Dong Whi Yoo

Drishti Goel, Agam Goyal, Veda Duddu et al.

Language models are increasingly being deployed for conversational support in informal caregiving contexts, where interactions often extend beyond information-seeking: caregivers seek emotional reassurance, guidance, and help, while navigating uncertain, relationally complex care decisions. Yet most safety evaluations assess model behavior under generic prompts, leaving a critical question unexamined: does a model's safety profile change with its support role? We study this by operationalizing four expert-reviewed support roles grounded in social support theory: Inform, Coach, Relate, and Listen, and comparing them against two baseline controls: a basic prompting condition and a retrieval-augmented generation (RAG) condition. We evaluate across three language models (GPT-4o-mini, Llama-3.1-8B-Instruct, and MedGemma-1.5-4b-it) on 5,000 real-world queries from online Alzheimer's Disease and Related Dementias (ADRD) communities. We find that the LLM's support role systematically shapes both the prevalence and composition of interactional risks. Furthermore, a human evaluation study reveals a perceived quality--safety tension: more directive, information-oriented roles are rated as more helpful and trustworthy despite exhibiting elevated interactional risk profiles. We release ~90,000 support role-conditioned model responses with risk annotations as an ecologically grounded resource for research on safer LLM-mediated conversational support.

Jiwon Kim, Maya Ajit, Sherry Gong et al.

Large language models (LLMs) show promise in generating supportive responses for mental health queries, but improving their usefulness, empathy, and safety often requires substantial compute, expert input, and labeled data. At the same time, deploying proprietary, cloud-based models for mental health-related interactions raises important privacy and data-governance concerns, given the sensitivities. To address this challenge, we introduce LLUMI setup that can be hosted in-house within protected environments. LLUMI consists of two complementary components: a generation model (GM), which drafts supportive responses to mental health queries, and an improvement model (IM), which revises an initial human-crafted response. We leverage feedback signals from Reddit mental health communities, using community endorsement patterns such as upvotes and downvotes to construct chosen-rejected response pairs for Supervised Fine Tuning (SFT) and Direct Preference Optimization (DPO). We further align LLUMI using human evaluation across five dimensions: readability, empathy, connection, actionability, and safety. Our results show that, despite relying on smaller open-source models rather than proprietary cloud-based GPT models, LLUMI achieves comparable performance across linguistic analyses and human evaluations. These findings suggest that open-source models, when trained with community-derived preference signals, can support high-quality mental health support assistance while offering a more privacy-preserving alternative for sensitive support contexts.

Soonho Kwon, Dong Whi Yoo, Shaowen Bardzell et al.

We present four conceptual value-sensitive AI systems to examine how the presence of AI could influence praying experiences. Drawing on key values and practices associated with praying identified through a diary study, we designed AI systems intended to "assist" prayer practices. These designs were presented to participants through speculative design workbooks, serving as provocations to co-reflect on how the intervention of AI systems might shape their praying experiences. Our findings suggest that a sense of authenticity (or feeling a genuine connection to the divine) is a crucial value, while the presence of AI was often perceived as diminishing this authenticity, particularly when AI assumed too much agency in guiding praying practices. Based on our findings, we argue that AI system designs for deeply value-laden experiences should preserve users' agency in shaping their own experiences by maintaining interpretive openness, perhaps by leveraging AI's inexplicability as a resource for personal meaning-making or by recognizing non-use of AI as a legitimate design choice.

Soonho Kwon, Dong Whi Yoo, Koustuv Saha et al.

This study examines how parents of LGBTQ+ individuals in South Korea navigate the emotional rupture fueled by fear, isolation, and disorientation after learning their children's queer identity, encounter queer-related (mis)information as a way of coping with this emotional toll, and come to listen to queer realities relationally. Through this process, we highlight how parents reconstruct their identities as supportive parents, which reshapes their informating practices, making them more critical in assessing queer-related (mis)information, developing strategies to protect themselves from harmful narratives, and actively challenging misinformation to support others navigating similar experiences. This work contributes to CSCW by (1) foregrounding parents of LGBTQ+ individuals, an underrepresented yet critical stakeholder group in Queer HCI; (2) demonstrating how identity reconfiguration following a trauma-healing process could transform information practices; and (3) arguing that addressing misinformation requires attention beyond individual fact-based discerning to account for its relational, cultural, and emotional dimensions. Further, we invite CSCW scholars to reconsider the balance between abstracting and humanizing information, explore future design possibilities for parents of LGBTQ+ children, and reflect on the role of researchers as participants in collective research communities fueled by care.

Shanshan Zhu, Wenxuan Song, Jiayue Melissa Shi et al.

Most personal wellbeing apps present summative dashboards of health and physical activity metrics, yet many users struggle to translate this information into meaningful understanding. These apps commonly support engagement through goals, reminders, and structured targets, which can reinforce comparison, judgment, and performance anxiety. To explore a complementary approach that prioritizes self-reflection, we design KRIYA, an AI wellbeing companion that supports co-interpretive engagement with personal wellbeing data. KRIYA aims to collaborate with users to explore questions, explanations, and future scenarios through features such as Comfort Zone, Detective Mode, and What-If Planning. We conducted semi-structured interviews with 18 college students interacting with a KRIYA prototype using hypothetical data. Our findings show that through KRIYA interaction, users framed engaging with wellbeing data as interpretation rather than performance, experienced reflection as supportive or pressuring depending on emotional framing, and developed trust through transparency. We discuss design implications for AI companions that support curiosity, self-compassion, and reflective sensemaking of personal health data.

Soonho Kwon, Dong Whi Yoo, Younah Kang

This speculative video piece showcases participants interacting with a career counseling AI agent, unaware that the responses were actually derived from the fortunetelling of a mudang (a Korean traditional shaman). Our work captures this deception and documents participants' reactions, showcasing shifts in their initial perceptions of the agent's advice following the reveal. Notably, even after learning that the advice came from a mudang rather than an AI, participants did not change their initial attitudes toward the advice they received. This raises questions about the perceived importance of AI's explainability and accuracy. By juxtaposing scientific and pre-scientific approaches, we aim to provoke discussions on human agency in the age of AI. We argue that, regardless of AI's advancements, we continue to navigate life in fundamentally human ways -- wonderfully messy and uncertain.

Dong Whi Yoo, Jiayue Melissa Shi, Violeta J. Rodriguez et al.

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

Jiayue Melissa Shi, Dong Whi Yoo, Keran Wang et al.

Family caregivers of individuals with Alzheimer's Disease and Related Dementia (AD/ADRD) face significant emotional and logistical challenges that place them at heightened risk for stress, anxiety, and depression. Although recent advances in generative AI -- particularly large language models (LLMs) -- offer new opportunities to support mental health, little is known about how caregivers perceive and engage with such technologies. To address this gap, we developed Carey, a GPT-4o-based chatbot designed to provide informational and emotional support to AD/ADRD caregivers. Using Carey as a technology probe, we conducted semi-structured interviews with 16 family caregivers following scenario-driven interactions grounded in common caregiving stressors. Through inductive coding and reflexive thematic analysis, we surface a systemic understanding of caregiver needs and expectations across six themes -- on-demand information access, emotional support, safe space for disclosure, crisis management, personalization, and data privacy. For each of these themes, we also identified the nuanced tensions in the caregivers' desires and concerns. We present a mapping of caregiver needs, AI chatbot's strengths, gaps, and design recommendations. Our findings offer theoretical and practical insights to inform the design of proactive, trustworthy, and caregiver-centered AI systems that better support the evolving mental health needs of AD/ADRD caregivers.

Soorya Ram Shimgekar, Violeta J. Rodriguez, Paul A. Bloom et al.

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

Drishti Goel, Jeongah Lee, Qiuyue Joy Zhong et al.

Caregivers seeking AI-mediated support express complex needs -- information-seeking, emotional validation, and distress cues -- that warrant careful evaluation of response safety and appropriateness. Existing AI evaluation frameworks, primarily focused on general risks (toxicity, hallucinations, policy violations, etc), may not adequately capture the nuanced risks of LLM-responses in caregiving-contexts. We introduce RubRIX (Rubric-based Risk Index), a theory-driven, clinician-validated framework for evaluating risks in LLM caregiving responses. Grounded in the Elements of an Ethic of Care, RubRIX operationalizes five empirically-derived risk dimensions: Inattention, Bias & Stigma, Information Inaccuracy, Uncritical Affirmation, and Epistemic Arrogance. We evaluate six state-of-the-art LLMs on over 20,000 caregiver queries from Reddit and ALZConnected. Rubric-guided refinement consistently reduced risk-components by 45-98% after one iteration across models. This work contributes a methodological approach for developing domain-sensitive, user-centered evaluation frameworks for high-burden contexts. Our findings highlight the importance of domain-sensitive, interactional risk evaluation for the responsible deployment of LLMs in caregiving support contexts. We release benchmark datasets to enable future research on contextual risk evaluation in AI-mediated support.

Jiwon Kim, Violeta J. Rodriguez, Dong Whi Yoo et al.

Large language models (LLMs) are increasingly used for mental health support, yet they can produce responses that are overly directive, inconsistent, or clinically misaligned, particularly in sensitive or high-risk contexts. Existing approaches to mitigating these risks largely rely on implicit alignment through training or prompting, offering limited transparency and runtime accountability. We introduce PAIR-SAFE, a paired-agent framework for auditing and refining AI-generated mental health support that integrates a Responder agent with a supervisory Judge agent grounded in the clinically validated Motivational Interviewing Treatment Integrity (MITI-4) framework. The Judgeaudits each response and provides structuredALLOW or REVISE decisions that guide runtime response refinement. We simulate counseling interactions using a support-seeker simulator derived from human-annotated motivational interviewing data. We find that Judge-supervised interactions show significant improvements in key MITI dimensions, including Partnership, Seek Collaboration, and overall Relational quality. Our quantitative findings are supported by qualitative expert evaluation, which further highlights the nuances of runtime supervision. Together, our results reveal that such pairedagent approach can provide clinically grounded auditing and refinement for AI-assisted conversational mental health support.

Jiayue Melissa Shi, Keran Wang, Dong Whi Yoo et al.

Alzheimer's Disease and Related Dementias (AD/ADRD) are progressive neurodegenerative conditions that impair memory, thought processes, and functioning. Family caregivers of individuals with AD/ADRD face significant mental health challenges due to long-term caregiving responsibilities. Yet, current support systems often overlook the evolving nature of their mental wellbeing needs. Our study examines caregivers' mental wellbeing concerns, focusing on the practices they adopt to manage the burden of caregiving and the technologies they use for support. Through semi-structured interviews with 25 family caregivers of individuals with AD/ADRD, we identified the key causes and effects of mental health challenges, and developed a temporal mapping of how caregivers' mental wellbeing evolves across three distinct stages of the caregiving journey. Additionally, our participants shared insights into improvements for existing mental health technologies, emphasizing the need for accessible, scalable, and personalized solutions that adapt to caregivers' changing needs over time. These findings offer a foundation for designing dynamic, stage-sensitive interventions that holistically support caregivers' mental wellbeing, benefiting both caregivers and care recipients.

Shreya Haran, Samiha Thatikonda, Dong Whi Yoo et al.

Mental health concerns are rising globally, prompting increased reliance on technology to address the demand-supply gap in mental health services. In particular, mental health chatbots are emerging as a promising solution, but these remain largely untested, raising concerns about safety and potential harms. In this paper, we dive into the literature to identify critical gaps in the design and implementation of mental health chatbots. We contribute an operational checklist to help guide the development and design of more trustworthy, safe, and user-friendly chatbots. The checklist serves as both a developmental framework and an auditing tool to ensure ethical and effective chatbot design. We discuss how this checklist is a step towards supporting more responsible design practices and supporting new standards for sociotechnically sound digital mental health tools.