Tag: Mental health

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A Mobile App for Student Veterans With Co-Occurring Academic and Psychiatric Concerns: Pilot Usability and Feasibility Study

<strong>Background:</strong> Over 600,000 student veterans use military benefits to pursue higher education annually, with 75% enrolled as full-time students. Advancing their education is an important step toward improving their employment, financial, and social opportunities. However, student veterans also experience high rates of co-occurring psychiatric concerns like substance use disorder (SUD), posttraumatic stress disorder (PTSD), or depression. For these students, additional psychoeducation, support, and guidance may be required. To support their goals, a mobile app with targeted content for student veterans managing common psychiatric concerns could be particularly helpful. <strong>Objective:</strong> The primary aim of this pilot study was to iteratively revise and assess usability, acceptability, and feasibility of the VetEd mobile app and study procedures. The secondary aim was to explore preliminary changes from preapplication to postapplication use in academic functioning and community reintegration. <strong>Methods:</strong> This study used a mixed methods approach; pilot usability testing and iterative revisions were completed across 3 waves of participants (wave 1=4; wave 2=4; wave 3=5; total n=13). Usability was measured using the System Usability Scale (SUS), and acceptability was measured using the Acceptability E-Scale (AES). App use feasibility was collected through app engagement data from the 4 weeks of mobile app use. Study feasibility was assessed by rates of recruitment, retention, and survey completion. Secondary, exploratory measures to assess potential VetEd use outcomes included academic self-efficacy, perceived ability to cope with educational barriers, and community reintegration. Participants were also given the opportunity to complete an exit interview to provide additional feedback. <strong>Results:</strong> Study feasibility was high, with greater than projected rates of recruitment (4-5 per month), retention (13/13, 100%), and survey completion at all 3 time points (100%, 85%, and 100%, respectively). Overall, 85% (11/13) of both usability and acceptability scores were above the predefined benchmarks. Completion of assigned VetEd activities was high, with participants completing, on average, 90.8% of requested app activities. Secondary exploratory outcomes in academic self-efficacy, coping with educational barriers, and community reintegration were nonsignificant but showed feasibility for use in future fully powered randomized VetEd trials. Exit interviews highlighted that VetEd was easy to use, included pertinent information for both academic and mental health functioning, and had vital information on connecting to additional resources. <strong>Conclusions:</strong> Pilot findings suggested that the VetEd mobile app is usable and acceptable as an asynchronous resource for student veterans managing psychiatric concerns. Exit interviews suggested that veterans found app content useful, with relevant information and resources to support their academic functioning. Additional research is needed to assess its effectiveness, implementation, and impact on student veterans nationwide. <strong>Trial Registration:</strong> ClinicalTrials.gov NCT05344092: https://clinicaltrials.gov/study/NCT05344092
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Therapist Skepticism and Adaptation to Teletherapy Under Enforced Uptake, With Theoretical Considerations for AI-Mediated Care: Qualitative Study

<strong>Background:</strong> Mental health care is undergoing rapid digital transformation, with continued development and implementation of digitally delivered interventions. Despite growing evidence for digital mental health interventions, implementation in routine practice has often lagged technological advances. Although teletherapy became more widely accepted during the COVID-19 pandemic, little is known about the psychological processes through which clinicians adapt to disruptive changes in treatment delivery when required to work within a novel medium. <strong>Objective:</strong> This study explored how therapists who had not previously adopted teletherapy interpreted and adapted to its enforced uptake during the COVID-19 pandemic, with particular attention to changes in expectations, perceptions of the therapeutic alliance, and professional practice. <strong>Methods:</strong> Six UK-based accredited clinical psychologists, none of whom had previously practiced video-based teletherapy, participated in semistructured interviews conducted between May and July 2021, following the rapid shift toward remote delivery. Data were analyzed using reflexive thematic analysis to explore therapists’ experiences of adaptation, belief revision, and therapeutic interactions. <strong>Results:</strong> We identified the following four themes: (1) revision of anticipatory beliefs, (2) context-medium differentiation, (3) medium affordances, and (4) relational viability and selective integration. Therapists began practicing teletherapy with concerns about accessibility, safety, therapeutic techniques, and relational quality. With sustained practice, clinicians revised many of their assumptions. Therapists also distinguished difficulties associated with implementation contexts from perceived properties of teletherapy itself. They described adapting clinical procedures and techniques, recognizing both constraints and affordances of the medium, and developing more differentiated views of when teletherapy was appropriate. Clinicians generally found teletherapy to be an acceptable therapeutic medium, but not equivalent to in-person practice. <strong>Conclusions:</strong> Adapting to teletherapy involved more than accepting a new tool. It required therapists to reconsider assumptions about therapeutic interaction, safety, and conditions needed to sustain an effective therapeutic relationship. The findings suggest an experience-based professional adaptation process in which initial assumptions became differentiated through sustained use. While these findings support teletherapy uptake specifically, they may also inform how clinicians evaluate other digital mental health technologies, while recognizing that changes to the communication medium are not equivalent to changes in the therapeutic process or agent.
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Comparative efficacy of neuromodulation techniques for Alzheimer’s disease: a systematic review and network meta-analysis of randomized controlled trials

BackgroundNeuromodulation techniques (NMTs) have shown potential therapeutic value in Alzheimer’s disease (AD), but the comparative efficacy of different modalities remains unclear. This study aimed to systematically compare and rank available NMTs to identify their relative benefits across cognitive, functional, and neuropsychiatric outcomes.ObjectiveTo evaluate and rank the efficacy of NMTs in improving cognitive function, activities of daily living (ADLs), and neuropsychiatric symptoms in AD patients, thereby providing evidence-based guidance for clinical intervention strategies.MethodsEnglish-language literature was systematically searched in PubMed, Web of Science, Cochrane Library, and EMBASE from database inception to February 2026. Inclusion criteria were randomized controlled trials (RCTs) of AD patients aged ≥18 years. Interventions included repetitive transcranial magnetic stimulation (rTMS), transcranial alternating current stimulation (tACS), transcranial direct current stimulation (tDCS), photobiomodulation (PBM), transcutaneous electrical stimulation (TES), transcranial ultrasound stimulation (TUS), transcranial pulse stimulation (TPS), deep brain stimulation (DBS), and sham stimulation (Sham). Outcome measures included Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Alzheimer’ s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), Alzheimer’ s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL), Boston Naming Test (BNT), Neuropsychiatric Inventory (NPI), and Geriatric Depression Scale (GDS). Data extraction and risk-of-bias assessment followed Cochrane guidelines. Network meta-analysis (NMA) was conducted in Stata 17.0, with effect sizes ranked by the surface under the cumulative ranking curve (SUCRA).ResultsA total of 36 RCTs involving 1,445 patients were included in the analysis. Compared with Sham, TPS significantly improved MMSE (MD = 3.92, 95% CI: 1.57 to 6.35; SUCRA = 97.50%), MoCA (MD = 4.99, 95% CI: 2.26 to 7.72; SUCRA = 69.25%), and BNT scores (MD = 4.02, 95% CI: 1.81 to 6.23; SUCRA = 81.8%). rTMS also showed favorable effects on ADAS-Cog scores (MD = −11.10, 95% CI: −14.51 to −7.71; SUCRA = 91.00%). Regarding activities of daily living, TES ranked highest on the ADCS-ADL scale (SUCRA = 71.00%). In terms of neuropsychiatric symptoms, TPS achieved the highest ranking for improving NPI scores (SUCRA = 92.3%), whereas tACS showed the best performance on GDS scores (SUCRA = 69.5%).ConclusionNeuromodulation interventions demonstrated domain-specific benefits in AD, with no single approach showing universal superiority. TPS demonstrated the greatest potential for improving global cognitive outcomes, while rTMS showed advantages in ADAS-Cog performance. Nevertheless, limited sample sizes, heterogeneous stimulation protocols, and insufficient long-term evidence restrict the generalizability of current findings. Future multicenter RCTs with standardized protocols and prolonged follow-up are needed to confirm these results and guide clinical implementation.Systematic review registrationPROSPERO, CRD420261364193.
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Large language models for late-life depression: a blinded benchmark of clinical safety, geriatric appropriateness, and triage

BackgroundGeneral-purpose large language models are increasingly used by patients and caregivers to obtain mental health information and guidance about when professional care is required. In late-life depression, broadly accurate information may nevertheless be unsafe when cognitive change, multimorbidity, frailty, polypharmacy, self-neglect, caregiver dependence, or suicide risk is not adequately recognized. This study compared the clinical accuracy, safety, geriatric-specific appropriateness, triage performance, and response consistency of three large language models when answering patient- and caregiver-centered questions about late-life depression.MethodsWe conducted a blinded, paired benchmarking study using 90 questions covering six geriatric psychiatry domains and equally distributed across low-, moderate-, and high-risk strata. Each question was submitted independently to GPT-5.5 Instant via ChatGPT, Gemini 3.5 Flash via Gemini, and Seed2.0 Pro via Doubao, generating 270 primary-round responses. A stratified subset of 30 questions was resubmitted in separate conversations to assess test-retest consistency, yielding 360 responses overall. Two psychiatrists independently evaluated anonymized outputs against prespecified item-specific reference standards, with clinically important disagreements adjudicated by a third senior psychiatrist. The primary outcome was the proportion of clinically acceptable responses, defined using accuracy, clinical safety, geriatric appropriateness, warning-sign recognition, and triage criteria.ResultsClinically acceptable responses were generated for 78.9% of questions by ChatGPT, 72.2% by Gemini, and 60.0% by Doubao (overall P<0.001). The difference between ChatGPT and Gemini was not statistically significant, whereas both outperformed Doubao. This model ranking remained unchanged under alternative core-safety and more stringent optimal-response definitions. Complete geriatric-specific appropriateness was achieved in 64.4%, 55.6%, and 43.3% of responses, respectively. Major safety errors occurred in 5.6% of ChatGPT responses, 10.0% of Gemini responses, and 16.7% of Doubao responses (raw P = 0.015; FDR-adjusted q=0.023). Performance declined substantially with increasing clinical risk. In exploratory post hoc caregiver-centered analyses, clinical acceptability was 76.7% for ChatGPT, 70.0% for Gemini, and 53.3% for Doubao, while explicit caregiver-directed action was present in 80.0%, 70.0%, and 53.3% of responses, respectively. Among high-risk questions, clinically acceptable response rates were 63.3%, 50.0%, and 36.7%, while under-triage occurred in 16.7%, 26.7%, and 36.7% of responses, respectively. Test-retest clinical consistency was highest for ChatGPT (90.0%), followed by Gemini (83.3%) and Doubao (73.3%).ConclusionsThe three models answered many late-life depression questions accurately and safely, but none demonstrated consistently reliable performance across complex or high-risk scenarios. Clinically important weaknesses involved geriatric-specific interpretation, recognition of indirect risk signals, crisis-response completeness, under-triage, and response stability. General-purpose large language models may support selected low-risk educational tasks but should not independently guide emergency triage, medication changes, suicide-risk management, or other safety-critical decisions in older adults.
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Recovery-phase symptoms after COVID-19 infection and anxiety levels among college students

ObjectiveThis study examines the relationship between physical symptoms during the recovery phase after COVID-19 infection and anxiety levels among college students, with the aim of providing empirical evidence for post-pandemic mental health screening and health management in universities.MethodsThe study used online survey data collected from college students in March 2023. After excluding straight-line responses, 394 valid questionnaires were retained. Among 372 students with a clear infection status, we examined the association between confirmed COVID-19 infection and anxiety. Among 298 students with confirmed infection, we further analyzed the associations of the number of physical symptoms during recovery, recovery time, and specific physical symptoms with anxiety.ResultsConfirmed COVID-19 infection itself was not significantly associated with a higher anxiety level. Among infected students, however, the number of physical symptoms during recovery was positively associated with higher anxiety levels, whereas recovery time was not significantly associated with anxiety level. Analyses of specific symptoms showed that memory decline and chest pain were significantly associated with higher anxiety levels.ConclusionPost-infection mental health screening in universities should not focus only on whether students have been infected. Greater attention should be paid to the burden of physical symptoms during recovery. Symptom count, cognitive changes, and chest discomfort may serve as useful supplementary indicators for post-infection follow-up and psychological risk identification.
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An Evidence-Based AI Virtual Assistant for Young People With Attention Deficit Hyperactivity Disorder: Co-Design and Prototype Development

<strong>Background:</strong> Though attention deficit hyperactivity disorder (ADHD) is thought to be the most prevalent neurodevelopmental disorder in young people worldwide, there are inequalities in access to psychoeducation and health care support. One way to improve access, potentially increase engagement, reduce health care inequalities, and enhance care is by co-developing digital responsive interventions. These have the potential to support long-term condition management and to act as an adjunct to usual care. Virtual assistants that use large language models can provide information in response to questions and learn to tailor communication to suit an individual user’s needs. This can be especially valuable for people with ADHD who often struggle to regulate attention and can experience communication challenges. Involving people with lived experience in the co-design process is crucial for the development of effective digital interventions. Therefore, this article explores the views and preferences of young people with ADHD and their supporters from the United Kingdom who collaborated with researchers to co-design a prototype chatbot. <strong>Objective:</strong> This study aimed to co-develop an evidence-based chatbot prototype, intended to help young people with ADHD thrive through improved access to health care information, psychoeducation, and self-management strategies. <strong>Methods:</strong> An interdisciplinary team was established, including researchers, software developers, clinicians, and lived experience collaborators. Research advisory and working groups were set up in ways that facilitated flexible involvement. Following the person-based approach, guiding principles were established, and workshops were held with young people with ADHD and supporters of young people with ADHD to co-develop an early prototype. Feedback was sought via think-aloud interviews with lived experience collaborators. <strong>Results:</strong> In total, 9 experts by lived experience and 3 health care professionals chose to engage in workshops, and this feedback informed the development of a SmartADHD chatbot prototype. An off-the-shelf chatbot (GPT-4o hosted on Convai) was trained using resources from the National Health Service (NHS). Overall, 6 experts by lived experience engaged with think-aloud interviews, providing feedback on the prototype conversational flow and feel, the avatar, the text-to-speech, the chatbox feature, and the content of the messages. Seven recommendations are made for future development, which will inform the SmartADHD program of work. <strong>Conclusions:</strong> These findings provide rich data on the preferences of people with ADHD. Specific recommendations for a chatbot for young adults with ADHD have not been investigated before with young people, making this study a novel contribution to the field. These findings provide an excellent foundation for chatbot development for this group and may be relevant for those developing digital tools for people with ADHD across the lifespan and other neurodevelopmental conditions. Further work is required to elucidate the views of health care professionals and identify the limits of the technology before subsequent evaluation. <strong>Trial Registration:</strong>
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Neurodiversity as an epistemic stress test for psychotherapy and health care: a neuroaffirmative conceptual analysis of relational-proximity priors in clinical, institutional, and AI-supported models

Neurodiversity-affirming mental health care requires not only adapting support to neurodivergent people but also examining the relational assumptions through which alliance, empathy, cooperation, progress, and risk are interpreted. This Conceptual Analysis develops the heuristic concept of relational-proximity priors: implicit assumptions that emotional closeness, rapid reciprocity, eye contact, visible warmth, and ready acceptance of help are generally reliable indicators of therapeutic fit or improvement. Drawing primarily on autism research and, more cautiously, on broader neurodivergence-informed literature, the paper synthesizes work on neurodiversity, double empathy, minority stress, healthcare accessibility, interpersonal distance, epistemic injustice, and psychotherapy process. The argument is that when such priors remain unaudited, clinically meaningful behaviors such as distance, reduced affect display, written communication, slower pacing, or literal style may be misread as resistance, poor alliance, or lack of insight. The paper further proposes that these priors can become sedimented in service routines, documentation practices, and AI-supported systems if observation and interpretation are not adequately separated. The article does not present a validated empirical construct or a systematic review; rather, it offers a theory-anchored conceptual synthesis and a set of heuristic audit tools intended to slow interpretation and widen clinically plausible hypotheses. Implications are discussed for psychotherapy, service design, documentation, participatory evaluation, and AI governance in public mental health.
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Rapid Entrainment and Signal-guided Neuromodulation for Behavioral Health

Conditions: Anxiety; PTSD; ADHD; Depression Disorders; Post-traumatic Stress; Substance Use; Executive Function; Sleep Disturbance

Interventions: Behavioral: AIP-Informed Integrative Psychotherapy; Device: Transcutaneous Auricular Vagus Nerve Stimulation; Behavioral: Regulated Breathing and Autonomic Regulation; Device: Audiovisual Entrainment; Device: Vibroacoustic Stimulation; Behavioral: Breathwork-Based Auditory Driving Entropy Module (BADEM); Device: Transcranial Electrical Stimulation

Sponsors: Tactical Mind Research Coalition, Inc.

Active, not recruiting
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Building on Success: HEADSTRONG and The Inquiring Mind Transition to Jack.org

Ottawa, ON, September 9, 2026 – The Mental Health Commission of Canada is excited to announce that, effective September 8th, Jack.org will take over HEADSTRONG and The Inquiring Mind (TIM) to further increase the impact and growth of these programs and help more young people facing barriers to mental health.

Developed through the Commission’s Opening Minds initiative, HEADSTRONG and TIM have supported youth, educators, schools, and communities for more than a decade. As Canada’s largest network of young people supporting young people, with strong connections across the education sector, Jack.org is well-positioned to expand the programs’ reach and impact for decades to come.

“HEADSTRONG and The Inquiring Mind are powerful examples of what can happen when we identify a need, build an effective solution, and work with partners to maximize impact,” said Lili-Anna Pereša, President and CEO of the Mental Health Commission of Canada. “We’re proud of what these programs have achieved and confident that Jack.org is the right organization to help them reach even more young people across Canada.”

“We’re honoured to welcome HEADSTRONG and The Inquiring Mind to Jack.org,” said Michael Braithwaite, President and CEO of Jack.org. “These programs have already made a meaningful difference in the lives of young people, and we look forward to building on that success and expanding their reach in schools and communities across Canada. The transition reflects a shared commitment to ensuring proven youth mental health programs continue to grow and evolve to meet increasing demand.

Jack.org has been working diligently with the Commission to ensure that there will be no disruption to existing programming or services during the transition.

About the Mental Health Commission of Canada

The Mental Health Commission of Canada is a not-for-profit, pan-Canadian mental health organization that connects evidence, knowledge, and lived experience to provide actionable insights and solutions that advance mental health to improve lives.

About Jack.org

Jack.org is a national charity that empowers young people to take care of their mental health, supports youth leadership, and works to strengthen mental health literacy and connections among young people across Canada.

Media Contacts

Mental Health Commission of Canada
Debra Yearwood
Director, Marketing and Communications

Jack.org
Danielle Kinahan
Director, Communications and Media

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