Large Language Models (LLMs) have remarkable capabilities across NLP tasks. However, their performance in multilingual contexts, especially within the mental health domain, has not been thoroughly explored. In this paper, we evaluate proprietary and open-source LLMs on eight mental health datasets in various languages, as well as their machine-translated (MT) counterparts. We compare LLM performance in zero-shot, few-shot, and fine-tuned settings against conventional NLP baselines that do not employ LLMs. In addition, we assess translation quality across language families and typologies to understand its influence on LLM performance. Proprietary LLMs and fine-tuned open-source LLMs achieve competitive F1 scores on several datasets, often surpassing state-of-the-art results. However, performance on MT data is generally lower, and the extent of this decline varies by language and typology. This variation highlights both the strengths of LLMs in handling mental health tasks in languages other than English and their limitations when translation quality introduces structural or lexical mismatches.

Social media text data are often used to train Machine Learning (ML) models to identify users exhibiting high-risk mental health behaviors. However, sharing this sensitive data poses privacy risks and limits the growth of benchmark datasets. We comprehensively evaluate whether privacy-preserving ML techniques can enable safer data sharing while preserving performance. Specifically, we apply federatedlearning (FL) and Differentially Private FL for two widely-studied mental health prediction tasks: depression detection on X (Twitter) and suicide crisis detection on Reddit. We simulate realistic data-sharing scenarios by treating each user as a client in a non-IID setting, evaluating across different client fractions, aggregation strategies, and privacy budgets. While FL achieves comparable performance to centralized training (centralized 𝐹 1 = 85.63; best FL model 𝐹 1 = 83.16) on depression identification, we find that Differentially Private FL has a large performance-privacy trade-off (up to 𝐹 1 = 27.01 drop) even with low levels of noise (𝜖 = 50). This is due to the distortion of highly informative yet sparse mental health linguistic markers related to mental health, like health topics and emotion words. This research empirically demonstrates the potential and limitations of current privacy preservation techniques for mental health inference tasks.

Social media data has been used for detecting users with mental disorders, such as depression. Despite the global significance of cross-cultural representation and its potential impact on model performance, publicly available datasets often lack crucial metadata relatedto this aspect. In this work, we evaluate the generalization of benchmark datasets to build AI models on cross-cultural Twitter data. We gather a custom geo-located Twitter dataset of depressed users from seven countries as a test dataset. Our results show that depressiondetection models do not generalize globally. The models perform worse on Global South users compared to Global North. Pre-trainedlanguage models achieve the best generalization compared to Logistic Regression, though still show significant gaps in performance on depressed and non-Western users. We quantify our findings and provide several actionable suggestions to mitigate this issue