Ottawa ON, November 10, 2026 — The Canadian Centre on Substance Use and Addiction and the Mental Health Commission of Canada signed a renewed memorandum of understanding on November 9, 2026, issuing the following joint statement:
“The Canadian Centre on Substance Use and Addiction (CCSA) and the Mental Health Commission of Canada (the Commission) have renewed their memorandum of understanding, reaffirming a long-standing commitment to working together to improve mental health and substance use health outcomes for people in Canada. Through this collaboration, both organizations can leverage expertise and networks to bring about meaningful change and improve wellness for individuals and their communities.
While our organizations have collaborated for many years, both with and without a formal agreement, this renewed MOU reflects our shared belief that the challenges facing people in Canada are best addressed through partnership.
Mental health and substance use health are deeply interconnected. Many people experience challenges in these areas together, and they require coordinated, person-centred approaches that recognize the complexity of people’s lives. By bringing together our respective expertise, CCSA and the Commission can strengthen knowledge exchange, inform policy discussions, support innovation, and advance practical solutions that better serve people and communities across Canada.
Our collaboration already extends across a range of initiatives. Most recently, the CCSA and the Commission partnered to develop Canada’s first guidance for the responsible use of artificial intelligence in mental health and substance use health. This work is helping establish practical criteria grounded in trust and explainability, human-centred care, equity, and data governance, demonstrating how our organizations can work together to address emerging opportunities and challenges in health care.
This renewed agreement is not simply about formalizing a partnership. It is about affirming our continued commitment to collaboration, recognizing that meaningful progress happens when organizations work together toward shared goals.
We look forward to building on our partnership in the years ahead.”
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 Commission The Mental Health Commission of Canada is a pan-Canadian, not-for-profit organization that connects evidence, knowledge, and lived experience to provide actionable insights and solutions that advance mental health and improve lives. Guided by our vision of “Strong Evidence. Strong Solutions. Strong Mental Health.” We deliver on our mission by enabling collective action, informing solutions and decision-making, transforming knowledge and building capacity.
Media contacts Mélissa Joseph, Strategic Communications Advisor Canadian Centre on Substance Use and Addiction 613‑235‑4048 x 364|mjoseph@ccsa.ca
and
Debra Yearwood, Director, Marketing and Communications Mental Health Commission of Canada 613-402-9080 mediaphone@mentalhealthcommission.ca
Children’s books about mental health can help young readers understand emotions, learn about their (or a friend’s) diagnosis, and build resilience. It seems like there’s a book for nearly any topic, from OCD, anxiety, or autism to body image, grief, or big feelings. That’s because the mental-health kids’ book category is burgeoning: For our third-annual best books list, we looked at nearly 200 titles published in 2026 — more contenders than we’ve ever had before — and narrowed them down to 70 semi-finalists. Then Child Mind Institute clinicians and editorial staff reviewed and rated the books, highlighting ones that accurately depict mental health challenges and how to help kids handle them, to settle on the 20 titles below as their top picks. From an adorable board book about mindfulness that features sensory stimulation to a young-adult novel about a 16-year-old with spiraling social anxiety, this list has something for every age, from toddler to teen.
ADHD! Understanding You, Your Brain, and How to Thrive in a Neurodiverse World
Written by Rachel Brian
An illustrated guidebook welcomes in all readers, whether they have ADHD or know someone who does. Each page utilizes graphics like comic panels, word balloons, and line drawings to help break down important topics including “What Is ADHD?” into bite-size pieces of information. It also gives ideas about how to handle challenges, like when big emotions show up or when you feel restless. Says a Child Mind Institute expert: “The visuals and language are child-friendly and will help kids understand an ADHD diagnosis.” Ages 7–10. Published by Little, Brown Books for Young Readers.
Get It Done & Have Fun!: ADHD Hacks for Awesome Kids
Written by Penn and Kim Holderness, illustrated by Vin Vogel
Narrated by a plucky, rhyming squirrel named Squeaky McGee, this book gives kids with ADHD advice on how to complete the mundane tasks that may trouble them. These tips are delivered in boisterous verse (“A hack is a way to take a dull chore — and make it a super-fun game you adore.”), with suggestions for brushing teeth, making the bed, and more. The authors bolster their catchy tale with an appendix that explains the importance of motivation and how parents can further guide their children in creating hacks. “I like how the book explains the components of what makes a good hack, which includes being interesting, challenging, and new,” says an expert from the Child Mind Institute. Ages 6–10. Published by Little, Brown Books for Young Readers.
Written by Trudy Ludwig, illustrated by Maribel Lechuga
Thea is just beginning school in this picture book, and she is desperately hoping that her first week will be flawless and her new teacher will like her. But no amount of preparation can ensure everything will go smoothly, and it doesn’t. Happily, Thea’s teacher emphasizes that everybody makes mistakes, and the important thing is being kind to yourself and others. “I really enjoy how the teacher normalizes feelings of anxiety by sharing with the kids that she gets nervous too,” says a Child Mind Institute expert. “The author also provides brief but helpful tips about how it’s okay to make mistakes, and what to do when you feel stuck.” Ages 3–7. Published by Alfred A. Knopf.
Written by Marcela Ferreira, illustrated by Mark Chambers
With a mix of empathy and humor, this picture book helps kids face their fears. A boy is at the beach when he spots a small shark in the water, and he won’t go in. His grandfather takes him fishing on the lake instead, but it’s a no go. Every body of water, even a bubble bath, now makes the boy “jumpy” and “suspicious.” So grandpa decides to tell a story about his fear of bears when he was young and how he learned how to live with them. And it works! In a sweet ending, the boy, now an adult, passes on that wisdom to his grandchild. “I liked that the book discussed that fears are real and can always be present, but that it’s important not to let them get in the way of doing things you love,” says a Child Mind Institute expert. Ages 3–7. Published by Charlesbridge.
Written by Debra Kempf Shumaker, illustrated by Lavanya Naidu
The dread that accompanies the end of the weekend grips Josie every Sunday, so she hatches humorous plans to avoid going back to school. However, when she actually gets to class, the week goes fine. So, why does the fear come back every Sunday, and why are her parents a bit grumpy that night also? The story has the family come up with clever ways to cope with the fear they share by focusing on the things that are worth looking forward to in the days to come. “I loved this book! It’s so realistic for children who experience anxiety about going to school. I enjoyed how her parents were able to acknowledge and empathize with her feelings,” says an expert from the Child Mind Institute. “At the end of the book, it provides simple, yet practical, tools for parents.” Ages 3–7. Published by Alfred A. Knopf.
In this very engaging young-adult novel about wilderness “adventure therapy,” 16-year-old Case narrates the story, slowly revealing the details behind the loss of his older brother. When the kids’ counselor suddenly disappears, the group has to learn to work together to find their way home. “You’ll feel the crippling grip of social anxiety, the power of finding belonging and understanding with peers thrown together in a wilderness survival situation,” said a Child Mind Institute expert. “While there are some troubling scenes, including a wildfire, this book could and should inspire conversations.” Ages 14–18. Published by Harperteen.
This middle-grade novel features two narrators: 12-year-old Sadie and Radley, who at 13 has become a famous YouTube influencer. Rad claims to be a survivalist, but Sadie has skills taught to her by her late father, whom she still misses. When she enters a contest to meet Rad, on behalf of her autistic brother Silas, the kids are swept into a dangerous adventure. They must contend with injuries, a mountain lion, their differences, and the emotional baggage they carry as they try to make it home alive. “This is a great book and hard to put down! It provides an inside view of what it is like losing a parent and how one copes by sister-smothering her autistic younger sibling,” says a Child Mind Institute expert. Ages 8–12. Published by Alfred A. Knopf.
Utilizing pictures and a fun rhyme scheme to illustrate a myriad of body types, this book presents the scope of humanity, more so than in other books with a similar theme. “The author achieves the message of body positivity very well. The book shows so many body differences that aren’t shown often with well-done art and a diverse cast,” says a Child Mind Institute expert. “It’s an easy recommendation for a child with a disability or anything about their body they’re insecure about.” Ages 3–6. Published by Bloomsbury Children’s Books.
Written by Karen Krossing, illustrated by Dorothy Leung
In this beautifully illustrated picture book, a persistent cloud hangs over Tansy’s head and grows so large that it begins to rain — but only on her. Tansy’s dad gives her a raincoat and umbrella, and her teacher sets up a fan to move the cloud, which help “a little.” Eventually, she begins to accept the cloud and discovers ways to make the best of a difficult situation with the support of friends and family. “The main character’s emotional reactions, including her sadness, frustration, and eventual resilience, are relatable and easy for young readers to connect with,” says a Child Mind Institute expert. “This story highlights perseverance through challenges that do not have an easy fix, while offering a hopeful message about acceptance, coping, and the importance of support from others.” Ages 4–8. Published by Charlesbridge.
Professor Thomas Cat’s Guide to Understanding the Human Brain: The Dyslexia Files
Written by Rachel Allen, PhD, illustrated by Miguel Díaz Rivas
This graphic novel stars Professor Cat, a slightly arrogant feline scientist who takes Ava on a tour of a brain factory to explain how the mind of a kid with dyslexia works. The author, a neuroscientist, keeps things fun and light but doesn’t sugarcoat Ava’s situation. Ava has struggles, but her dyslexia also gives her strengths. The book includes experiments, such as a Dyslexia Simulator that allows people to see what reading for someone with dyslexia is like. An expert at the Child Mind Institute says that it “really dives into understanding dyslexia, including brain structures, characteristics, and support while being fun and easy to follow.” Ages 9–14. Published by Magination Press.
A rocket ship named Rocco loves blasting around the solar system. For Rocco, the rings of Saturn are like slides and the tethers of space stations are swings. Unfortunately, this out-of-this-world playground also has satellites that hog rides and rovers that steal toys. Eventually the roughhousing of the meteors drives Rocco away from the galaxy, looking for relief. The peaceful calm of an empty region lets him regain his cool, and he is able to brave going back. “The story is a clever play on words with the character needing space and the action taking place in space,” said a Child Mind Institute expert. “It also shows ways you can handle needing space.” A list of great tips is found alongside a brief astronomy guide to some of the wonders Rocco encounters. Ages 4–8. Published by Simon & Schuster.
Written by Karen Gebbia, illustrated by Mette Engell
A cozy, gentle story about patience comes on a hot day when Nana sets out to make Charlotte her real iced tea. There are many steps to Nana’s recipe, so she tells Charlotte to find something useful to do while she waits. But the tea is still not ready! As the hours pass, something surprising happens: Charlotte stops wanting to speed up the tea-making process and starts noticing the beautiful moments inside the waiting. “I like the message of finding ways to tolerate waiting and even finding the fun in them,” says a Child Mind Institute expert. She also appreciates the back matter for parents on how to help kids wait more patiently and enjoy slower moments. Ages 5–9. Published by Lerner Books.
A brilliant rhyming picture book that can be sung to the tune of “Twinkle, Twinkle Little Star” covers many emotions, from frustration to disappointment. It pairs the feelings with mindfulness strategies to work through them. For example, when a child is frustrated, the book encourages kids to “Run in circles, twist and shout. Let the feelings all come out.” Says a Child Mind Institute expert: “This book would be good for both the grown-up and child reading it because it gives grown-ups a way to help kids express and manage feelings. The note to caregivers at the end is very digestible and helpful, as are the emotion regulation games.” Ages 3–5. Published by Beaming Books.
This young-adult novel introduces readers to 17-year-old Bliss, who in the span of two weeks meets and falls in love with her co-narrator Solomon. Bliss’s family runs a funeral home, which gives her both a reputation as being a bit strange and an interesting perspective on grief. Both kids are confronted by death, even as their romance begins, but the story retains a sense of hope thanks to Bliss’s attitude. “The book was a very engaging read. Among the themes is learning to accept the realities of life and death,” said a Child Mind Institute expert. “Woven into the narrative is how to navigate these situations in a healthy way.” Ages 12–18. Published by Bloomsbury.
A young girl processes loss when her beloved backyard tree has to be removed. Although the parents knew the day will come, the girl isn’t prepared and struggles emotionally with the inevitable. The family presses some of its leaves as a remembrance. “Gentle and reassuring, this book can help foster conversations about sadness, loss, coping with change, the circle of life, and resilience,” says a Child Mind Institute expert. “The story ends on a hopeful note as she plants a new tree in its place and takes on the role of caregiver, illustrating how new life can emerge after loss and how love, memories, and growth can continue even as things change.” Ages 4–8. Published by Penguin Random House.
In this board book, children can trace their fingers over eight die-cut, differently textured surfaces that take the shape of natural wonders like stars, waves, mountains, flowers, and, of course, rainbows. While they touch these colorful pictures, they’re instructed to breathe in and out to cope with any difficult feelings they may be experiencing. “I love how this simple book pairs feelings and the mindfulness technique of shape breathing,” said an expert from the Child Mind Institute. “The book is easy to read with cute visuals and applies the senses through using different textures.” Ages 2–4. Published by Abrams Books.
Written by Chloe Ito Ward, illustrated by Yaroslava Apollonova
Starting with the prompt “What does learning look like?” the book begins with an image of circle time, and the idea: “Sometimes learning looks like…crisscross applesauce, hands in your lap.” But one of the kids isn’t happy, and she supplies an alternative: “But I don’t learn like that. I tap my feet on the floor with arms bouncing on my knees or squeezing a ball. When my body moves, I can learn.” And so it goes, with different kids sharing a broad range of learning practices. “I liked that this book normalizes all the different accommodations and ways kids learn!” says a Child Mind Institute expert. “I also appreciated the glossary of terms and possible accommodations at the end. I think this book would be good for both children with learning differences and those without, to normalize the experience.” Ages 3–6. Penguin Random House.
Peyton is a young girl dealing with OCD (obsessive-compulsive disorder), which has caused her to stop doing many of the things she enjoys. She’s frightened that she might hurt herself or her sister, unless she avoids some things around her, such as the color red. The graphic novel’s art and lettering brilliantly depict her thoughts as intrusive and all-consuming. However, there is also a sweetness and warmth to the characters that makes readers want to root for Peyton as she bravely enters therapy. The author, who also has OCD, realistically depicts ERP (exposure and response prevention), in which “you are repeatedly exposed to your fears until they become less scary.” A Child Mind Institute expert believes that the story “describes OCD and ERP well through very adolescent-friendly language.” Ages 8–12. Published by First Second.
Written by Pooja Makhijani, illustrated by Nadia Alam
This gentle picture book follows Asha, who is so thrilled to welcome her newborn sister Maya home from the hospital that she is bubbling over with excitement. However, she’s surprised that her mother doesn’t seem to share her joy. As a matter of fact, Mama is distracted, anxious, and teary. Fortunately, her Papa doesn’t hesitate to call in Asha’s grandmothers as reinforcements. Together, the family eases Mama’s daily burdens and gives her the time and space she needs to recover. “This is a simple story that teaches kids about postpartum depression,” says an expert from the Child Mind Institute. “The book is helpful for mothers or other caregivers to read to youngsters, allowing them to acknowledge the sadness their child is likely already aware of, and not keeping that information hidden.” Ages 5–8. Published by Penguin Random House.
In this charming picture book, Hanna excels in sports, but math leaves her confused. Her initial plan to just pretend that she understands naturally doesn’t work out. She’s visited by a spritely, glowing ball of energy called Help, who encourages her to ask for assistance. Sure enough, this works for finding things and tying her laces, but can it help with arithmetic? When it does, Hanna realizes she can offer help herself to others who struggle with the things that she finds easy. “The book has a good description of learning challenges, the hesitancy around asking for help, and a really nice resource at the end about everyone having different strengths,” says a Child Mind Institute expert. Ages 3–6. Published by Bloomsbury Children’s Books.
<strong>Background:</strong> Psychotherapy is a primary treatment for many mental health conditions, yet the dynamic interplay among therapist behaviors, client responses, and the therapeutic relationship remains difficult to disentangle at scale. Traditional process research relies on labor-intensive human coding, limiting the ability to model moment-to-moment therapeutic dynamics across large datasets. <strong>Objective:</strong> This study aimed to develop and validate a computational framework for modeling therapist-client interaction processes and to examine how therapist behaviors and relational qualities relate to client self-disclosure and emotional expression in psychotherapy sessions. <strong>Methods:</strong> We developed automated assessment pipelines using large language models (LLMs) to measure therapist behaviors (empathy or exploration), relational quality (rapport), and client outcomes (self-disclosure, self-directed negative emotion, or outward-directed negative emotion). Model-generated scores were validated against human annotations. We then applied these measures to approximately 2000 hours of psychotherapy transcripts from the Alexander Street corpus. This yielded an estimation sample of 119,233 client utterances from 1573 sessions and 37 clients. Because utterances are nested within sessions and sessions within clients, we estimated a saturated multivariate structural equation model with SEs clustered at the session level. Results were confirmed in a multilevel regression model with random intercepts for session and client. <strong>Results:</strong> Following comparative validation of 6 candidate language models, automated measures showed good to excellent agreement with human annotations (intraclass correlation coefficient [ICC]=0.60-0.81) for rapport (ICC=0.81), self-disclosure (ICC=0.78), empathy components (ICC=0.60-0.75), and emotion measurements (ICC=0.66-0.80). Structural equation modeling analyses revealed that therapist empathy and exploration were each associated with increased client disclosure (empathy: β=.086, 95% CI 0.078-0.095; exploration: β=.086, 95% CI 0.078-0.094; both <i>P</i><.001) and increased expression of self-directed negative emotions, comprising sadness, anxiety, fear, and depression (empathy: β=.118, 95% CI 0.110-0.127; exploration: β=.078, 95% CI 0.070-0.087; both <i>P</i><.001). Both behaviors were also associated with reduced expressions of enjoyment (empathy: β=–.037; exploration: β=–.041; both <i>P</i><.001). Surprisingly, rapport in the prior session showed no association with client self-disclosure or negative emotion expression. <strong>Conclusions:</strong> This study demonstrates that LLM-based measurement combined with structural modeling can capture core therapeutic processes at scale. Empathy and exploration showed small but consistent turn-level associations with client disclosure and emotional expression, whereas prior-session rapport did not show a robust association. These findings provide a computational foundation for precision modeling of psychotherapy processes and may offer actionable insights for scalable therapist training and AI-supported clinical education systems.
Background: AI technologies have considerable potential to support mental health practitioners in identifying depression symptoms. However, existing tools are often developed with limited practitioner involvement and evaluated primarily on technical performance, leaving questions of clinical relevance, ethical design, and practitioner trust insufficiently addressed. Objective: This study aimed to examine how iterative co-design with mental health practitioners can inform the development of an AI-based model for identifying depression symptoms, focusing on how practitioner input shaped its clinical relevance and ethical foundations across 2 design cycles. Method: We conducted a 2-stage qualitative co-design study. In stage 1, we developed DepressionSymp 1.0, a fine-tuned GPT-3.5 model trained on the CounselChat dataset, identifying 5 symptom categories based on the () criteria and the Linguistic Inquiry and Word Count (LIWC-22) psycholinguistic framework, reviewed and discussed by 6 mental health practitioners during online co-design workshops. In stage 2, this feedback informed DepressionSymp 2.0, expanded to 10 symptom categories and reviewed by 8 further practitioners in a second round of workshops. Results: Practitioners valued the structured symptom outputs for reducing cognitive workload and supporting intervention planning. In stage 1, indirect indicators such as social withdrawal, financial difficulties, and major life changes were often classified as lifestyle factors rather than symptoms; this informed the expansion to 10 categories in stage 2, described as clearer and more useful for preassessment. Risk categorization was identified as the most ethically sensitive aspect across both stages, alongside broader concerns including the lack of nonverbal information in text-based assessments, cultural and linguistic differences in symptom expression, and the potential for automation bias without sufficient human oversight. Conclusions: Iterative co-design with mental health practitioners is valuable for developing AI-based tools that are clinically relevant and ethically grounded, demonstrating how qualitative practitioner feedback can inform iterative model refinement and ethical design. Findings inform design implications around large language model (LLM) features, practitioner-in-the-loop oversight, and ethical considerations covering clinical standards, informed consent, and data governance. Future work should prioritize larger-scale independent validation, formal safety evaluation, and culturally diverse dataset development.
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IntroductionAdolescent mental health is a pressing global concern, and in collectivist societies such as China, family and school contexts are particularly influential. This study examined whether interpersonal self-support mediates the association between family cohesion and self-esteem among Chinese adolescents and whether school attachment moderates the first stage of that mediation pathway.MethodsA cross-sectional survey was conducted with 728 adolescents (mean age = 13.81 years, SD = 0.91, range 12–16; 44.0% male) from five public junior high schools in Hunan Province, China. Confirmatory factor analyses were conducted in Mplus 8.3, and the moderated mediation model was tested with Hayes’ PROCESS macro (Model 7) in SPSS 27 using observed variables and 5,000 bootstrap samples.ResultsFamily cohesion was positively associated with self-esteem and with interpersonal self-support, and interpersonal self-support partially mediated the family cohesion–self-esteem association. School attachment moderated the first stage of the mediation pathway, b = 0.076, 95% CI [0.024, 0.128], ΔR2 = .008: the positive association between family cohesion and interpersonal self-support was significant at all levels of school attachment and was stronger among adolescents reporting higher school attachment, and the conditional indirect effect increased from 0.107 at low to 0.153 at high school attachment.DiscussionThe indirect pathway was secondary to the direct association between family cohesion and self-esteem, and the moderation effect was modest. Because the design was cross-sectional and self-reported, these associations should not be interpreted causally. The findings suggest that schools may support the benefits of family cohesion for adolescent self-esteem by strengthening teacher-student relationships and cultivating a sense of belonging.
Consider what passes for success in technology policy. An AI company promises that its chatbot will not encourage suicide. A social media platform makes it more difficult for children to buy fentanyl. These are important protections, and they should have existed all along. But companies can clear these low bars while continuing to make products that leave young people dependent on simulated friendships or trapped in feeds built to keep them scrolling.
We have historically allowed the debate over technology to be defined by the worst thing a product might do, with remarkably little discussion of the insidious damage it does every day. As we transition into an era defined by powerful AI products, we should demand that the tech industry do more than merely address catastrophic harms. We should take measures to ensure that its products don’t erode how we think, learn, and interact with one another.
A teenager who develops an unhealthy attachment to an AI companion may never appear in a lawsuit or a newspaper, except in the most egregious cases. Neither will the student who begins relying on a chatbot to write every paper, or the young person who measures their life against a social media feed engineered to provoke envy and keep them watching. A product can meet every narrow safety requirement and still leave our entire culture worse off in ways that don’t always make headlines.
A narrow definition of success defined around safety is politically convenient for the technology industry, and companies actively promote such definitions. Taking steps to prevent spectacular disasters is good for business: It can mean fewer lawsuits and less pressure for serious regulation. Confronting the everyday consequences of dependence would require something considerably more threatening to their bottom line. It might mean asking companies to add more friction to their products or actively limit engagement or features that lead to negative outcomes, such as addictive attention-hacking algorithms.
Technology giants have instead worked to shape legislation around the harms they are already under direct pressure to address. This year, for example, Google backed bills to regulate AI chatbots in several states. The legislation mandated basic protections against sexual content and promotion of self-harm that tech companies should have established regardless, but with broad carve-outs that could exempt some of the most popular services. Passing these bills allowed legislators to claim a safety win while efforts to promote stronger legislation—laws designed to prevent children from becoming emotionally dependent on AI—failed. This playbook worked in states like Nebraska, producing legislation heavily influenced by industry at the expense of bills that would have done more to hold companies accountable.
We have been through a version of this with social media. Globally, people who use the internet now spend an average of more than two hours a day on social media platforms—time that has been quietly taken from ordinary life and handed over to companies whose profits depend on keeping us there. No one, outside perhaps a few tech CEOs, wanted these algorithms to occupy such a large portion of our waking hours, and their cultural engineering can actually contribute to violence on a devastating scale. Meta’s platforms have been cited for contributing to the Rohingya genocide in Myanmar, anti-Muslim riots in Sri Lanka, and alleged calls for violence during Ethiopia’s Tigray war. The same incentives operate in the feeds that shape young Americans’ understanding of politics, their peers, and the wider world.
AI is extending this logic into parts of life that social media could influence only from a distance. It offers to write our thoughts for us and stand in for the people we might otherwise turn to. A third of teens now choose to discuss serious matters with AI companions instead of other people. MIT researchers found that young people using ChatGPT to write essays showed weaker brain connectivity during the task, and their evidence indicated that “cognitive debt” persisted even after the task was complete. There is plenty we still need to learn about the long-term effects. We already have reason to ask whether technology marketed as making us more capable is eroding the habits and relationships that help us develop capabilities in the first place.
Follow this way of thinking to its logical endpoint and you get a world of perfectly sanitized entertainment, with chatbots ready to spare us the difficulty of thinking or of dealing with another person’s feelings (or even our own). But anyone who has struggled to write something worth reading, or repair a damaged friendship, knows how much gets lost in that bargain. We build judgment through effort and friction, and we learn to live with other people by confronting the fact that they have needs and opinions of their own.
We should demand safety as a minimum, yes—and then demand considerably more. Technology companies and school districts should have to show beyond a reasonable doubt that AI improves learning and critical thinking before making it a fixture in classrooms. Companies should be prohibited from designing companions that pretend to be conscious or profess love to users, and they should face independent scrutiny of how their systems affect relationships and people’s ability to think for themselves. The companies that have inserted their products into nearly every part of modern life have earned obligations far greater than avoiding the next terrible headline.
Sam Hiner is the cofounder and executive director of the Young People’s Alliance, where he coordinated a coalition of advocates to pass laws regulating AI companions in eight states in 2026—laws such as California’s SB1119. Sam graduated from the University of North Carolina atChapel Hill in 2025 and was named to the 2026 Forbes 30 Under 30 Social Impact list.
Emma Leiken is executive director of the Responsible Technology Youth Power Fund at Hopelab, which has raised more than $9 million for youth-led tech accountability work, and teaches technology policy at the Columbia School of International and Public Affairs. She was previously TikTok’s global head of youth safety and well-being policy and worked on responsible technology at Omidyar Network.
Background: Design research on AI technologies for mental health has expanded rapidly, yet existing work has largely focused on practitioners’ perspectives within isolated therapeutic stages or specific services. As a result, there is limited understanding of how practitioners view the role of AI across the full therapeutic journey, including assessment, diagnosis, and treatment, or how these perspectives can be translated into actionable and ethically grounded design guidance. This lack of stage-specific guidance introduces several risks: (1) the development of AI tools that practitioners may not trust or adopt, (2) heightened ethical concerns, particularly in diagnosis where bias and erosion of human judgment are most likely, and (3) missed opportunities to leverage AI to support ongoing assessment and treatment adaptation. Objective: This study aimed to explore mental health practitioners’ perspectives on how AI may support or hinder therapeutic practice across all 3 therapeutic stages, with particular attention to their ethical considerations. Methods: We conducted semistructured interviews with 18 mental health practitioners to explore how AI may support or hinder therapeutic practice across assessment, diagnosis, and treatment. Data were analyzed thematically, and ethical challenges were organized using 4 biomedical principles. This study received approval from the Lancaster University Institutional Ethics Committee (ID 3530). Results: Findings suggest a stage-specific pattern: practitioners identified valuable roles for AI in supporting clinical assessment and treatment, while expressing strong resistance to autonomous AI diagnosis, which was regarded as the most ethically sensitive stage. Across contexts, AI was seen as supporting and validating, rather than replacing, clinical judgment. Ethical concerns were organized using these principles, with key issues including data validity, inclusivity, privacy, transparency, and explainability. Grounded in these findings, four design directions are proposed: (1) AI-enabled clinical assessment hubs for analyzing multimodal patient data to support transparent decision-making; (2) natural language processing-based tools to enable richer understanding of patients’ lived experiences; (3) new models of trust to support ethically sensitive AI-assisted diagnostic decision-making; and (4) large language model–powered personalized and adaptive mental health support systems that maintain human-AI partnership and preserve practitioners’ central role in care. Conclusions: This study provides a stage-specific understanding of practitioners’ perspectives on AI use across assessment, diagnosis, and treatment and systematically frames ethical challenges using biomedical principles. The findings translate practitioner insights into actionable design guidance for ethically informed AI-supported mental health practice.
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IntroductionContagious yawning has been proposed to reflect multiple aspects of social cognition, including empathy, emotional contagion, self-processing, Theory of Mind (ToM), and action observation mechanisms such as the human mirror neuron system (hMNS). However, its underlying mechanisms remain debated, with evidence suggesting additional roles for social attention, gaze allocation, social motivation, and neurobiological factors. This systematic review examined evidence for reduced contagious yawning in Autism Spectrum Disorder (ASD), schizophrenia-spectrum disorders, and psychopathic traits, and evaluated potential underlying mechanisms.MethodsPubMed, PsycINFO, and Scopus were systematically searched for clinical and mechanistic studies of contagious yawning in psychiatric and healthy populations. Studies were screened using predefined eligibility criteria, and risk of bias was assessed using design-specific Joanna Briggs Institute (JBI) critical appraisal tools. Twenty-three studies met the inclusion criteria.ResultsReduced contagious yawning was reported in ASD, psychopathic traits, and schizophrenia-spectrum disorders, although findings varied across conditions. In ASD, reduced contagious yawning was associated with social attention, gaze allocation, oxytocin-related processes, and broader social-cognitive differences. In psychopathic traits, evidence more consistently implicated affective-interpersonal traits and reduced emotional responsiveness. Evidence for schizophrenia-spectrum disorders was more limited, with proposed mechanisms including impairments in social cognition, ToM, negative symptoms, and possible medication effects. Neuroimaging and electrophysiological findings implicate brain systems involved in social cognition, self-processing, and action observation, although the specific role of the hMNS remains uncertain.DiscussionReduced contagious yawning may reflect altered social-cognitive processing rather than empathy alone, with contributing mechanisms differing across psychiatric conditions. Interpretation is limited by small sample sizes, methodological heterogeneity, and variation in study design. Further well-powered studies are needed to clarify its neurobiological basis and clinical significance.
BackgroundSpine pinching is a promising alternative for autism spectrum disorder (ASD), yet its effects on multi-region molecular coordination remain unclear. This study examined the effects of spine pinching on cellular Fos proto-oncoprotein (c-Fos) and Oxytocin Receptor (OXTR) expression in the prefrontal cortex, hypothalamus, and amygdala, and further analyzed expression patterns across these regions using profile analysis to explore the coordinated multi-region regulation underlying improvements in social and empathic deficits.MethodsAn ASD rat model was established by valproic acid (VPA) induction. After behavioral testing, rats were divided into the model group (MG), spine pinching group (SPG), and blank control group (BC). SPG received a 15-day intervention from postnatal day 22. Then, open field, three-chamber social, and fear empathy tests were performed; brain tissues were collected for immunohistochemistry and western blotting, and profile analysis was conducted.ResultsVPA-induced ASD rats showed developmental and ASD-like behavioral deficits. MG rats exhibited social and empathy deficits and reduced c-Fos and OXTR levels in the prefrontal cortex, hypothalamus, and amygdala versus BC. Spine pinching improved these ASD-like behavioral deficits. Immunohistochemistry revealed that c-Fos and OXTR expression increased significantly in all three brain regions after spine pinching. Western blot analysis further supported these findings, showing significant upregulation in most brain regions and consistent upward trends in the remaining regions. Profile analysis revealed parallel expression profiles across regions, suggesting coordinated multi-region regulation.ConclusionSpine pinching effectively improves core ASD-like behavioral deficits in ASD rats, potentially through coordinated regulation of the multi-regional social-emotional network.
