-based interventions show promise in reducing this gap; however, there are currently no standard self-guided internet-based interventions for depressive symptoms in veterans. Deprexis is one such intervention that leverages cognitive behavioral therapy to target depressive symptoms. Objective: This pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of Deprexis, a fully self-guided internet-based intervention for depression, in US military veterans with mild to severe depressive symptoms. Methods: This open-label pilot trial recruited 19 veterans with mild to severe depression (mean age 55.5, SD 8.2 y; baseline Quick Inventory of Depressive Symptomatology—Self-Report [QIDS-SR]: mean 16.2, SD 4.1) for an 8-week course of Deprexis, with self-report assessments at baseline, posttreatment (8 wk), and follow-up (16 wk). Primary outcomes included depressive symptoms (QIDS-SR), functional disability (World Health Organization Disability Assessment Schedule 2.0), and symptom-related disability (Sheehan Disability Scale). Feasibility was assessed through recruitment and retention rates, and acceptability was measured using validated questionnaires (Credibility and Expectancy Questionnaire and Client Satisfaction Questionnaire). Multilevel models examined change over time, with effect sizes calculated using pooled SDs from unconditional models. Results: Recruitment and retention targets were met, with 15 out of 19 (79%) participants meeting the adherence criteria (ie, ≥60 min of active program use). Of these, 14 participants completed posttreatment questionnaires and were included in the completer analyses. The program received a positive acceptability rating: of the 18 participants who completed follow-up assessments, 78% (n=14) rated services as good or excellent and 72% (n=13) were satisfied with the amount of help received. No safety concerns were reported. Among completers (n=14), QIDS-SR scores decreased from baseline to posttreatment (estimate −2.22, SE 1.44; =.14; =−0.54, 95% CI −1.07 to 0.13) and follow-up (estimate −2.85, SE 1.19; =.02; =−0.70, 95% CI −1.21 to −0.08) with moderate-to-large effect sizes. Effect sizes were similar in the total sample. Functioning (World Health Organization Disability Assessment Schedule 2.0) improved among completers at follow-up (estimate −8.09, SE 3.80; =.045; =−0.41, 95% CI −0.96 to −0.05). Disability (Sheehan Disability Scale) did not significantly improve from baseline to posttreatment or follow-up. Conclusions: This pilot trial demonstrates that Deprexis is feasible and acceptable for veterans with mild to severe depression, with preliminary evidence of effectiveness for depressive symptoms. The delayed emergence of functional improvements and sustained gains at follow-up support the potential of this scalable intervention. The results provide a strong foundation for the ongoing randomized controlled trial. Trial Registration: ClinicalTrials.gov NCT06217198; https://clinicaltrials.gov/study/NCT06217198 International Registered Report Identifier (IRRID): RR2-10.2196/59119
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Developing a Text Messaging Intervention to Increase Uptake of the Screening and Treatment for Anxiety and Depression Program Among Community College Students: Formative Study Using a Human-Centered Design Approach
Background: Community college (CC) students face significant mental health concerns but are unlikely to receive treatment. Barriers to mental health service uptake among CC students have been delineated, but few studies have identified strategies to improve uptake. Text messaging has been used to address engagement barriers to mental health services among adolescents and adults, but little research has explored this strategy for CC students. Objective: The goal of this study was to partner with CC students to co-design and conduct pilot usability testing of a text messaging intervention to address barriers and increase uptake of a mental health screening and treatment program, called Screening and Treatment for Anxiety and Depression (STAND), offered to CC students. Methods: We conducted 2 parallel sets of 4 co-design focus groups with CC students who had varying levels of engagement with STAND. We used rapid qualitative analysis to extract key themes, create text message prototypes and refine them, and present updated prototypes to gather feedback across workshops. We also assessed six usability factors on a 5-point Likert scale: satisfaction, helpfulness, attractiveness, readability, comprehension, and likelihood of getting started with STAND after receiving texts. Results: Key themes emerged about perceptions of texting, barriers to STAND, a basic framework for the text message intervention, feedback about the format of messages, and feedback about the content of messages. Students expressed positive regard for text messaging and general agreement on key barriers to STAND. Students codeveloped a framework for the intervention, including (1) delivering introductory texts to engage students in the text messages, (2) providing a personalized approach for students to select barriers most salient for them, and (3) delivering tailored content designed by students to address each barrier. Across workshops, several themes emerged with regard to how messages should be formatted and delivered, including the following: use short messages; use not too many messages; use relevant language; use images, memes, and short videos; and make messages “human-like.” Themes related to the content of messages included the following: reminders that you are not alone, knowledge that STAND has worked for other students, expressing understanding of student context and stressors, and providing an option to speak to a team member. Mean ratings on usability factors ranged from 3.88 (SD 0.64) to 4.25 (SD 0.46). Conclusions: This study describes a process for co-designing a text messaging mental health engagement intervention with CC students that is grounded in a human-centered design approach. Further research is needed to rigorously test this intervention and make iterative refinements to improve response and effectiveness.
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Subcortical gray matter atrophy and iron deposition in patients with vascular dementia: a multimodal MRI study
PurposeVascular dementia (VAD) is the second most common type of dementia worldwide. Therefore, early detection and diagnosis, along with a clear understanding of its pathogenesis are critical for mitigating disease progression. In the present study, we aimed to elucidate the associations of brain volume and iron deposition with VAD based on structural brain and iron content analyses.MethodsFifty-three patients with VAD and 43 control participants were recruited for this study. All participants underwent the Mini-Mental State Examination (MMSE) and brain MRI scans. This study primarily focused on the volume of specific brain regions (assessed using FreeSurfer) and iron deposition (evaluated using quantitative susceptibility mapping [QSM]). Linear regression analysis was also performed.ResultsPatients with VAD exhibited significant reductions in brain volume in the left putamen (β = −0.342, 95% CI: −0.581 to −0.104), left pallidum (β = −0.099, 95% CI: −0.187 to −0.001), left hippocampus (β = −0.138, 95% CI: −0.271 to −0.004), and right hippocampus (β = −0.235, 95% CI: −0.420 to −0.051). Additionally, significant increases in iron levels were identified in the left (β = 0.006, 95% CI: 0.002 to 0.010) and right (β = 0.005, 95% CI: 0.001 to 0.009) hippocampus.ConclusionsThese findings indicate that brain volume reduction and increased iron levels in specific regions may be associated with cognitive deficits in patients with VAD.
Editorial: eHealth and personalized medicine in mental health and neurodevelopmental disorders: digital innovation for diagnosis, care, and clinical management
Remimazolam versus propofol on seizure adequacy in electroconvulsive therapy: a retrospective cohort study
ObjectiveElectroconvulsive therapy (ECT) is a core treatment modality for severe mental disorders, and the choice of anesthetic induction agent directly impacts seizure quality and therapeutic outcomes. This study aimed to compare the effects of remimazolam versus propofol on seizure adequacy during ECT.MethodsThis retrospective secondary analysis was conducted using data from a prospective observational cohort. A total of 859 ECT sessions from 114 patients were included. The primary outcome was the rate of adequate seizure, defined as an electroencephalographic (EEG) ictal duration of ≥15 seconds. Secondary outcomes included EEG seizure duration, post-ictal suppression index (PSI), maximum sustained power (MSP), and average seizure energy index (ASEI). Stabilized inverse probability of treatment weighting was employed to balance baseline covariates between groups, with balance assessed by standardized mean differences. Generalized linear mixed models were used to compare intergroup differences, accounting for random effects at the patient level. Subgroup analysis, E-value calculation, and propensity score matching (PSM) at 1:1 and 1:2 ratios were performed as sensitivity analyses to assess the robustness of the results. ResultsA total of 859 ECT sessions were included, with 179 in the remimazolam group and 680 in the propofol group. Baseline characteristics were well-balanced between groups after weighting. The remimazolam group exhibited a significantly higher rate of adequate seizures compared with the propofol group (adjusted odds ratio: 12.054, 95% confidence interval: 5.758–25.233, P < 0.001), along with prolonged EEG seizure duration and elevated MSP. No significant between-group differences were observed in PSI or ASEI. The results of all sensitivity analyses were consistent with those of the primary analysis.ConclusionRemimazolam was associated with a higher rate of EEG seizure adequacy and longer EEG seizure duration; however, whether this electrophysiological advantage translates into better clinical outcomes remains to be investigated in prospective studies.
Latest developments in the use of e-cigarettes by people with schizophrenia spectrum disorders who smoke: a scoping review
BackgroundTobacco use is significantly more prevalent among individuals with schizophrenia spectrum disorders (SSD) compared to the general population, contributing to elevated rates of premature mortality from smoking-related diseases. Despite a decline in smoking prevalence in the general population, individuals with SSD continue to smoke at persistently high rates, driven by biological, psychological, and social factors. Standard smoking cessation approaches yield markedly poorer outcomes in this group compared to non-psychiatric populations. This scoping review aimed to map the emerging evidence on the use of e-cigarettes among individuals with SSD or serious mental illness (SMI).MethodsThis scoping review was conducted in accordance with the Population–Concept–Context (PCC) framework and reported following the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines. The review focused on studies published between January 2020 and February 2026, searched on PubMed and EMBASE, providing an up-to-date synthesis of emerging evidence on e-cigarette use in this vulnerable population.ResultsThree studies reported across four publications were included (total N = 323); one research group (Pratt et al.) contributed two separate publications reporting distinct outcomes from the same study cohort. Findings suggest that e-cigarette-based interventions are feasible and acceptable in individuals with SSD and SMI, with preliminary evidence of smoking reduction and decreased exposure to tobacco-related carcinogens. However, sustained harm reduction appeared dependent on a combined approach considering that device provision was empowered in its efficacy to sustain harm reduction over time when integrated with behavioral support.ConclusionsThe available evidence, while preliminary and limited by the small number of included studies, should be interpreted with caution regarding generalizability to patients with Schizophrenia Spectrum Disorders exclusively, as three of the four included publications recruited participants with broader SMI diagnoses of which SSD represents only a subset. Further research, including larger adequately powered trials with standardized outcome measures and longer follow-up, is needed to establish the generalizability and long-term impact of these interventions.