Recent research has explored computational tools to manage workplace stress via personal sensing, a measurement paradigm in which behavioral data streams are collected from technologies including smartphones, wearables, and personal computers. As these tools develop, they invite inquiry into how they can be appropriately implemented towards improving workers' well-being. In this study, we explored this proposition through formative interviews followed by a design provocation centered around measuring burnout in a U.S. resident physician program. Residents and their supervising attending physicians were presented with medium-fidelity mockups of a dashboard providing behavioral data on residents' sleep, activity and time working; self-reported data on residents' levels of burnout; and a free text box where residents could further contextualize their well-being. Our findings uncover tensions around how best to measure workplace well-being, who within a workplace is accountable for worker stress, and how the introduction of such tools remakes the boundaries of appropriate information flows between worker and workplace. We conclude by charting future work confronting these tensions, to ensure personal sensing is leveraged to truly improve worker well-being.

For people diagnosed with mental health conditions, psychiatric hospitalization is a major life transition, involving clinical treatment, crisis stabilization and loss of access of social networks and technology. The period after hospitalization involves not only management of the condition and clinical recovery but also re-establishing social connections and getting back to social and vocational roles for successful reintegration - a significant portion of which is mediated by social technology. However, little is known about how people get back to social lives after psychiatric hospitalization and the role social technology plays during the reintegration process. We address this gap through an interview study with 19 individuals who experienced psychiatric hospitalization in the recent past. Our findings shed light on how people's offline and online social lives are deeply intertwined with management of the mental health condition after hospitalization. We find that social technology supports reintegration journeys after hospitalization as well as presents certain obstacles. We discuss the role of social technology in significant life transitions such as reintegration and conclude with implications for social computing research, platform design and clinical care.

involving resuming social roles and responsibilities, overcoming stigma and self-maintenance of the condition. Both clinical recovery and social reintegration need to go hand-in-hand for the overall well-being of individuals. However, research exploring social media for mental health has considered narrower, disjoint conceptualizations of people with mental illness - either as a patient or as a support-seeker. In this paper, we combine medical records with social media data of 254 consented individuals who have experienced a psychiatric hospitalization to address this gap. Adopting a theory-driven, Gaussian Mixture modeling approach, we provide a taxonomy of six heterogeneous behavioral patterns characterizing peoples' mental health status transitions around hospitalizations. Then we present an empirically derived framework, based on feedback from clinical researchers, to understand peoples' trajectories around clinical recovery and social reintegration. Finally, to demonstrate the utility of this taxonomy and the empirical framework, we assess social media signals that are indicative of individuals' reintegration trajectories post-hospitalization. We discuss the implications of combining peoples' clinical and social experiences in mental health care and the opportunities this intersection presents to post-discharge support and technology-based interventions for mental health.

Impaired social functioning is a symptom of mental illness (e.g., depression, schizophrenia) and a wide range of other conditions (e.g., cognitive decline in the elderly, dementia). Today, assessing social functioning relies on subjective evaluations and self assessments. We propose a different approach and collect detailed social functioning measures and objective mobile sensing data from N=55 outpatients living with schizophrenia to study new methods of passively accessing social functioning. We identify a number of behavioral patterns from sensing data, and discuss important correlations between social function sub-scales and mobile sensing features. We show we can accurately predict the social functioning of outpatients in our study including the following sub-scales: prosocial activities (MAE = 7.79, r = 0.53), which indicates engagement in common social activities; interpersonal behavior (MAE = 3.39, r = 0.57), which represents the number of friends and quality of communications; and employment/occupation (MAE = 2.17, r = 0.62), which relates to engagement in productive employment or a structured program of daily activity. Our work on automatically inferring social functioning opens the way to new forms of assessment and intervention across a number of areas including mental health and aging in place.

Schizophrenia is a severe psychiatric disorder. We use the CrossCheck study dataset to develop methods to predict whether or not a patient with schizophrenia is going to relapse from mobile phone data. Out of 75 patients in the year long randomized controlled trial only 27 relapse episodes occur. We apply various techniques to address predicting rare events in a longitudinal dataset. We apply resampling methods combining oversampling relapse examples and undersampling non-relapse examples and impute missing data. To avoid overfitting, we apply feature selection and transformation (i.e., PCA) to reduce the feature dimensionality. We find the best relapse prediction result using the first 100 principal components from both passive sensing and self-reports with 30-day prediction windows (precision=26.8%, recall=28.4%). If we demand the recall to be greater than 50%, we find the best result using 25 principle components from both passive sensing and self-reports with 30-day prediction windows (precision=15.4%, recall=51.6%).

A growing body of research is combining social media data with machine learning to predict mental health states of individuals. An implication of this research lies in informing evidence-based diagnosis and treatment. However, obtaining clinically valid diagnostic information from sensitive patient populations is challenging. Consequently, researchers have operationalized characteristic online behaviors as "proxy diagnostic signals" for building these models. This paper posits a challenge in using these diagnostic signals, purported to support clinical decision-making. Focusing on three commonly used proxy diagnostic signals derived from social media, we find that predictive models built on these data, although offer strong internal validity, suffer from poor external validity when tested on mental health patients. A deeper dive reveals issues of population and sampling bias, as well as of uncertainty in construct validity inherent in these proxies. We discuss the methodological and clinical implications of these gaps and provide remedial guidelines for future research.

Self-disclosure of stigmatized conditions is known to yield therapeutic benefits. Social media sites are emerging as promising platforms enabling disclosure around a variety of stigmatized concerns, including mental illness. What kind of behavioral changes precede and follow such disclosures? Do the therapeutic benefits of "opening up" manifest in these changes? In this paper, we address these questions by focusing on disclosures of schizophrenia diagnoses made on Twitter. We adopt a clinically grounded quantitative approach to first identify temporal phases around disclosure during which symptoms of schizophrenia are likely to be significant. Then, to quantify behaviors before and after disclosures, we define linguistic measures drawing from literature on psycholinguistics and the socio-cognitive model of schizophrenia. Along with significant linguistic differences before and after disclosures, we find indications of therapeutic outcomes following disclosures, including improved readability and coherence in language, future orientation, lower self preoccupation, and reduced discussion of symptoms and stigma perceptions. We discuss the implications of social media as a new therapeutic tool in supporting disclosures of stigmatized conditions.

Early detection of mental health changes in individuals with serious mental illness is critical for effective intervention. CrossCheck is the first step towards the passive monitoring of mental health indicators in patients with schizophrenia and paves the way towards relapse prediction and early intervention. In this paper, we present initial results from an ongoing randomized control trial, where passive smartphone sensor data is collected from 21 outpatients with schizophrenia recently discharged from hospital over a period ranging from 2-8.5 months. Our results indicate that there are statistically significant associations between automatically tracked behavioral features related to sleep, mobility, conversations, smart-phone usage and self-reported indicators of mental health in schizophrenia. Using these features we build inference models capable of accurately predicting aggregated scores of mental health indicators in schizophrenia with a mean error of 7.6% of the score range. Finally, we discuss results on the level of personalization that is needed to account for the known variations within people. We show that by leveraging knowledge from a population with schizophrenia, it is possible to train accurate personalized models that require fewer individual-specific data to quickly adapt to new users.