Dominic Dwyer

Stephanie Fong, Zimu Wang, Guilherme C. Oliveira et al.

The medical adoption of NLP tools requires interpretability by end users, yet traditional explainable AI (XAI) methods are misaligned with clinical reasoning and lack clinician input. We introduce CHiRPE (Clinical High-Risk Prediction with Explainability), an NLP pipeline that takes transcribed semi-structured clinical interviews to: (i) predict psychosis risk; and (ii) generate novel SHAP explanation formats co-developed with clinicians. Trained on 944 semi-structured interview transcripts across 24 international clinics of the AMP-SCZ study, the CHiRPE pipeline integrates symptom-domain mapping, LLM summarisation, and BERT classification. CHiRPE achieved over 90% accuracy across three BERT variants and outperformed baseline models. Explanation formats were evaluated by 28 clinical experts who indicated a strong preference for our novel concept-guided explanations, especially hybrid graph-and-text summary formats. CHiRPE demonstrates that clinically-guided model development produces both accurate and interpretable results. Our next step is focused on real-world testing across our 24 international sites.

Yaling Shen, Stephanie Fong, Yiwen Jiang et al.

The increasing integration of large language models (LLMs) into mental health applications necessitates robust frameworks for evaluating professional safety alignment. Current evaluative approaches primarily rely on refusal-based safety signals, which offer limited insight into the nuanced behaviors required in clinical practice. In mental health, clinically inadequate refusals can be perceived as unempathetic and discourage help-seeking. To address this gap, we move beyond refusal-centric metrics and introduce \texttt{PsychEthicsBench}, the first principle-grounded benchmark based on Australian psychology and psychiatry guidelines, designed to evaluate LLMs' ethical knowledge and behavioral responses through multiple-choice and open-ended tasks with fine-grained ethicality annotations. Empirical results across 14 models reveal that refusal rates are poor indicators of ethical behavior, revealing a significant divergence between safety triggers and clinical appropriateness. Notably, we find that domain-specific fine-tuning can degrade ethical robustness, as several specialized models underperform their base backbones in ethical alignment. PsychEthicsBench provides a foundation for systematic, jurisdiction-aware evaluation of LLMs in mental health, encouraging more responsible development in this domain.

Xiangyu Zhao, Yaling Shen, Yiwen Jiang et al.

Depression is one of the most prevalent mental health disorders globally. In recent years, multi-modal data, such as speech, video, and transcripts, has been increasingly used to develop AI-assisted depression assessment systems. Large language models have further advanced this field due to their strong language understanding and generalization capabilities. However, conventional LLMs remain text-centric and cannot process the rich non-verbal cues found in audio and visual modalities, which are critical components in mental health evaluation. While multi-modal LLMs offer a promising direction, few are tailored for psychological applications. In this study, we propose a novel multi-modal LLM framework for depression detection. Our approach augments an audio language model with visual understanding and aligns audio-visual features at the timestamp level. This fine-grained alignment improves modeling of temporal dynamics across modalities while reducing the need for extensive training data and computational resources. Experiments on the DAIC-WoZ dataset demonstrate that our model outperforms both single-modality approaches and previous multi-modal methods. Moreover, the proposed framework can be extended to incorporate additional physiological signals, paving the way for broader clinical applications beyond mental health.