Debate and Dilemmas Regarding Generative AI in Mental Health Care: Scoping Review.

BACKGROUND: Mental disorders have ranked among the top 10 prevalent causes of burden on a global scale. Generative artificial intelligence (GAI) has emerged as a promising and innovative technological advancement that has significant potential in the field of mental health care. Nevertheless, there is a scarcity of research dedicated to examining and understanding the application landscape of GAI within this domain. OBJECTIVE: This review aims to inform the current state of GAI knowledge and identify its key uses in the mental health domain by consolidating relevant literature. METHODS: Records were searched within 8 reputable sources including Web of Science, PubMed, IEEE Xplore, medRxiv, bioRxiv, Google Scholar, CNKI and Wanfang databases between 2013 and 2023. Our focus was on original, empirical research with either English or Chinese publications that use GAI technologies to benefit mental health. For an exhaustive search, we also checked the studies cited by relevant literature. Two reviewers were responsible for the data selection process, and all the extracted data were synthesized and summarized for brief and in-depth analyses depending on the GAI approaches used (traditional retrieval and rule-based techniques vs advanced GAI techniques). RESULTS: In this review of 144 articles, 44 (30.6%) met the inclusion criteria for detailed analysis. Six key uses of advanced GAI emerged: mental disorder detection, counseling support, therapeutic application, clinical training, clinical decision-making support, and goal-driven optimization. Advanced GAI systems have been mainly focused on therapeutic applications (n=19, 43%) and counseling support (n=13, 30%), with clinical training being the least common. Most studies (n=28, 64%) focused broadly on mental health, while specific conditions such as anxiety (n=1, 2%), bipolar disorder (n=2, 5%), eating disorders (n=1, 2%), posttraumatic stress disorder (n=2, 5%), and schizophrenia (n=1, 2%) received limited attention. Despite prevalent use, the efficacy of ChatGPT in the detection of mental disorders remains insufficient. In addition, 100 articles on traditional GAI approaches were found, indicating diverse areas where advanced GAI could enhance mental health care. CONCLUSIONS: This study provides a comprehensive overview of the use of GAI in mental health care, which serves as a valuable guide for future research, practical applications, and policy development in this domain. While GAI demonstrates promise in augmenting mental health care services, its inherent limitations emphasize its role as a supplementary tool rather than a replacement for trained mental health providers. A conscientious and ethical integration of GAI techniques is necessary, ensuring a balanced approach that maximizes benefits while mitigating potential challenges in mental health care practices.

Government-Nongovernmental Organization (NGO) Collaboration in Macao's COVID-19 Vaccine Promotion: Social Media Case Study.

BACKGROUND: The COVID-19 pandemic triggered unprecedented global vaccination efforts, with social media being a popular tool for vaccine promotion. OBJECTIVE: This study probes into Macao's COVID-19 vaccine communication dynamics, with a focus on the multifaceted impacts of government agendas on social media. METHODS: We scrutinized 22,986 vaccine-related Facebook posts from January 2020 to August 2022 in Macao. Using automated content analysis and advanced statistical methods, we unveiled intricate agenda dynamics between government and nongovernment entities. RESULTS: "Vaccine importance" and "COVID-19 risk" were the most prominent topics co-occurring in the overall vaccine communication. The government tended to emphasize "COVID-19 risk" and "vaccine effectiveness," while regular users prioritized vaccine safety and distribution, indicating a discrepancy in these agendas. Nonetheless, the government has limited impact on regular users in the aspects of vaccine importance, accessibility, affordability, and trust in experts. The agendas of government and nongovernment users intertwined, illustrating complex interactions. CONCLUSIONS: This study reveals the influence of government agendas on public discourse, impacting environmental awareness, public health education, and the social dynamics of inclusive communication during health crises. Inclusive strategies, accommodating public concerns, and involving diverse stakeholders are paramount for effective social media communication during health crises.

Perspectives on Surrogacy in Chinese Social Media: A Content Analysis of Microblogs on Weibo.

Background: This article explores the social media discourse on transnational surrogacy and the issue of surrogacy more broadly considering recent news about the Chinese celebrity Zheng Shuang, which revealed that she had hired a surrogate mother in the United States and had later abandoned the surrogate babies. It aims to provide insight on how Chinese citizenry uses social media to express opinions on ethical and legal issues concerning surrogacy. Methods: We conducted a content analysis of microblogs from the social media platform Weibo posted within a month after the event was reported on January 17, 2021. The entire data set included 37,895 posts, which were analyzed for topic exploration using word frequency and keyword co-occurrence techniques, and a smaller sample of 1,000 posts was selected for an in-depth content analysis. Results: We established that the words "Zheng Shuang," "surrogacy," "babies," "abandoning babies," and "Zhang Heng" were most frequently used, with "law," "ethics," "justification," "legality," and "illegal" sharing high connections with these keywords. The qualitative content analysis further established that 399 microblogs (39.9%) expressed value judgements towards Zheng Shuang's surrogacy, and 61.9% (n=247) opposed her surrogacy, while only 7.0% (n=28) were supportive. The major reason (n=72) against the celebrity's surrogacy was that it was unfair and risky to surrogate children in this case. One hundred twenty-eight posts made value judgements towards surrogacy in principle, with 115 opposing surrogacy, and only two supportive posts. We also established that users with legal background had very limited presence in surrogacy discussions on Weibo, while users from healthcare professions did not engage at all in the social media debate. Conclusion: Opposition to surrogacy in Chinese social media discourse is primarily based on ethical and moral objections. The protection of surrogate children and surrogate women's rights was the major concerns expressed by social media users, suggesting that this issue would likely be at the center of a future public debate regarding the regulation of surrogacy. We found the lack of healthcare professionals' perspectives in social media discussions on Zheng's Surrogacy disconcerting and suggest their inclusion in public deliberations to ensure that the public is better educated, and substantive concerns are properly addressed.

Health Communication through Positive and Solidarity Messages Amid the COVID-19 Pandemic: Automated Content Analysis of Facebook Uses.

The COVID-19 outbreak has caused significant stress in our lives, which potentially increases frustration, fear, and resentful emotions. Managing stress is complex, but helps to alleviate negative psychological effects. In order to understand how the public coped with stress during the COVID-19 pandemic, we used Macao as a case study and collected 104,827 COVID-19 related posts from Facebook through data mining, from 1 January to 31 December 2020. Divominer, a big-data analysis tool supported by computational algorithm, was employed to identify themes and facilitate machine coding and analysis. A total of 60,875 positive messages were identified, with 24,790 covering positive psychological themes, such as "anti-epidemic", "solidarity", "hope", "gratitude", "optimism", and "grit". Messages that mentioned "anti-epidemic", "solidarity", and "hope" were the most prevalent, while different crisis stages, key themes and media elements had various impacts on public involvement. To the best of our knowledge, this is the first-ever study in the Chinese context that uses social media to clarify the awareness of solidarity. Positive messages are needed to empower social media users to shoulder their shared responsibility to tackle the crisis. The findings provide insights into users' needs for improving their subjective well-being to mitigate the negative psychological impact of the pandemic.