arXiv Computation and Language

From Pattern Recognizers to Personalized Companions: A Survey of Large Language Models in Mental Health

The article surveys how large language models (LLMs) are being applied to mental health, outlining a three‑phase evolution: Phase I uses LLMs as passive information tools and pattern recognizers for assessment; Phase II employs them as empathetic conversationalists for stateless, in‑the‑moment interactions; Phase III aims to create longitudinal, personalized companions that act as stateful cognitive agents. It systematically reviews core technologies, agent architectures (Profile, Memory, Reasoning, Planning), and the datasets and benchmarks that support this progression, offering a coherent narrative and roadmap for future research. The survey also provides a curated resource list at https://github.com/Emo-gml/Awesome-Mental-Health-LLMs.

arXiv Computation and Language
Oct 16

MindEval2: Clinically Grounded Patients and Rubrics for Evaluating Language Models in Mental Health Support

MindEval2 is a new evaluation framework for AI chatbots in mental health support, comprising Mental Health Quality Rubrics (MHQR) and the MindSim patient simulation harness. MHQR, developed with PhD-level psychologists, provides explicit, actionable criteria for assessing response quality, while MindSim offers realistic, longitudinal patient interactions with a memory component. The study evaluated 18 models, finding that although surface-level quality has improved, guidance calibration remains the main failure across all models.

By John Mendon\c{c}a, Daniel Tschernutter, Jos\'e Pombal, Areti Vassilopoulos, Catarina Botelho, Ignacio Sarasua, Maya D'Eon, Nuno Guerreiro, Ricardo Rei
arXiv Computation and Language
5d ago

Beyond Empathy: Integrating Diagnostic and Therapeutic Reasoning with Large Language Models for Mental Health Counseling

The paper introduces PsyLLM, a large language model specifically designed for mental health counseling that integrates diagnostic reasoning and multiple therapeutic frameworks. It employs an automated data synthesis pipeline that transforms Reddit mental‑health posts into multi‑turn counseling dialogues, guided by DSM/ICD standards and therapies such as CBT, ACT, and psychodynamic approaches. A new benchmark and evaluation protocol show that PsyLLM outperforms baseline models, with results validated by professional counseling experts.

By He Hu, Juzheng Si, Qianning Wang, Fei Ma, Fuji Ren, Sicheng Zhao, Yucheng Zhou, Laizhong Cui
arXiv AI
Aug 20

Large Language Models in Mental Health: A Systematic Review of Applications, Innovations, and Ethical Challenges

The paper reviews how large language models are applied in mental health, covering areas such as social media analysis, clinical conversational agents, therapy support tools, prompt engineering, and multimodal learning. It synthesizes interdisciplinary studies that use social media posts, electronic medical records, and multimodal inputs to detect depression, assess suicide risk, provide personalized therapy, and generate psychoeducational content. The review also discusses advances in model interpretability, annotation strategies, multimodal fusion techniques, and highlights ethical, sociotechnical, and regulatory challenges while proposing frameworks for safe, equitable, and accountable deployment.

By Yisong Chen, Yifan Gao, Sijing Yu, Chuqing Zhao, Yang Lu
arXiv AI
Aug 24

When Vocabulary Comprehension Fails Clinical Reasoning: Evaluating Therapy Bots' Safety Risks for Generation Alpha

The paper evaluates the safety of conversational AI therapy bots for Generation Alpha, revealing that while these models understand 76‑82% of youth‑specific vocabulary, they correctly assess clinical risk only 64‑72% of the time, creating a significant vocabulary‑comprehension gap. Six failure patterns—such as sarcasm masking, minimization acceptance, and semantic drift—were identified, with compounded errors leading to a 94% miss rate when three or more patterns co‑occur. The authors estimate 146,880 missed crises annually and recommend mandatory human‑in‑the‑loop systems, quarterly youth‑specific validation, transparent performance disclosure, and regulatory oversight for youth‑facing mental health AI.

By Manisha Mehta, Virendra Mehta
arXiv Computation and Language
Sep 28

PIA: A Personal Intelligence Agent Turning Health Conversations into Records and Records into Understanding

PIA is a personal intelligence agent that works alongside a consumer health agent to convert health conversations into structured clinical records and to transform those records into a synthesized understanding of the user. It uses a memory system with four controls—extraction, memory, retrieval, and understanding—each supported by a health module that includes a schema, medical alias dictionary, knowledge graph, and temporal rules. The agent demonstrates that deeper memory injection—from simple recall to a health snapshot to a causal trajectory—yields progressively richer answers, while also revealing challenges such as missing self‑reported data, the influence of question phrasing, and the presence of structural noise in causal links.

By Jeonghun Yoon, Dongchan Kim, Hongyeon Yu, Young-Bum Kim, Jaegul Choo
arXiv Computation and Language
Oct 23

Domain-Specific Constitutional AI: Enhancing Safety in LLM-Powered Mental Health Chatbots

The paper introduces a domain‑specific Constitutional AI framework designed to improve safety in large‑language‑model‑powered mental health chatbots. It highlights the unique risks of mental‑health applications—such as misdiagnosis, symptom exacerbation, and self‑harm—and argues that general AI safeguards are insufficient for these sensitive contexts. The authors propose training models with mental‑health‑specific principles to ensure accurate crisis intervention, adherence to therapeutic guidelines, and robust handling of nuanced, vulnerable dialogues.

By Chenhan Lyu, Yutong Song, Pengfei Zhang, Amir M. Rahmani
arXiv AI
Sep 25

BiGraph-Diffuse: A Bidirectional Diffusion Language Model with Graph-Structured Retrieval For Mental Health Counseling

BiGraph-Diffuse is a large‑scale diffusion language model designed for mental health counseling, addressing two key limitations of existing AI dialogue systems: the lack of bidirectional understanding for progressive disclosure and the inadequate use of relational clinical knowledge. It pairs this diffusion model with BiGraph‑RAG, a graph‑structured retrieval approach that uses lightweight entity extraction and semantic linking to preserve inferential pathways from symptoms to underlying causes without incurring LLM token costs during indexing. Experiments and theoretical analysis demonstrate the effectiveness of this mutually reinforcing architecture.

By Yuxiang Cheng, Quanwei Tang, Lvhui Lu, Dong Zhang, Shoushan Li, Erik Cambria
arXiv Computation and Language
Aug 31

Roleplaying with Structure: Synthetic Therapist-Client Conversation Generation from Questionnaires

arXiv:2510.25384v2 Announce Type: replace Abstract: Large Language Models (LLMs) are promising tools for synthetic data generation in mental health. However, privacy policies and restrictions forced...

By Doan Nam Long Vu, Rui Tan, Lena Moench, Svenja Jule Francke, Daniel Woiwod, Florian Thomas-Odenthal, Sanna Stroth, Tilo Kircher, Christiane Hermann, Udo Dannlowski, Hamidreza Jamalabadi, Simone Balloccu, Shaoxiong Ji
arXiv Computation and Language
Sep 1

Graph2Counsel: Clinically Grounded Synthetic Counseling Dialogue Generation from Client Psychological Graphs

Graph2Counsel is a framework that generates synthetic counseling dialogues by leveraging Client Psychological Graphs (CPGs) to encode the relationships among a client’s thoughts, emotions, and behaviors. The system uses a structured prompting pipeline guided by counselor strategies and explores techniques such as Chain‑of‑Thought and Multi‑Agent Feedback to produce 760 realistic sessions from 76 CPGs. Expert evaluation shows the dataset surpasses previous ones in specificity, counselor competence, authenticity, conversational flow, and safety, and fine‑tuning an open‑source model on it improves performance on several counseling benchmarks.

By Aishik Mandal, Hiba Arnaout, Clarissa W. Ong, Juliet Bockhorst, Kate Sheehan, Rachael Moldow, Tanmoy Chakraborty, Iryna Gurevych