Technology-mediated screening interviews for youth mental health: content validation, randomized controlled trial, and expert evaluation

Early identification of mental health disorders in children and adolescents is essential for optimal outcomes, yet access to specialist psychiatric assessment remains limited by severe workforce shortages and geographic barriers. This study presents a comprehensive validation of technology-mediated screening interviews for youth mental health assessment through three sequential investigations (ISRCTN Registry, ISRCTN68006163, registered on 16/04/2025). First, content validity was established through expert evaluation, demonstrating that all screening questions met established psychometric criteria for relevance and clarity. Next a randomized controlled trial compared psychiatrist-led interviews with tablet-based chatbot and humanoid robot modalities among 106 young patients aged 10-19 receiving mental health treatment. Psychiatrist-led interviews achieved higher satisfaction scores, particularly for communication quality, while willingness to repeat screening did not differ significantly across modalities. Personality characteristics, specifically conscientiousness and open-mindedness, predicted satisfaction with communication across all conditions. Finally, expert clinical evaluation of recorded interviews revealed comparable ratings across modalities for most dimensions, with only alignment with other assessment methods favoring psychiatrist-led approaches over robot-delivered interviews. The results show technology-mediated screening, using the proposed interview, demonstrates acceptable content validity, user feasibility from youth perspective, and clinical utility from expert perspectives. These findings support implementation of accessible, self-administered screening tools as complementary first-step assessments that maintain clinical relevance while expanding access to mental health evaluation for youth populations in underserved settings where specialist availability is limited. Author SummaryIn the research, we addressed a critical challenge in youth mental health: limited access to specialists who can conduct timely psychiatric assessments. With only one child psychiatrist available for every 350 young people needing care, many children and adolescents face significant delays in receiving help. We investigated whether AI-assisted screening interviews, conducted through tablet chatbots or humanoid robots, could expand access while maintaining clinical value. We conducted three validation studies with 106 young patients aged 10-19 and mental health experts. Our findings demonstrate that while young people preferred human psychiatrists for conducting interviews, they were equally willing to repeat screenings with technology-based systems. Importantly, expert psychiatrists rated the clinical value of information gathered through AI-assisted interviews as comparable to traditional methods across most evaluation criteria. The results suggest that technology-mediated screening could serve as an accessible first step in mental health assessment, particularly in settings where specialists are unavailable. This approach has potential to improve early identification of mental health concerns while preserving the clinical rigor necessary for responsible care of vulnerable youth populations.