Susan B. Rubin

Benjamin Lange, Geoff Keeling, Kyle Pedersen et al.

Bottom-up responsible innovation initiatives seek to empower technology development teams to engage in ethical reflection, yet such interventions frequently fail to achieve practitioner engagement. Why do some ethics interventions succeed while others are dismissed as irrelevant, adversarial, or disconnected from work? This paper proposes epistemic trust -- the degree to which practitioners regard an intervention, its facilitators, and its content as credible, relevant, and actionable -- as a conceptual model linking intervention design to engagement outcomes. Drawing on philosophical work on testimony and on practice-based qualitative analysis of over 70 moral imagination workshops with engineering teams between 2019 and 2025, we identify five dimensions of epistemic trust salient to ethics interventions (Relevance, Inclusivity, Agency, Authority, and Alignment) and present a typology of 23 failure modes that arise when these dimensions are inadequately addressed. We derive nine design principles for cultivating epistemic trust, grounded in our operationalisation of moral imagination through technomoral scenarios and structured deliberation. Our findings contribute to the literature on collaborative socio-technical integration by specifying conditions of uptake that existing frameworks leave undertheorised. We acknowledge limitations including selection effects from voluntary participation and the absence of formal outcome measures, and position our failure mode typology as practitioner hypotheses warranting further empirical validation.

Hannah R. Lawrence, Renee A. Schneider, Susan B. Rubin et al.

Global rates of mental health concerns are rising, and there is increasing realization that existing models of mental health care will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health related tasks. In this paper, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs' application to mental health and encourage the adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. It is especially critical to ensure that mental health LLMs are fine-tuned for mental health, enhance mental health equity, and adhere to ethical standards and that people, including those with lived experience with mental health concerns, are involved in all stages from development through deployment. Prioritizing these efforts will minimize potential harms to mental health and maximize the likelihood that LLMs will positively impact mental health globally.