Background: Large language models (LLMs) now enable chatbots to engage in sensitive mental health conversations, including depression self-management. Yet their rapid deployment often overlooks how well these tools align with the priorities of people with lived experiences, which can introduce harms such as inaccurate information, lack of empathy, or inadequate crisis support. Objective: This study explores how people with lived experience of depression experience an LLM-based mental health chatbot in self-management contexts, and what perceived benefits, limitations, and concerns inform harm-mitigating design implications. Methods: We developed a technology probe (a GPT-4o–based chatbot named Zenny) designed to simulate depression self-management scenarios grounded in prior research. We conducted interviews with 17 individuals with lived experiences of depression, who interacted with Zenny during the session. We applied qualitative content analysis to interview transcripts, notes, and chat logs using sensitizing concepts related to values and harms. Results: We identified 3 themes shaping participants’ evaluations: (1) informational accuracy and applicability, including concerns about incorrect or misleading information, vagueness, and fit with personal constraints; (2) emotional support vs need for human connection, including validation and a judgment-free space alongside perceived limits of machine empathy; and (3) a personalization-privacy dilemma, where participants wanted more tailored guidance while withholding sensitive information and using privacy-preserving tactics. Conclusions: People with lived experience of depression evaluated LLM-based mental health chatbots through intertwined priorities of actionable information, emotional validation with clear limits, and personalization that does not require unsafe data disclosure. These findings suggest concrete design strategies to mitigate harms and support LLM-based tools as complements to, rather than replacements for, human support and recovery.
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IOCDF Calls for Reinstatement of SAMHSA Grants, Renewed Commitment to Mental Health Support
The International OCD Foundation is alarmed by the apparent sudden and widespread termination of grants supporting vital mental health and addiction services previously funded through the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).
These programs provide life-saving services for individuals experiencing acute mental health crises and help prevent symptoms from escalating to emergency or inpatient levels of care.
As detailed in our recent white paper, America’s OCD Care Crisis, 95% of Americans with obsessive compulsive disorder (OCD) are not receiving the most effective treatment. When OCD goes untreated or is treated with approaches that are not evidence-based, individuals face increased distress, functional impairment, isolation, and elevated risk of crisis. Access to trained clinicians and community-based mental health services is essential for helping people remain safe during periods of heightened distress and navigate next steps for treatment.
At a time when so many people with OCD and related disorders already struggle to access appropriate care, reducing support for frontline mental health professionals further weakens an already fragile system.
The IOCDF urges the reinstatement of these grants and continued federal commitment to accessible, evidence-based mental health and addiction services for all who need them.
Contact your congressional representative now to support the reinstatement of SAMHSA grants >>
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Facing the Monster: My Journey Living with OCD and Finding Hope
by David Kedeme
I remember the day my white high top Puma sneakers my parents gifted me for Christmas became the exact opposite of the color they came boxed in. It was a post rainy day in middle school, on a mulch covered, semi grassy area we considered our soccer field with two benches representing goals. After enjoying an intense match, what I did not enjoy but assumingly brushed off was the fact of how dirty my shoes were. Fast forward to later that day, I spent hours cleaning the shoes, trying to restore them to their original look.
Something felt different than other times I cleaned.
Every speck had to be clean. The more time I spent, the more visible other “not as clean” areas of the shoes became, requiring their own dedicated time of cleaning. Slowly, this cascaded into many other aspects of life such as my bedroom and closet needing to be organized a certain way, a tornado of relentless doubts concerning my relationships, with this dark monster in my head controlling what I can do, think, and feel. It felt like an eternity but at the same time as if no time passed from when I first touched to clean those shoes to when I could not sleep in my own bedroom and instead slept downstairs due to not wanting to mess the space up and not being able to enter and exit my closet as easily, so needing to rewear clothes days on end. I thought that doing what the monster or voice or whatever it was wanted would lead me to peace, as the relief from the sky high anxiety and gloom that came from performing what I know now as compulsions came only to have what I learned were obsessions come back, if not stronger, reinforcing this vicious cycle. My parents noticed my change in behavior, from avoiding my room at most costs to being late to dinner by up to an hour or two at times. I had only vaguely heard of obsessive compulsive disorder, OCD, and brought the idea up to my parents. The landscape we were dealing with was completely new and I felt even more alone due to this in addition to the isolation the condition induces you to be in. But we began to look for therapists, where I started talk therapy, with the therapist trying their best but the therapy modality was not the right one for me. Next up was a hypnotherapist, which also did not work for me. I needed some action to be okay with the high emotion filled state I was in when the bouts came on, in other words, exposure and response prevention therapy. After doing some research, I landed upon NOCD, an OCD teletherapy and advocacy organization.
I could not believe what I was hearing through the basement, not my room, laptop screen about actually going into my room, and that was not even the worst part. I just had to open my closet, take clothes out, move items in my room, and not do anything. “Maybe it is, maybe it is not” was a phrase that my therapist told me throughout therapy. With the significant support of my family, therapist, and friends, I was able to be okay with not being okay. Exposure and response prevention therapy makes you face the monster, making you enter the state in which you experience high anxiety. The therapy makes you look the monster in the face and realize it was not that big, not talking or engaging with you, making you sit in the discomfort and not do anything you so desperately want to do. With this methodology and rigor, I was able to coexist with the beast, and slowly it shrank, still existing though. But that is okay. That happens.
OCD belongs to a category of disorders called Obsessive Compulsive and Related Disorders within the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition, a manual that influences not only how patients receive care but also research funding and medical training. Although not officially recognized in the manual, there are many discussed subtypes of OCD depending on the obsessions and or compulsions one experiences. Some people, like me, had symptoms that ebbed and flowed in terms of severity and percolated from subtype to subtype. My symptoms throughout my experience with the condition range from having to keep most of the items in my room a certain way, doubting whether I want to be with my partner, questioning my morals, wondering whether something happened in the past pertaining to people in my life even though it did not, and more. Throughout typing this, thoughts flood my head, similar to ones I experienced, say, six years ago.
I hope to be able to perform research in the condition as well as treat people who were and are in my shoes. With up to 242 million people worldwide meeting clinical diagnostic criteria for OCD, about 40 to 60 percent experiencing treatment resistant OCD, more than two thirds of the general public not being able to accurately identify OCD, and mental health still being stigmatized today, there is more needed to be done from all fronts. When one type of online treatment is sought, about two thirds of patients achieve a clinically significant outcome, but on average, it takes greater than seven years for someone to receive a diagnosis of OCD and it can take up to seventeen years for an individual diagnosed with OCD to receive treatment. This is a multifaceted problem that requires a multifaceted approach which requires a banding of people worldwide to come together to promote awareness of the condition and a safe space for people throughout who have OCD.
Today, as I am typing this, I still am experiencing many of the symptoms I have before. The condition does not just go away, but it does become more manageable. If you are struggling, there is hope, there is a way, no matter how impossible it feels. I felt as if there was none, no light at the end of the tunnel, spending many hours crying out asking why to a source I was not even aware of, answered only by my own repetitive thoughts. But as someone who has been there, you will be okay. Even if multiple therapeutic modalities do not work, you feel like you want to give up because a current exposure seems impossible to do, you feel more anxiety at times, you feel like you are letting people down if you do not improve, you feel like the monster you were once fighting off keeps going, keep going. Seek help in many ways, rely on your community, and for those who have a hard time finding one, we are here for you, the International OCD Foundation community, and I most certainly am as well. Thank you for reading this and I am sending you hope and luck wherever you are. You are never alone.
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Commercial or industrial use of mental health data for research: primer and best-practice guidelines from the DATAMIND patient/public Lived Experience Advisory Group
BackgroundRoutinely collected health data, such as that held by United Kingdom (UK) national health services (NHS), has important research uses. However, its use requires public trust and transparency. Access by commercial/industrial organisations is especially sensitive for the public, as is mental health (MH) data. Although existing MH data science guidelines emphasise patient/public involvement (PPI), they do not cover commercial uses specifically.ObjectivesTo develop patient- and public-led guidelines for the commercial and industrial use of MH data for research. Though UK-focused, their principles may apply internationally.MethodsA PPI Lived Experience Advisory Group (LEAG) was created within DATAMIND, a UK data hub for MH informatics. Initial discussion yielded a requirement for definitions and explanations of concepts relating to MH data research, developed iteratively. Subsequently, the LEAG developed guidelines via a qualitative quasi-Delphi approach. The agreed scope excluded data provided for research with informed consent, data processing arrangements (e.g. companies hosting electronic systems on the instruction of health services), and compliance with legal minimum requirements. The scope included the use of routinely collected MH data for research by commercial/industrial organisations without explicit consent, and aspects of industry-led MH data collection conducted with consent.ResultsAlongside the primer in MH data research concepts, the LEAG provide best-practice guidelines relating to commercial/industrial research use of MH data, for organisations controlling MH data (such as NHS bodies) and for commercial applicants seeking access. Core principles include transparency, patient rights, meaningful PPI, stringent governance, and statistical disclosure control. The guidelines recommend a risk–benefit approach to assessing data access applications, within limits that include avoiding the export of unconsented patient-level data outside NHS-controlled secure data environments, and not providing commercial applicants with access to unconsented free-text MH data. Further recommendations for NHS executive and regulatory bodies relate to public choice and transparency, clarity of guidance to research-active NHS organisations, and support for de-identification.ConclusionsMH data research requires patient/public involvement and understanding. These guidelines reflect the views of people with personal or family experience of mental ill health. We hope they are useful to the MH research community and increase public transparency and trust.
Synergies in psychedelic-assisted therapy: a qualitative interview study of psychotherapeutic processes
Research on the therapeutic effects of psychedelics in psychiatry, commonly referred to as Psychedelic-Assisted Therapy (PAT), has expanded substantially in recent years. The context-dependent nature of psychedelics has sparked discussion about the importance of the psychotherapeutic environment in achieving beneficial outcomes. This study explores the contribution of psychotherapeutic factors on PAT in Switzerland, where psychedelic treatments can be implemented within long-term clinical frameworks. Seven semi-structured interviews were conducted with Swiss therapists to explore how they frame psychedelic treatments and the role of the psychotherapeutic setting in facilitating therapeutic outcomes. Thereby, individual experiences of the patients as reported by the therapists, were particularly considered. Thematic analysis identified two main themes, each with several sub-themes. The first theme revealed that while psychotherapeutic techniques are adapted to PAT, they retain similarities to non-psychedelic psychotherapy practices, supporting patients in having meaningful therapeutic experiences. The second theme describes a synergistic relationship between psychedelics and psychotherapy, amplifying underlying general psychotherapeutic factors such as trust, a sense of profundity, and the emergence of therapeutic experiences. The interviewed therapists agreed that psychedelics work as unspecific catalysts for psychotherapeutic processes, while still acknowledging the potential for psychopharmacological effects or the interaction between psychedelics and psychotherapy to create unique psychotherapeutic processes. Findings from our sample suggest that, for specific indications, incorporating psychedelics into long-term psychotherapeutic treatment may strengthen therapeutic processes. Future research could investigate the efficacy of PAT within the framework of specific psychotherapeutic modalities or in different settings, including prospective quantitative assessments of outcomes. Ultimately, clarifying mechanisms of action of PAT may help to enhance its efficacy and potentially to integrate psychedelic treatments into mainstream mental health care.
Asking for help: the development of a simulation-based mental health application to enhance depression literacy, mental health communication, and help-seeking among Black autistic youth
Black autistic youth experience disproportionately high rates of depression and face intersecting barriers such as racial discrimination, stigma, and limited access to care, yet few interventions address their needs. This study introduces Asking for Help (A4H), a culturally responsive, simulation-based intervention designed to improve depression literacy and help-seeking skills through an e-learning module and interactive conversation practice. Guided by mental health literacy theory, the Theory of Help-Seeking Behavior, the Theory of Planned Behavior, and Disability Critical Theory, A4H was developed using community-engaged and user-centered design principles. Usability testing employed a mixed-methods design with 32 participants (12 youth, 10 caregivers, 8 specialists) using the System Usability Scale (SUS), Patient Health Questionnaire-9 (PHQ-9), and semi-structured interviews. Black autistic youth reported moderate depressive symptoms (mean PHQ-9 = 14.7) and rated usability slightly below benchmark (mean SUS = 66.2), while caregivers and specialists scored higher (73.5 and 71.0). Qualitative feedback highlighted cultural relevance and immediate feedback as strengths, with recommendations for simplified language, improved navigation, and multimodal supports; emotional safety and trust were critical for engagement. No short-term symptom change was observed, consistent with the formative design. Findings indicate A4H is feasible and culturally responsive but requires refinements before efficacy testing to assess impacts on literacy, help-seeking intentions, and communication skills.
Internet addiction in adolescents with suicidal ideation: the role of self-esteem and school connectedness
BackgroundInternet addiction (IA) has become a growing concern, particularly among adolescents, due to its adverse effects on mental health, physical well-being, and future development. Adolescents with suicidal ideation (SI) are particularly vulnerable to IA, which may be associated with a higher risk of engaging in suicidal behaviors. However, the relationship and underlying mechanisms between SI and IA remain unclear. This study, grounded in the cognitive-behavioral model of pathological internet use, investigates the relationship and explores the roles of self-esteem (mediator) and school connectedness (moderator) in this association.MethodsIn this cross-sectional study, 462 Chinese adolescents with SI (79.0% female) were recruited from psychiatric outpatient clinics between June 2024 and September 2025. Validated instruments measured SI, self-esteem, school connectedness, and IA. Structural equation modeling with bootstrapping procedures was used to test the mediation effect of self-esteem on the relationship between SI and IA. The moderating role of school connectedness was examined using PROCESS Model 8.ResultsSI was positively associated with IA (β = 0.224, p < 0.001). SI was negatively associated with self-esteem (β = -0.464, p < 0.001), and self-esteem was further negatively associated with IA (β = -0.448, p < 0.001). Self-esteem partially mediated the relationship between SI and IA, with an indirect effect of 0.208 (95% CI: 0.154-0.271). School connectedness significantly moderated the direct association between SI and IA (β = -0.005, p = 0.001), but did not moderate the association between SI and the mediator, self-esteem (β = 0.004, p = 0.202).ConclusionThis study identifies a significant positive association between SI and IA among adolescents with SI, with self-esteem partially mediating this link. Furthermore, school connectedness showed a very weak buffering effect on the direct association between SI and IA, and it does not moderate the association between SI and self-esteem. These findings enhance our understanding of the mechanisms underlying IA in this vulnerable population and suggest potential targets for interventions.
The Role of Disulfide Bonds in the GluN1 Subunit in the Early Trafficking and Functional Properties of GluN1/GluN2 and GluN1/GluN3 NMDA Receptors
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World Mental Health Day Statement
Ottawa – October 10, 2025
As someone who has worked in countries affected by conflict and humanitarian crises, I’ve learned that physical displacement is only part of the story. The mental and emotional toll defines the other half of that experience, and often for much longer.
This World Mental Health Day focuses on mental health in humanitarian emergencies. It asks us to consider not just the scale of the challenge, but the strength of the response possible when communities lead the way.
There is no single solution to the mental health impacts of humanitarian crises. But what I’ve witnessed, both internationally and here on Turtle Island, is that the most meaningful support often comes from within affected communities themselves.
Whether it’s refugees organizing healing circles in displacement camps, neighbours checking in on one another after a wildfire, or volunteers trained to provide peer support—these acts of care are not just helpful. They are essential. They save lives.
Right now, the world feels heavy. The growing phenomenon of eco-anxiety, combined with escalating crises of famine, war, and displacement, can make hope feel out of reach. We see the numbers—123 million people forcibly displaced worldwide—and it can be overwhelming.
But I’ve also seen what happens when we share that weight by leaning on one another. This is equally true for humanitarian aid workers, who are responding to unprecedented numbers of conflicts and urgencies at home and around the globe.
As the World Health Organization reminds us, “Humanitarian workers face extreme stress and are often directly affected by the crisis they respond to.”
As a member of this community, I know that sustaining an effective humanitarian response means meeting the needs of those providing comfort and care, whether through peer support, workplace health programs, or Mental Health First Aid. Here at home, programs like The Working Mind – First Responder are helping to create a culture of care for those we call on in crisis.
The way we heal—whether we’re first responders or community workers, volunteers or refugees—is through community. It’s in the everyday ways we show up for one another: listening without judgment, making space for grief and fear, and recognizing that asking for help is an act of courage.
On this World Mental Health Day, let’s all find the courage to lean on each other.
Lili-Anna Pereša C.Q.
President & CEO
Mental Health Commission of Canada
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Canada Gets its First National Guidance on AI for Mental and Substance Use Health
Ottawa (ONTARIO) – In a first-of-its-kind initiative, national guidance for using artificial intelligence (AI) in the mental and substance use health field is being developed through a partnership between the Canadian Centre on Substance Use and Addiction (CCSA) and the Mental Health Commission of Canada.
AI is increasingly being used for healthcare triage, service navigation, service delivery, and communication, but developers and users have no guidelines specific to mental or substance use health to support its effective and safe use. The recently published E-Mental Health Strategy for Canada highlights the need for safety in this field.
The new National Guidance for Artificial Intelligence Use in Mental Health and Substance Use Health Care will provide guidance, tools, and resources to help practitioners, organizations, and health leaders in efficiently evaluating and implementing AI-enabled mental health and substance use health care services and solutions. It will also support people with lived or living experience of mental health or substance use health concerns in making informed choices about these technologies, while helping technology companies design and improve such solutions to meet the needs of those who use them.
“People are excited about what AI can bring, but the saying ‘break it then fix it’ can take on new dangers when what is at risk is people’s lives. This guidance will allow innovators to move fast while working to ensure it’s done safely and in a way that increases impact and access,” says CCSA CEO Dr. Alexander Caudarella.
The Mental Health Commission of Canada President and CEO Lili-Anna Pereša adds, “Technology can be a powerful ally in transforming mental health care, but innovation must be matched with responsibility. Communities are the best problem-solvers. By working together with developers, providers, and people with lived experience, we’re creating guidance that ensures AI enhances care safely and meaningfully.”
The National Guidance team will share its early findings at several upcoming conferences, including the World Psychiatric Association’s World Congress of Psychiatry, the Canadian Centre on Substance Use and Addiction’s Issues of Substance conference, and the eMental Health International Collaborative (eMHIC) Congress.
In Canada, mental health and substance use health needs are highly common, yet many people continue to face significant barriers to care, including limited access, stigma, financial costs, and lack of tailored treatment options.
The National Guidance for Artificial Intelligence Use with Mental Health and Substance Use Health is expected to launch in 2026/2027.
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About CCSA:
CCSA was created by Parliament to provide national leadership to address substance use in Canada. A trusted counsel, we provide national guidance to decision makers by harnessing the power of research, curating knowledge and bringing together diverse perspectives. CCSA activities and products are made possible through a financial contribution from Health Canada. The views of CCSA do not necessarily represent the views of Health Canada.
About The Mental Health Commission of Canada:
The Commission leads the development and dissemination of innovative programs and tools to support the mental health and wellness of people in Canada. Through its unique mandate from the Government of Canada, the Commission supports federal, provincial, and territorial governments as well as organizations in the implementation of sound public policy. The Commission’s current mandate aims to deliver on priority areas identified in the Mental Health Strategy for Canada in alignment with the delivery of its strategic plan.
Media contacts:
Canadian Centre on Substance Use and Addiction
Christine LeBlanc, Senior Strategic Communications Advisor
613-898-6343 | cleblanc@ccsa.ca
Mental Health Commission of Canada
media@mentalhealthcommission.ca
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