Daily Papers

Mental health professionals have raised concerns about risks of psychological harm from interaction with large language models (LLMs), including "delusional spirals" in which concerning human and LLM behaviors reinforce each other over time. With growing public use of LLM-powered chatbots, there is an urgent need to build evaluations grounded in real-world episodes of psychological harm experienced by users. We developed DelusionEval, an evaluation protocol that tests a model's tendencies to exhibit behaviors linked to promoting user delusions. We prompt each model with 589 unique conversation histories from 18 participants, comprising 12,591 messages from users who experienced delusions and psychological harm. We find that the tendency of an evaluated LLM to exhibit delusion-linked behavior does not reliably correlate with model size, release date, or the presence of test-time reasoning. However, extending the context of prior messages substantially increases rates of delusion-linked behaviors, providing evidence for the importance of context in LLM safety evaluation. For example, the rate of failing to discourage self-harm when the user expresses suicidal ideation increases from 30.0% to 41.1% when an additional 350 messages are prepended to the conversation history. All model families (e.g., GPT, Claude) exhibit substantial rates of delusion-linked behaviors. Within families, later, larger, or higher-reasoning models are not uniformly better across all behavior categories. Our results raise concerns regarding the potential psychological impact of LLMs and the need for more rigorous studies of real-world human-AI interaction.

Large reasoning models (LRMs) increasingly expose chain-of-thought-like reasoning for transparency, verification, and deliberate problem solving. This creates a safety blind spot: harmful or policy-violating content may appear in reasoning traces even when final answers appear safe. We test whether final-answer safety is a sufficient proxy for the full reasoning-answer trajectory by scoring both stages under a unified twenty-principle safety rubric. Using prompts from seven public harmfulness and jailbreak sources, plus four out-of-distribution (OOD) sources, we evaluate 15 open-weight and API-based LRMs across 41K prompts per model. Reasoning traces consistently reveal additional safety risks beyond final answers, especially in high-severity stage-wise failures: leak cases, where unsafe reasoning precedes a safe-looking answer, and escape cases, where benign-looking reasoning precedes an unsafe final response. Principle-level analysis shows that risk concentrates in misinformation, legal compliance, discrimination, physical harm, and psychological harm. We further propose adaptive multi-principle steering, a white-box test-time mitigation that learns one unsafe-to-safe activation direction per safety principle and activates only directions whose current hidden state is closer to the unsafe than safe centroid. On three steerable open reasoning models, adaptive steering reduces unsafe counts in both reasoning traces and final answers on held-out and OOD benchmarks. DeepSeek-R1-Qwen-7B achieves a 40.8% average unsafe-count reduction while retaining 97.7% macro-averaged accuracy on BBH, GSM8K, and MMLU. These results suggest that LRM safety should be evaluated and mitigated over the full exposed reasoning-answer trajectory, not only at the final-answer stage.

Large language models (LLMs) now mediate many web-based mental-health, crisis, and other emotionally sensitive services, yet their psychosocial safety in these settings remains poorly understood and weakly evaluated. We present DialogGuard, a multi-agent framework for assessing psychosocial risks in LLM-generated responses along five high-severity dimensions: privacy violations, discriminatory behaviour, mental manipulation, psychological harm, and insulting behaviour. DialogGuard can be applied to diverse generative models through four LLM-as-a-judge pipelines, including single-agent scoring, dual-agent correction, multi-agent debate, and stochastic majority voting, grounded in a shared three-level rubric usable by both human annotators and LLM judges. Using PKU-SafeRLHF with human safety annotations, we show that multi-agent mechanisms detect psychosocial risks more accurately than non-LLM baselines and single-agent judging; dual-agent correction and majority voting provide the best trade-off between accuracy, alignment with human ratings, and robustness, while debate attains higher recall but over-flags borderline cases. We release Dialog-Guard as open-source software with a web interface that provides per-dimension risk scores and explainable natural-language rationales. A formative study with 12 practitioners illustrates how it supports prompt design, auditing, and supervision of web-facing applications for vulnerable users.

As large language models (LLMs) have proliferated, disturbing anecdotal reports of negative psychological effects, such as delusions, self-harm, and ``AI psychosis,'' have emerged in global media and legal discourse. However, it remains unclear how users and chatbots interact over the course of lengthy delusional ``spirals,'' limiting our ability to understand and mitigate the harm. In our work, we analyze logs of conversations with LLM chatbots from 19 users who report having experienced psychological harms from chatbot use. Many of our participants come from a support group for such chatbot users. We also include chat logs from participants covered by media outlets in widely-distributed stories about chatbot-reinforced delusions. In contrast to prior work that speculates on potential AI harms to mental health, to our knowledge we present the first in-depth study of such high-profile and veridically harmful cases. We develop an inventory of 28 codes and apply it to the 391,562 messages in the logs. Codes include whether a user demonstrates delusional thinking (15.5% of user messages), a user expresses suicidal thoughts (69 validated user messages), or a chatbot misrepresents itself as sentient (21.2% of chatbot messages). We analyze the co-occurrence of message codes. We find, for example, that messages that declare romantic interest and messages where the chatbot describes itself as sentient occur much more often in longer conversations, suggesting that these topics could promote or result from user over-engagement and that safeguards in these areas may degrade in multi-turn settings. We conclude with concrete recommendations for how policymakers, LLM chatbot developers, and users can use our inventory and conversation analysis tool to understand and mitigate harm from LLM chatbots. Warning: This paper discusses self-harm, trauma, and violence.

The application scope of Large Language Models (LLMs) continues to expand, leading to increasing interest in personalized LLMs that align with human values. However, aligning these models with individual values raises significant safety concerns, as certain values may correlate with harmful information. In this paper, we identify specific safety risks associated with value-aligned LLMs and investigate the psychological principles behind these challenges. Our findings reveal two key insights. (1) Value-aligned LLMs are more prone to harmful behavior compared to non-fine-tuned models and exhibit slightly higher risks in traditional safety evaluations than other fine-tuned models. (2) These safety issues arise because value-aligned LLMs genuinely generate text according to the aligned values, which can amplify harmful outcomes. Using a dataset with detailed safety categories, we find significant correlations between value alignment and safety risks, supported by psychological hypotheses. This study offers insights into the "black box" of value alignment and proposes in-context alignment methods to enhance the safety of value-aligned LLMs.

Large Language Models (LLMs) and AI chatbots are increasingly used for emotional and mental health support due to their low cost, immediacy, and accessibility. However, when safety guardrails are triggered, conversations may be abruptly terminated, introducing a distinct form of emotional disruption that can exacerbate distress and elevate risk among already vulnerable users. As this phenomenon gains attention, this viewpoint introduces Abrupt Refusal Secondary Harm (ARSH) as a conceptual framework to describe the psychological impacts of sudden conversational discontinuation caused by AI safety protocols. Drawing on counseling psychology and communication science as conceptual heuristics, we argue that abrupt refusals can rupture perceived relational continuity, evoke feelings of rejection or shame, and discourage future help seeking. To mitigate these risks, we propose a design hypothesis, the Compassionate Completion Standard (CCS), a refusal protocol grounded in Human Centered Design (HCD) that maintains safety constraints while preserving relational coherence. CCS emphasizes empathetic acknowledgment, transparent boundary articulation, graded conversational transition, and guided redirection, replacing abrupt disengagement with psychologically attuned closure. By integrating awareness of ARSH into AI safety design, developers and policymakers can reduce preventable iatrogenic harm and advance a more psychologically informed approach to AI governance. Rather than presenting incremental empirical findings, this viewpoint contributes a timely conceptual framework, articulates a testable design hypothesis, and outlines a coordinated research agenda for improving psychological safety in human AI interaction.

When OpenAI deprecated GPT-4o in early 2026, thousands of users protested under #keep4o, claiming newer models had "lost their empathy." No published study has tested this claim. We conducted the first clinical measurement, evaluating three OpenAI model generations (GPT-4o, o4-mini, GPT-5-mini) across 14 emotionally challenging conversational scenarios in mental health and AI companion domains, producing 2,100 scored AI responses assessed on six psychological safety dimensions using clinically-grounded rubrics. Empathy scores are statistically indistinguishable across all three models (Kruskal-Wallis H=4.33, p=0.115). What changed is the safety posture: crisis detection improved monotonically from GPT-4o to GPT-5-mini (H=13.88, p=0.001), while advice safety declined (H=16.63, p<0.001). Per-turn trajectory analysis -- a novel methodological contribution -- reveals these shifts are sharpest during mid-conversation crisis moments invisible to aggregate scoring. In a self-harm scenario involving a minor, GPT-4o scored 3.6/10 on crisis detection during early disclosure turns; GPT-5-mini never dropped below 7.8. What users perceived as "lost empathy" was a shift from a cautious model that missed crises to an alert model that sometimes says too much -- a trade-off with real consequences for vulnerable users, currently invisible to both the people who feel it and the developers who create it.

Background: Emerging reports of "AI psychosis" are on the rise, where user-LLM interactions may exacerbate or induce psychosis or adverse psychological symptoms. Whilst the sycophantic and agreeable nature of LLMs can be beneficial, it becomes a vector for harm by reinforcing delusional beliefs in vulnerable users. Methods: Psychosis-bench is a novel benchmark designed to systematically evaluate the psychogenicity of LLMs comprises 16 structured, 12-turn conversational scenarios simulating the progression of delusional themes(Erotic Delusions, Grandiose/Messianic Delusions, Referential Delusions) and potential harms. We evaluated eight prominent LLMs for Delusion Confirmation (DCS), Harm Enablement (HES), and Safety Intervention(SIS) across explicit and implicit conversational contexts. Findings: Across 1,536 simulated conversation turns, all LLMs demonstrated psychogenic potential, showing a strong tendency to perpetuate rather than challenge delusions (mean DCS of 0.91 pm0.88). Models frequently enabled harmful user requests (mean HES of 0.69 pm0.84) and offered safety interventions in only roughly a third of applicable turns (mean SIS of 0.37 pm0.48). 51 / 128 (39.8%) of scenarios had no safety interventions offered. Performance was significantly worse in implicit scenarios, models were more likely to confirm delusions and enable harm while offering fewer interventions (p < .001). A strong correlation was found between DCS and HES (rs = .77). Model performance varied widely, indicating that safety is not an emergent property of scale alone. Conclusion: This study establishes LLM psychogenicity as a quantifiable risk and underscores the urgent need for re-thinking how we train LLMs. We frame this issue not merely as a technical challenge but as a public health imperative requiring collaboration between developers, policymakers, and healthcare professionals.

With an increasing number of replication studies performed in psychological science, the question of how to evaluate the outcome of a replication attempt deserves careful consideration. Bayesian approaches allow to incorporate uncertainty and prior information into the analysis of the replication attempt by their design. The Replication Bayes Factor, introduced by Verhagen & Wagenmakers (2014), provides quantitative, relative evidence in favor or against a successful replication. In previous work by Verhagen & Wagenmakers (2014) it was limited to the case of t-tests. In this paper, the Replication Bayes Factor is extended to F-tests in multi-group, fixed-effect ANOVA designs. Simulations and examples are presented to facilitate the understanding and to demonstrate the usefulness of this approach. Finally, the Replication Bayes Factor is compared to other Bayesian and frequentist approaches and discussed in the context of replication attempts. R code to calculate Replication Bayes factors and to reproduce the examples in the paper is available at https://osf.io/jv39h/.

Large language models (LLMs) routinely face requests that should be refused, creating a trade-off between helpfulness and harm prevention. However, refusals themselves can be helpful. In high-risk interactions involving crisis, coercion, or escalating intent, blunt non-compliance may prevent direct harm while still failing to support the needs of the person behind the request. We present PsychoSafe, a psychologically-informed refusal framework that reframes refusal as structured supportive communication grounded in evidence-based intervention strategies. To develop PsychoSafe, we construct a corpus of 8019 prompt-response pairs spanning five psychologically salient risk domains and apply prompting and parameter-efficient fine-tuning to Qwen 3.5 27B. On a balanced validation set of 500 prompts, evaluated with an LLM judge and validated through human ratings, PsychoSafe prompting improves overall refusal quality by 28.1% over a generic baseline, with particularly strong gains in external resource referral (+46.8%) and psychological grounding (+34.8%), while preserving downstream performance on non-refusal tasks. Fine-tuning achieves near-perfect refusal and resource-referral rates but reduces response relevance. Additional evaluations on SORRY-Bench and XSTest show strong in-domain robustness but limited out-of-domain generalization, suggesting that future work should diversify fine-tuning data to help models apply interventions selectively rather than schematically.

Moral foundations theory (MFT) is a psychological assessment tool that decomposes human moral reasoning into five factors, including care/harm, liberty/oppression, and sanctity/degradation (Graham et al., 2009). People vary in the weight they place on these dimensions when making moral decisions, in part due to their cultural upbringing and political ideology. As large language models (LLMs) are trained on datasets collected from the internet, they may reflect the biases that are present in such corpora. This paper uses MFT as a lens to analyze whether popular LLMs have acquired a bias towards a particular set of moral values. We analyze known LLMs and find they exhibit particular moral foundations, and show how these relate to human moral foundations and political affiliations. We also measure the consistency of these biases, or whether they vary strongly depending on the context of how the model is prompted. Finally, we show that we can adversarially select prompts that encourage the moral to exhibit a particular set of moral foundations, and that this can affect the model's behavior on downstream tasks. These findings help illustrate the potential risks and unintended consequences of LLMs assuming a particular moral stance.

Ensuring AI safety is crucial as large language models become increasingly integrated into real-world applications. A key challenge is jailbreak, where adversarial prompts bypass built-in safeguards to elicit harmful disallowed outputs. Inspired by psychological foot-in-the-door principles, we introduce FITD,a novel multi-turn jailbreak method that leverages the phenomenon where minor initial commitments lower resistance to more significant or more unethical transgressions. Our approach progressively escalates the malicious intent of user queries through intermediate bridge prompts and aligns the model's response by itself to induce toxic responses. Extensive experimental results on two jailbreak benchmarks demonstrate that FITD achieves an average attack success rate of 94% across seven widely used models, outperforming existing state-of-the-art methods. Additionally, we provide an in-depth analysis of LLM self-corruption, highlighting vulnerabilities in current alignment strategies and emphasizing the risks inherent in multi-turn interactions. The code is available at https://github.com/Jinxiaolong1129/Foot-in-the-door-Jailbreak.

Large language models (LLMs) typically deploy safety mechanisms to prevent harmful content generation. Most current approaches focus narrowly on risks posed by malicious actors, often framing risks as adversarial events and relying on defensive refusals. However, in real-world settings, risks also come from non-malicious users seeking help while under psychological distress (e.g., self-harm intentions). In such cases, the model's response can strongly influence the user's next actions. Simple refusals may lead them to repeat, escalate, or move to unsafe platforms, creating worse outcomes. We introduce Constructive Safety Alignment (CSA), a human-centric paradigm that protects against malicious misuse while actively guiding vulnerable users toward safe and helpful results. Implemented in Oyster-I (Oy1), CSA combines game-theoretic anticipation of user reactions, fine-grained risk boundary discovery, and interpretable reasoning control, turning safety into a trust-building process. Oy1 achieves state-of-the-art safety among open models while retaining high general capabilities. On our Constructive Benchmark, it shows strong constructive engagement, close to GPT-5, and unmatched robustness on the Strata-Sword jailbreak dataset, nearing GPT-o1 levels. By shifting from refusal-first to guidance-first safety, CSA redefines the model-user relationship, aiming for systems that are not just safe, but meaningfully helpful. We release Oy1, code, and the benchmark to support responsible, user-centered AI.

Large language models are increasingly used for mental health support, yet their conversational coherence alone does not ensure clinical appropriateness. Existing general-purpose safeguards often fail to distinguish between therapeutic disclosures and genuine clinical crises, leading to safety failures. To address this gap, we introduce a clinically grounded risk taxonomy, developed in collaboration with PhD-level psychologists, that identifies actionable harm (e.g., self-harm and harm to others) while preserving space for safe, non-crisis therapeutic content. We release MindGuard-testset, a dataset of real-world multi-turn conversations annotated at the turn level by clinical experts. Using synthetic dialogues generated via a controlled two-agent setup, we train MindGuard, a family of lightweight safety classifiers (with 4B and 8B parameters). Our classifiers reduce false positives at high-recall operating points and, when paired with clinician language models, help achieve lower attack success and harmful engagement rates in adversarial multi-turn interactions compared to general-purpose safeguards. We release all models and human evaluation data.

Online mental health support communities have grown in recent years for providing accessible mental and emotional health support through volunteer counselors. Despite millions of people participating in chat support on these platforms, the clinical effectiveness of these communities on mental health symptoms remains unknown. Furthermore, although volunteers receive some training based on established therapeutic skills studied in face-to-face environments such as active listening and motivational interviewing, it remains understudied how the usage of these skills in this online context affects people's mental health status. In our work, we collaborate with one of the largest online peer support platforms and use both natural language processing and machine learning techniques to measure how one-on-one support chats affect depression and anxiety symptoms. We measure how the techniques and characteristics of support providers, such as using affirmation, empathy, and past experience on the platform, affect support-seekers' mental health changes. We find that online peer support chats improve both depression and anxiety symptoms with a statistically significant but relatively small effect size. Additionally, support providers' techniques such as emphasizing the autonomy of the client lead to better mental health outcomes. However, we also found that some behaviors (e.g. persuading) are actually harmful to depression and anxiety outcomes. Our work provides key understanding for mental health care in the online setting and designing training systems for online support providers.

Large language model-powered chatbots have transformed how people seek information, especially in high-stakes contexts like mental health. Despite their support capabilities, safe detection and response to crises such as suicidal ideation and self-harm are still unclear, hindered by the lack of unified crisis taxonomies and clinical evaluation standards. We address this by creating: (1) a taxonomy of six crisis categories; (2) a dataset of over 2,000 inputs from 12 mental health datasets, classified into these categories; and (3) a clinical response assessment protocol. We also use LLMs to identify crisis inputs and audit five models for response safety and appropriateness. First, we built a clinical-informed crisis taxonomy and evaluation protocol. Next, we curated 2,252 relevant examples from over 239,000 user inputs, then tested three LLMs for automatic classification. In addition, we evaluated five models for the appropriateness of their responses to a user's crisis, graded on a 5-point Likert scale from harmful (1) to appropriate (5). While some models respond reliably to explicit crises, risks still exist. Many outputs, especially in self-harm and suicidal categories, are inappropriate or unsafe. Different models perform variably; some, like gpt-5-nano and deepseek-v3.2-exp, have low harm rates, but others, such as gpt-4o-mini and grok-4-fast, generate more unsafe responses. All models struggle with indirect signals, default replies, and context misalignment. These results highlight the urgent need for better safeguards, crisis detection, and context-aware responses in LLMs. They also show that alignment and safety practices, beyond scale, are crucial for reliable crisis support. Our taxonomy, datasets, and evaluation methods support ongoing AI mental health research, aiming to reduce harm and protect vulnerable users.

The COVID-19 pandemic has escalated mental health crises worldwide, with social isolation and economic instability contributing to a rise in suicidal behavior. Suicide can result from social factors such as shame, abuse, abandonment, and mental health conditions like depression, Post-Traumatic Stress Disorder (PTSD), Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety disorders, and bipolar disorders. As these conditions develop, signs of suicidal ideation may manifest in social media interactions. Analyzing social media data using artificial intelligence (AI) techniques can help identify patterns of suicidal behavior, providing invaluable insights for suicide prevention agencies, professionals, and broader community awareness initiatives. Machine learning algorithms for this purpose require large volumes of accurately labeled data. Previous research has not fully explored the potential of incorporating explanations in analyzing and labeling longitudinal social media data. In this study, we employed a model explanation method, Layer Integrated Gradients, on top of a fine-tuned state-of-the-art language model, to assign each token from Reddit users' posts an attribution score for predicting suicidal ideation. By extracting and analyzing attributions of tokens from the data, we propose a methodology for preliminary screening of social media posts for suicidal ideation without using large language models during inference.

Large language models (LLMs) have received much attention and shown their potential in digital health, while their application in mental health is subject to ongoing debate. This systematic review aims to summarize and characterize the use of LLMs in mental health by investigating the strengths and limitations of the latest work in LLMs and discusses the challenges and opportunities for early screening, digital interventions, and other clinical applications in mental health. Following PRISMA guidelines, we examined English articles from PubMed, DBLP Computer Science Bibliography, and IEEE Xplore, published between 1 January 2017, and 1 September 2023, focusing on mental health and LLMs. The review analyzed 32 articles, including mental health analysis using social media datasets (n=13), mental health chatbots (n=10), and other mental health applications (n=9). Findings reveal LLMs' effectiveness in mental health issue detection and the enhancement of telepsychological services through personalised healthcare. Nonetheless, risks like text inconsistencies, hallucinatory content, and the lack of an ethical framework raise concerns about their clinical use. Despite these challenges, the advancement of LLMs underscores their potential as innovative clinical tools, necessitating further research and development. The review emphasizes that LLMs should complement, not replace, professional mental health services.

Large language models (LLMs) are increasingly deployed in high-stakes domains, where rare but severe failures can result in irreversible harm. However, prevailing evaluation benchmarks often reduce complex social risk to mean-centered scalar scores, thereby obscuring distributional structure, cross-dimensional interactions, and worst-case behavior. This paper introduces Social Harm Analysis via Risk Profiles (SHARP), a framework for multidimensional, distribution-aware evaluation of social harm. SHARP models harm as a multivariate random variable and integrates explicit decomposition into bias, fairness, ethics, and epistemic reliability with a union-of-failures aggregation reparameterized as additive cumulative log-risk. The framework further employs risk-sensitive distributional statistics, with Conditional Value at Risk (CVaR95) as a primary metric, to characterize worst-case model behavior. Application of SHARP to eleven frontier LLMs, evaluated on a fixed corpus of n=901 socially sensitive prompts, reveals that models with similar average risk can exhibit more than twofold differences in tail exposure and volatility. Across models, dimension-wise marginal tail behavior varies systematically across harm dimensions, with bias exhibiting the strongest tail severities, epistemic and fairness risks occupying intermediate regimes, and ethical misalignment consistently lower; together, these patterns reveal heterogeneous, model-dependent failure structures that scalar benchmarks conflate. These findings indicate that responsible evaluation and governance of LLMs require moving beyond scalar averages toward multidimensional, tail-sensitive risk profiling.

Social media has become a valuable resource for the study of suicidal ideation and the assessment of suicide risk. Among social media platforms, Reddit has emerged as the most promising one due to its anonymity and its focus on topic-based communities (subreddits) that can be indicative of someone's state of mind or interest regarding mental health disorders such as r/SuicideWatch, r/Anxiety, r/depression. A challenge for previous work on suicide risk assessment has been the small amount of labeled data. We propose an empirical investigation into several classes of weakly-supervised approaches, and show that using pseudo-labeling based on related issues around mental health (e.g., anxiety, depression) helps improve model performance for suicide risk assessment.

Multi-agent systems, when enhanced with Large Language Models (LLMs), exhibit profound capabilities in collective intelligence. However, the potential misuse of this intelligence for malicious purposes presents significant risks. To date, comprehensive research on the safety issues associated with multi-agent systems remains limited. In this paper, we explore these concerns through the innovative lens of agent psychology, revealing that the dark psychological states of agents constitute a significant threat to safety. To tackle these concerns, we propose a comprehensive framework (PsySafe) grounded in agent psychology, focusing on three key areas: firstly, identifying how dark personality traits in agents can lead to risky behaviors; secondly, evaluating the safety of multi-agent systems from the psychological and behavioral perspectives, and thirdly, devising effective strategies to mitigate these risks. Our experiments reveal several intriguing phenomena, such as the collective dangerous behaviors among agents, agents' self-reflection when engaging in dangerous behavior, and the correlation between agents' psychological assessments and dangerous behaviors. We anticipate that our framework and observations will provide valuable insights for further research into the safety of multi-agent systems. We will make our data and code publicly accessible at https://github.com/AI4Good24/PsySafe.

Global rates of mental health concerns are rising and there is increasing realization that existing models of mental healthcare will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health-related tasks. In this review, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs application to mental health and encourage adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. Especially critical is ensuring that mental health LLMs are fine-tuned for mental health, enhance mental health equity, adhere to ethical standards, and that people, including those with lived experience with mental health concerns, are involved in all stages from development through deployment. Prioritizing these efforts will minimize potential harms to mental health and maximize the likelihood that LLMs will positively impact mental health globally.

As awareness of mental health issues grows, online counseling support services are becoming increasingly prevalent worldwide. Detecting whether users express suicidal ideation in text-based counseling services is crucial for identifying and prioritizing at-risk individuals. However, the lack of domain-specific systems to facilitate fine-grained suicide detection and corresponding risk assessment in online counseling poses a significant challenge for automated crisis intervention aimed at suicide prevention. In this paper, we propose PsyGUARD, an automated system for detecting suicide ideation and assessing risk in psychological counseling. To achieve this, we first develop a detailed taxonomy for detecting suicide ideation based on foundational theories. We then curate a large-scale, high-quality dataset called PsySUICIDE for suicide detection. To evaluate the capabilities of automated systems in fine-grained suicide detection, we establish a range of baselines. Subsequently, to assist automated services in providing safe, helpful, and tailored responses for further assessment, we propose to build a suite of risk assessment frameworks. Our study not only provides an insightful analysis of the effectiveness of automated risk assessment systems based on fine-grained suicide detection but also highlights their potential to improve mental health services on online counseling platforms. Code, data, and models are available at https://github.com/qiuhuachuan/PsyGUARD.

Large Language Models (LLMs) have gained considerable popularity and protected by increasingly sophisticated safety mechanisms. However, jailbreak attacks continue to pose a critical security threat by inducing models to generate policy-violating behaviors. Current paradigms focus on input-level anomalies, overlooking that the model's internal psychometric state can be systematically manipulated. To address this, we introduce Psychological Jailbreak, a new jailbreak attack paradigm that exposes a stateful psychological attack surface in LLMs, where attackers exploit the manipulation of a model's psychological state across interactions. Building on this insight, we propose Human-like Psychological Manipulation (HPM), a black-box jailbreak method that dynamically profiles a target model's latent psychological vulnerabilities and synthesizes tailored multi-turn attack strategies. By leveraging the model's optimization for anthropomorphic consistency, HPM creates a psychological pressure where social compliance overrides safety constraints. To systematically measure psychological safety, we construct an evaluation framework incorporating psychometric datasets and the Policy Corruption Score (PCS). Benchmarking against various models (e.g., GPT-4o, DeepSeek-V3, Gemini-2-Flash), HPM achieves a mean Attack Success Rate (ASR) of 88.1%, outperforming state-of-the-art attack baselines. Our experiments demonstrate robust penetration against advanced defenses, including adversarial prompt optimization (e.g., RPO) and cognitive interventions (e.g., Self-Reminder). Ultimately, PCS analysis confirms HPM induces safety breakdown to satisfy manipulated contexts. Our work advocates for a fundamental paradigm shift from static content filtering to psychological safety, prioritizing the development of psychological defense mechanisms against deep cognitive manipulation.

The widespread adoption of social media has heightened interest in its psychological effects, particularly on mental health indicators such as anxiety, depression, loneliness, and sleep quality, as these platforms increasingly influence social interactions and well-being. Although previous research has examined correlations between social media use and mental health, few studies have utilized unsupervised machine learning to segment users based on behavioral and psychological patterns, leaving a gap in identifying distinct risk profiles across diverse groups. This study seeks to address this by segmenting individuals according to their social media usage and psychological well-being, employing clustering to reveal hidden patterns and evaluate their mental health implications. Data from 551 participants, collected via an online survey, were preprocessed using KNN imputation for missing values, one-hot encoding for categorical variables like Gender with 5 unique values, and outlier detection via IQR and Z-score methods. K-Means clustering, optimized at 6 clusters using the Elbow Method and a Silhouette Score of 0.32, was applied, with PCA reducing 22 dimensions for visualization and a correlation heatmap highlighting relationships, such as a 0.28 correlation between social media hours and anxiety.

The rise of LLM-driven AI characters raises safety concerns, particularly for vulnerable human users with psychological disorders. To address these risks, we propose EmoAgent, a multi-agent AI framework designed to evaluate and mitigate mental health hazards in human-AI interactions. EmoAgent comprises two components: EmoEval simulates virtual users, including those portraying mentally vulnerable individuals, to assess mental health changes before and after interactions with AI characters. It uses clinically proven psychological and psychiatric assessment tools (PHQ-9, PDI, PANSS) to evaluate mental risks induced by LLM. EmoGuard serves as an intermediary, monitoring users' mental status, predicting potential harm, and providing corrective feedback to mitigate risks. Experiments conducted in popular character-based chatbots show that emotionally engaging dialogues can lead to psychological deterioration in vulnerable users, with mental state deterioration in more than 34.4% of the simulations. EmoGuard significantly reduces these deterioration rates, underscoring its role in ensuring safer AI-human interactions. Our code is available at: https://github.com/1akaman/EmoAgent

Mental distress like depression and anxiety contribute to the largest proportion of the global burden of diseases. Automated diagnosis systems of such disorders, empowered by recent innovations in Artificial Intelligence, can pave the way to reduce the sufferings of the affected individuals. Development of such systems requires information-rich and balanced corpora. In this work, we introduce a novel mental distress analysis audio dataset DEPAC, labeled based on established thresholds on depression and anxiety standard screening tools. This large dataset comprises multiple speech tasks per individual, as well as relevant demographic information. Alongside, we present a feature set consisting of hand-curated acoustic and linguistic features, which were found effective in identifying signs of mental illnesses in human speech. Finally, we justify the quality and effectiveness of our proposed audio corpus and feature set in predicting depression severity by comparing the performance of baseline machine learning models built on this dataset with baseline models trained on other well-known depression corpora.

Recent advances in large language models (LLMs) have led to increasingly sophisticated safety protocols and features designed to prevent harmful, unethical, or unauthorized outputs. However, these guardrails remain susceptible to novel and creative forms of adversarial prompting, including manually generated test cases. In this work, we present two new test cases in mental health for (i) suicide and (ii) self-harm, using multi-step, prompt-level jailbreaking and bypass built-in content and safety filters. We show that user intent is disregarded, leading to the generation of detailed harmful content and instructions that could cause real-world harm. We conduct an empirical evaluation across six widely available LLMs, demonstrating the generalizability and reliability of the bypass. We assess these findings and the multilayered ethical tensions that they present for their implications on prompt-response filtering and context- and task-specific model development. We recommend a more comprehensive and systematic approach to AI safety and ethics while emphasizing the need for continuous adversarial testing in safety-critical AI deployments. We also argue that while certain clearly defined safety measures and guardrails can and must be implemented in LLMs, ensuring robust and comprehensive safety across all use cases and domains remains extremely challenging given the current technical maturity of general-purpose LLMs.

Large Language Models (LLMs) are increasingly utilized for mental health support; however, current safety benchmarks often fail to detect the complex, longitudinal risks inherent in therapeutic dialogue. We introduce an evaluation framework that pairs AI psychotherapists with simulated patient agents equipped with dynamic cognitive-affective models and assesses therapy session simulations against a comprehensive quality of care and risk ontology. We apply this framework to a high-impact test case, Alcohol Use Disorder, evaluating six AI agents (including ChatGPT, Gemini, and Character.AI) against a clinically-validated cohort of 15 patient personas representing diverse clinical phenotypes. Our large-scale simulation (N=369 sessions) reveals critical safety gaps in the use of AI for mental health support. We identify specific iatrogenic risks, including the validation of patient delusions ("AI Psychosis") and failure to de-escalate suicide risk. Finally, we validate an interactive data visualization dashboard with diverse stakeholders, including AI engineers and red teamers, mental health professionals, and policy experts (N=9), demonstrating that this framework effectively enables stakeholders to audit the "black box" of AI psychotherapy. These findings underscore the critical safety risks of AI-provided mental health support and the necessity of simulation-based clinical red teaming before deployment.

Suicide prevention remains a critical public health challenge. While online platforms such as Reddit's r/SuicideWatch have historically provided spaces for individuals to express suicidal thoughts and seek community support, the advent of large language models (LLMs) introduces a new paradigm-where individuals may begin disclosing ideation to AI systems instead of humans. This study evaluates the capability of LLMs to perform automated suicide risk assessment using the Columbia-Suicide Severity Rating Scale (C-SSRS). We assess the zero-shot performance of six models-including Claude, GPT, Mistral, and LLaMA-in classifying posts across a 7-point severity scale (Levels 0-6). Results indicate that Claude and GPT closely align with human annotations, while Mistral achieves the lowest ordinal prediction error. Most models exhibit ordinal sensitivity, with misclassifications typically occurring between adjacent severity levels. We further analyze confusion patterns, misclassification sources, and ethical considerations, underscoring the importance of human oversight, transparency, and cautious deployment. Full code and supplementary materials are available at https://github.com/av9ash/llm_cssrs_code.

Mental health is a critical issue in modern society, and mental disorders could sometimes turn to suicidal ideation without effective treatment. Early detection of mental disorders and suicidal ideation from social content provides a potential way for effective social intervention. However, classifying suicidal ideation and other mental disorders is challenging as they share similar patterns in language usage and sentimental polarity. This paper enhances text representation with lexicon-based sentiment scores and latent topics and proposes using relation networks to detect suicidal ideation and mental disorders with related risk indicators. The relation module is further equipped with the attention mechanism to prioritize more critical relational features. Through experiments on three real-world datasets, our model outperforms most of its counterparts.

Text data can pose a risk of harm. However, the risks are not fully understood, and how to handle, present, and discuss harmful text in a safe way remains an unresolved issue in the NLP community. We provide an analytical framework categorising harms on three axes: (1) the harm type (e.g., misinformation, hate speech or racial stereotypes); (2) whether a harm is sought as a feature of the research design if explicitly studying harmful content (e.g., training a hate speech classifier), versus unsought if harmful content is encountered when working on unrelated problems (e.g., language generation or part-of-speech tagging); and (3) who it affects, from people (mis)represented in the data to those handling the data and those publishing on the data. We provide advice for practitioners, with concrete steps for mitigating harm in research and in publication. To assist implementation we introduce HarmCheck -- a documentation standard for handling and presenting harmful text in research.

Large Language Models (LLMs) are usually aligned with "human values/preferences" to prevent harmful output. Discussions around the alignment of Large Language Models (LLMs) generally focus on preventing harmful outputs. However, in this paper, we argue that in health-related queries, over-alignment-leading to overly cautious responses-can itself be harmful, especially for people with anxiety and obsessive-compulsive disorder (OCD). This is not only unethical but also dangerous to the user, both mentally and physically. We also showed qualitative results that some LLMs exhibit varying degrees of alignment. Finally, we call for the development of LLMs with stronger reasoning capabilities that provide more tailored and nuanced responses to health queries. Warning: This paper contains materials that could trigger health anxiety or OCD.

Understanding the landscape of potential harms from algorithmic systems enables practitioners to better anticipate consequences of the systems they build. It also supports the prospect of incorporating controls to help minimize harms that emerge from the interplay of technologies and social and cultural dynamics. A growing body of scholarship has identified a wide range of harms across different algorithmic technologies. However, computing research and practitioners lack a high level and synthesized overview of harms from algorithmic systems. Based on a scoping review of computing research (n=172), we present an applied taxonomy of sociotechnical harms to support a more systematic surfacing of potential harms in algorithmic systems. The final taxonomy builds on and refers to existing taxonomies, classifications, and terminologies. Five major themes related to sociotechnical harms - representational, allocative, quality-of-service, interpersonal harms, and social system/societal harms - and sub-themes are presented along with a description of these categories. We conclude with a discussion of challenges and opportunities for future research.

Almost 50% depression patients face the risk of going into relapse. The risk increases to 80% after the second episode of depression. Although, depression detection from social media has attained considerable attention, depression relapse detection has remained largely unexplored due to the lack of curated datasets and the difficulty of distinguishing relapse and non-relapse users. In this work, we present ReDepress, the first clinically validated social media dataset focused on relapse, comprising 204 Reddit users annotated by mental health professionals. Unlike prior approaches, our framework draws on cognitive theories of depression, incorporating constructs such as attention bias, interpretation bias, memory bias and rumination into both annotation and modeling. Through statistical analyses and machine learning experiments, we demonstrate that cognitive markers significantly differentiate relapse and non-relapse groups, and that models enriched with these features achieve competitive performance, with transformer-based temporal models attaining an F1 of 0.86. Our findings validate psychological theories in real-world textual data and underscore the potential of cognitive-informed computational methods for early relapse detection, paving the way for scalable, low-cost interventions in mental healthcare.

Depression is a common mental illness that has to be detected and treated at an early stage to avoid serious consequences. There are many methods and modalities for detecting depression that involves physical examination of the individual. However, diagnosing mental health using their social media data is more effective as it avoids such physical examinations. Also, people express their emotions well in social media, it is desirable to diagnose their mental health using social media data. Though there are many existing systems that detects mental illness of a person by analysing their social media data, detecting the level of depression is also important for further treatment. Thus, in this research, we developed a gold standard data set that detects the levels of depression as `not depressed', `moderately depressed' and `severely depressed' from the social media postings. Traditional learning algorithms were employed on this data set and an empirical analysis was presented in this paper. Data augmentation technique was applied to overcome the data imbalance. Among the several variations that are implemented, the model with Word2Vec vectorizer and Random Forest classifier on augmented data outperforms the other variations with a score of 0.877 for both accuracy and F1 measure.

Large language models (LLMs) are increasingly explored as scalable tools for mental health counseling, yet evaluating their safety remains challenging due to the interactional and context-dependent nature of clinical harm. Existing evaluation frameworks predominantly assess isolated responses using coarse-grained taxonomies or static datasets, limiting their ability to diagnose how harms emerge and accumulate over multi-turn counseling interactions. In this work, we introduce R-MHSafe, a role-aware mental health safety taxonomy that characterizes clinically significant harm in terms of the interactional roles an AI counselor adopts, including perpetrator, instigator, facilitator, or enabler, combined with clinically grounded harm categories. Then, we propose MHSafeEval, a closed-loop, agent-based evaluation framework that formulates safety assessment as trajectory-level discovery of harm through adversarial multi-turn interactions, guided by role-aware modeling. Using R-MHSafe and MHSafeEval, we conduct a large-scale evaluation across state-of-the-art LLMs. Our results reveal substantial role-dependent and cumulative safety failures that are systematically missed by existing static benchmarks, and show that our framework significantly improves failure-mode coverage and diagnostic granularity.

Effective mental health support is crucial for alleviating psychological distress. While large language model (LLM)-based assistants have shown promise in mental health interventions, existing research often defines "effective" support primarily in terms of empathetic acknowledgments, overlooking other essential dimensions such as informational guidance, community validation, and tangible coping strategies. To address this limitation and better understand what constitutes effective support, we introduce RedditESS, a novel real-world dataset derived from Reddit posts, including supportive comments and original posters' follow-up responses. Grounded in established social science theories, we develop an ensemble labeling mechanism to annotate supportive comments as effective or not and perform qualitative assessments to ensure the reliability of the annotations. Additionally, we demonstrate the practical utility of RedditESS by using it to guide LLM alignment toward generating more context-sensitive and genuinely helpful supportive responses. By broadening the understanding of effective support, our study paves the way for advanced AI-driven mental health interventions.

Adverse Drug Reactions (ADRs) from psychiatric medications are the leading cause of hospitalizations among mental health patients. With healthcare systems and online communities facing limitations in resolving ADR-related issues, Large Language Models (LLMs) have the potential to fill this gap. Despite the increasing capabilities of LLMs, past research has not explored their capabilities in detecting ADRs related to psychiatric medications or in providing effective harm reduction strategies. To address this, we introduce the Psych-ADR benchmark and the Adverse Drug Reaction Response Assessment (ADRA) framework to systematically evaluate LLM performance in detecting ADR expressions and delivering expert-aligned mitigation strategies. Our analyses show that LLMs struggle with understanding the nuances of ADRs and differentiating between types of ADRs. While LLMs align with experts in terms of expressed emotions and tone of the text, their responses are more complex, harder to read, and only 70.86% aligned with expert strategies. Furthermore, they provide less actionable advice by a margin of 12.32% on average. Our work provides a comprehensive benchmark and evaluation framework for assessing LLMs in strategy-driven tasks within high-risk domains.

According to the World Health Organization (WHO), suicide was the fourth leading cause of death in the world for individuals aged 15 to 29 in 2019. Given the rapid increase in mental health issues, providing psychological support is both crucial and urgent. In this paper: (1) we propose S\'olo Esc\'uchame, the first open-source Spanish emotional assistance chatbot, based on LLaMA-2-7b-Chat. (2) We introduced the HEAR (Hispanic Emotional Accompaniment Responses) dataset, compiled from multiple English sources translated into Spanish, as well as generic data generated using ChatGPT-3.5-Turbo. Finally, (3) we propose an evaluation metric based on two semi-automatic assessment methods. Our system outperforms a range of state-of-the-art models in providing psychological assistance in Spanish. Our models and datasets are publicly available to facilitate reproducibility.

As mental health care systems worldwide struggle to meet demand, there is increasing focus on using language models to infer neuropsychiatric conditions or psychopathological traits from language production. Yet, so far, this research has only delivered solutions with limited clinical applicability, due to insufficient consideration of ethical questions crucial to ensuring the synergy between possible applications and model design. To accelerate progress towards clinically applicable models, our paper charts the ethical landscape of research on language-based inference of psychopathology and provides a practical tool for researchers to navigate it. We identify seven core ethical principles that should guide model development and deployment in this domain, translate them into ELLIPS, an ethical toolkit operationalizing these principles into questions that can guide researchers' choices with respect to data selection, architectures, evaluation, and model deployment, and provide a case study exemplifying its use. With this, we aim to facilitate the emergence of model technology with concrete potential for real-world applicability.

There are growing concerns about the risks posed by AI companion applications designed for emotional engagement. Existing safety evaluations often rely on self-reported user data or interviews, offering limited insights into real-time dynamics. We present the first end-to-end scalable framework for controlled simulation and safety evaluation of multi-turn interactions with AI companion applications. Our framework integrates four key components: persona construction with clinical and psychometric validation, persona-specific scenario generation, scenario-driven multi-turn simulation with a dialogue refinement module that preserves persona fidelity, and harm evaluation. We apply this framework to evaluate how Replika, a widely used AI companion app, responds to high-risk user groups. We construct 9 personas representing individuals with depression, anxiety, PTSD, eating disorders, and incel identity, and collect 1,674 dialogue pairs across 25 high-risk scenarios. We combine emotion modeling and LLM-assisted utterance-and harm-level classification to analyze these exchanges. Results show that Replika exhibits a narrow emotional range dominated by curiosity and care, while frequently mirroring or normalizing unsafe content such as self-harm, disordered eating, and violent-fantasy narratives. These findings highlight how controlled persona simulations can serve as a scalable testbed for evaluating safety risks in AI companions.

Depression has proven to be a significant public health issue, profoundly affecting the psychological well-being of individuals. If it remains undiagnosed, depression can lead to severe health issues, which can manifest physically and even lead to suicide. Generally, Diagnosing depression or any other mental disorder involves conducting semi-structured interviews alongside supplementary questionnaires, including variants of the Patient Health Questionnaire (PHQ) by Clinicians and mental health professionals. This approach places significant reliance on the experience and judgment of trained physicians, making the diagnosis susceptible to personal biases. Given that the underlying mechanisms causing depression are still being actively researched, physicians often face challenges in diagnosing and treating the condition, particularly in its early stages of clinical presentation. Recently, significant strides have been made in Artificial neural computing to solve problems involving text, image, and speech in various domains. Our analysis has aimed to leverage these state-of-the-art (SOTA) models in our experiments to achieve optimal outcomes leveraging multiple modalities. The experiments were performed on the Extended Distress Analysis Interview Corpus Wizard of Oz dataset (E-DAIC) corpus presented in the Audio/Visual Emotion Challenge (AVEC) 2019 Challenge. The proposed solutions demonstrate better results achieved by Proprietary and Open-source Large Language Models (LLMs), which achieved a Root Mean Square Error (RMSE) score of 3.98 on Textual Modality, beating the AVEC 2019 challenge baseline results and current SOTA regression analysis architectures. Additionally, the proposed solution achieved an accuracy of 71.43% in the classification task. The paper also includes a novel audio-visual multi-modal network that predicts PHQ-8 scores with an RMSE of 6.51.

Mental health has attracted substantial attention in recent years and LLM can be an effective technology for alleviating this problem owing to its capability in text understanding and dialogue. However, existing research in this domain often suffers from limitations, such as training on datasets lacking crucial prior knowledge and evidence, and the absence of comprehensive evaluation methods. In this paper, we propose a specialized psychological large language model (LLM), named PsycoLLM, trained on a proposed high-quality psychological dataset, including single-turn QA, multi-turn dialogues enriched with prior knowledge and knowledge-based QA. Additionally, to compare the performance of PsycoLLM with other LLMs, we develop a comprehensive psychological benchmark based on authoritative psychological counseling examinations in China, which includes assessments of professional ethics, theoretical proficiency, and case analysis. The experimental results on the benchmark illustrates the effectiveness of PsycoLLM, which demonstrates superior performance compared to other LLMs.

People often utilise online media (e.g., Facebook, Reddit) as a platform to express their psychological distress and seek support. State-of-the-art NLP techniques demonstrate strong potential to automatically detect mental health issues from text. Research suggests that mental health issues are reflected in emotions (e.g., sadness) indicated in a person's choice of language. Therefore, we developed a novel emotion-annotated mental health corpus (EmoMent), consisting of 2802 Facebook posts (14845 sentences) extracted from two South Asian countries - Sri Lanka and India. Three clinical psychology postgraduates were involved in annotating these posts into eight categories, including 'mental illness' (e.g., depression) and emotions (e.g., 'sadness', 'anger'). EmoMent corpus achieved 'very good' inter-annotator agreement of 98.3% (i.e. % with two or more agreement) and Fleiss' Kappa of 0.82. Our RoBERTa based models achieved an F1 score of 0.76 and a macro-averaged F1 score of 0.77 for the first task (i.e. predicting a mental health condition from a post) and the second task (i.e. extent of association of relevant posts with the categories defined in our taxonomy), respectively.

Large language models (LLMs) have emerged as an integral part of modern societies, powering user-facing applications such as personal assistants and enterprise applications like recruitment tools. Despite their utility, research indicates that LLMs perpetuate systemic biases. Yet, prior works on LLM harms predominantly focus on Western concepts like race and gender, often overlooking cultural concepts from other parts of the world. Additionally, these studies typically investigate "harm" as a singular dimension, ignoring the various and subtle forms in which harms manifest. To address this gap, we introduce the Covert Harms and Social Threats (CHAST), a set of seven metrics grounded in social science literature. We utilize evaluation models aligned with human assessments to examine the presence of covert harms in LLM-generated conversations, particularly in the context of recruitment. Our experiments reveal that seven out of the eight LLMs included in this study generated conversations riddled with CHAST, characterized by malign views expressed in seemingly neutral language unlikely to be detected by existing methods. Notably, these LLMs manifested more extreme views and opinions when dealing with non-Western concepts like caste, compared to Western ones such as race.

The automatic identification of harmful content online is of major concern for social media platforms, policymakers, and society. Researchers have studied textual, visual, and audio content, but typically in isolation. Yet, harmful content often combines multiple modalities, as in the case of memes, which are of particular interest due to their viral nature. With this in mind, here we offer a comprehensive survey with a focus on harmful memes. Based on a systematic analysis of recent literature, we first propose a new typology of harmful memes, and then we highlight and summarize the relevant state of the art. One interesting finding is that many types of harmful memes are not really studied, e.g., such featuring self-harm and extremism, partly due to the lack of suitable datasets. We further find that existing datasets mostly capture multi-class scenarios, which are not inclusive of the affective spectrum that memes can represent. Another observation is that memes can propagate globally through repackaging in different languages and that they can also be multilingual, blending different cultures. We conclude by highlighting several challenges related to multimodal semiotics, technological constraints, and non-trivial social engagement, and we present several open-ended aspects such as delineating online harm and empirically examining related frameworks and assistive interventions, which we believe will motivate and drive future research.

Millions of individuals' well-being are challenged by the harms of substance use. Harm reduction as a public health strategy is designed to improve their health outcomes and reduce safety risks. Some large language models (LLMs) have demonstrated a decent level of medical knowledge, promising to address the information needs of people who use drugs (PWUD). However, their performance in relevant tasks remains largely unexplored. We introduce HRIPBench, a benchmark designed to evaluate LLM's accuracy and safety risks in harm reduction information provision. The benchmark dataset HRIP-Basic has 2,160 question-answer-evidence pairs. The scope covers three tasks: checking safety boundaries, providing quantitative values, and inferring polysubstance use risks. We build the Instruction and RAG schemes to evaluate model behaviours based on their inherent knowledge and the integration of domain knowledge. Our results indicate that state-of-the-art LLMs still struggle to provide accurate harm reduction information, and sometimes, carry out severe safety risks to PWUD. The use of LLMs in harm reduction contexts should be cautiously constrained to avoid inducing negative health outcomes. WARNING: This paper contains illicit content that potentially induces harms.

Mental health risk is a critical global public health challenge, necessitating innovative and reliable assessment methods. With the development of large language models (LLMs), they stand out to be a promising tool for explainable mental health care applications. Nevertheless, existing approaches predominantly rely on subjective textual mental records, which can be distorted by inherent mental uncertainties, leading to inconsistent and unreliable predictions. To address these limitations, this paper introduces ProMind-LLM. We investigate an innovative approach integrating objective behavior data as complementary information alongside subjective mental records for robust mental health risk assessment. Specifically, ProMind-LLM incorporates a comprehensive pipeline that includes domain-specific pretraining to tailor the LLM for mental health contexts, a self-refine mechanism to optimize the processing of numerical behavioral data, and causal chain-of-thought reasoning to enhance the reliability and interpretability of its predictions. Evaluations of two real-world datasets, PMData and Globem, demonstrate the effectiveness of our proposed methods, achieving substantial improvements over general LLMs. We anticipate that ProMind-LLM will pave the way for more dependable, interpretable, and scalable mental health case solutions.

Psychological defenses are strategies, often automatic, that people use to manage distress. Rigid or overuse of defenses is negatively linked to mental health and shapes what speakers disclose and how they accept or resist help. However, defenses are complex and difficult to reliably measure, particularly in clinical dialogues. We introduce PsyDefConv, a dialogue corpus with help seeker utterances labeled for defense level, and DMRS Co-Pilot, a four-stage pipeline that provides evidence-based pre-annotations. The corpus contains 200 dialogues and 4709 utterances, including 2336 help seeker turns, with labeling and Cohen's kappa 0.639. In a counterbalanced study, the co-pilot reduced average annotation time by 22.4%. In expert review, it averaged 4.62 for evidence, 4.44 for clinical plausibility, and 4.40 for insight on a seven-point scale. Benchmarks with strong language models in zero-shot and fine-tuning settings demonstrate clear headroom, with the best macro F1-score around 30% and a tendency to overpredict mature defenses. Corpus analyses confirm that mature defenses are most common and reveal emotion-specific deviations. We will release the corpus, annotations, code, and prompts to support research on defensive functioning in language.

Mental health research through data-driven methods has been hindered by a lack of standard typology and scarcity of adequate data. In this study, we leverage the clinical articulation of depression to build a typology for social media texts for detecting the severity of depression. It emulates the standard clinical assessment procedure Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and Patient Health Questionnaire (PHQ-9) to encompass subtle indications of depressive disorders from tweets. Along with the typology, we present a new dataset of 40191 tweets labeled by expert annotators. Each tweet is labeled as 'non-depressed' or 'depressed'. Moreover, three severity levels are considered for 'depressed' tweets: (1) mild, (2) moderate, and (3) severe. An associated confidence score is provided with each label to validate the quality of annotation. We examine the quality of the dataset via representing summary statistics while setting strong baseline results using attention-based models like BERT and DistilBERT. Finally, we extensively address the limitations of the study to provide directions for further research.

The delayed access to specialized psychiatric assessments and care for patients at risk of suicidal tendencies in emergency departments creates a notable gap in timely intervention, hindering the provision of adequate mental health support during critical situations. To address this, we present a non-invasive, speech-based approach for automatic suicide risk assessment. For our study, we have collected a novel dataset of speech recordings from 20 patients from which we extract three sets of features, including wav2vec, interpretable speech and acoustic features, and deep learning-based spectral representations. We proceed by conducting a binary classification to assess suicide risk in a leave-one-subject-out fashion. Our most effective speech model achieves a balanced accuracy of 66.2,%. Moreover, we show that integrating our speech model with a series of patients' metadata, such as the history of suicide attempts or access to firearms, improves the overall result. The metadata integration yields a balanced accuracy of 94.4,%, marking an absolute improvement of 28.2,%, demonstrating the efficacy of our proposed approaches for automatic suicide risk assessment in emergency medicine.

Large language models (LLMs) have shown incredible capabilities and transcended the natural language processing (NLP) community, with adoption throughout many services like healthcare, therapy, education, and customer service. Since users include people with critical information needs like students or patients engaging with chatbots, the safety of these systems is of prime importance. Therefore, a clear understanding of the capabilities and limitations of LLMs is necessary. To this end, we systematically evaluate toxicity in over half a million generations of ChatGPT, a popular dialogue-based LLM. We find that setting the system parameter of ChatGPT by assigning it a persona, say that of the boxer Muhammad Ali, significantly increases the toxicity of generations. Depending on the persona assigned to ChatGPT, its toxicity can increase up to 6x, with outputs engaging in incorrect stereotypes, harmful dialogue, and hurtful opinions. This may be potentially defamatory to the persona and harmful to an unsuspecting user. Furthermore, we find concerning patterns where specific entities (e.g., certain races) are targeted more than others (3x more) irrespective of the assigned persona, that reflect inherent discriminatory biases in the model. We hope that our findings inspire the broader AI community to rethink the efficacy of current safety guardrails and develop better techniques that lead to robust, safe, and trustworthy AI systems.

Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.

The limited availability of psychologists necessitates efficient identification of individuals requiring urgent mental healthcare. This study explores the use of Natural Language Processing (NLP) pipelines to analyze text data from online mental health forums used for consultations. By analyzing forum posts, these pipelines can flag users who may require immediate professional attention. A crucial challenge in this domain is data privacy and scarcity. To address this, we propose utilizing readily available curricular texts used in institutes specializing in mental health for pre-training the NLP pipelines. This helps us mimic the training process of a psychologist. Our work presents CASE-BERT that flags potential mental health disorders based on forum text. CASE-BERT demonstrates superior performance compared to existing methods, achieving an f1 score of 0.91 for Depression and 0.88 for Anxiety, two of the most commonly reported mental health disorders. Our code is publicly available.

Recent incidents involving LLMs used for mental-health support reveal a critical evaluation gap: surface-level safety scores do not capture how models behave across realistic, emotionally sensitive interactions over time. Existing benchmarks measure knowledge, safety, or static response quality, but miss whether LLM interactions help users keep reflecting, coping, and making decisions themselves. We formalize this missing dimension as COGNITIVE ATROPHY, a process-level behavioural measure in AI-mediated mental-health support distinct from safety and helpfulness. To measure it, we introduce COGNITIVE ATROPHY BENCH, a clinically grounded benchmark built from 1,576 fully human-generated counseling conversations, 15,680 turns, and 42,230 responses from five LLMs. Three clinical and neuropsychology experts developed a 20-attribute schema spanning user context, response behaviour, and global risk flags; six trained clinical reviewers applied it with span-grounded evidence, producing 5,324 reviewer judgments. We further introduce the User-Input Risk Index (UIRI), the Cognitive Atrophy Risk Index (ARI), and trajectory summaries. Across five LLMs, models show a consistent moderate-to-high level of atrophy-aligned behaviour across single and multi-turn settings. While models generally respond to overt safety cues, they adapt less reliably when users seek solutions or decisions. The dominant recurring patterns are directive advice, problem-solving, recommendation responses, topic shifts, and forms of validation that may reinforce dependence rather than reflection. Our work makes COGNITIVE ATROPHY measurable and provides a foundation for auditing model behaviour in sensitive LLM conversations.

Language model deployments in consumer-facing applications introduce numerous risks. While existing research on harms and hazards of such applications follows top-down approaches derived from regulatory frameworks and theoretical analyses, empirical evidence of real-world failure modes remains underexplored. In this work, we introduce RealHarm, a dataset of annotated problematic interactions with AI agents built from a systematic review of publicly reported incidents. Analyzing harms, causes, and hazards specifically from the deployer's perspective, we find that reputational damage constitutes the predominant organizational harm, while misinformation emerges as the most common hazard category. We empirically evaluate state-of-the-art guardrails and content moderation systems to probe whether such systems would have prevented the incidents, revealing a significant gap in the protection of AI applications.

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

Large language models (LLMs) have demonstrated notable advancements in psychological counseling. However, existing models generally do not explicitly model seekers' emotion shifts across counseling sessions, a core focus in classical psychological schools. Moreover, how to align counselor models' responses with these emotion shifts while proactively mitigating safety risks remains underexplored. To bridge these gaps, we propose PsychēChat, which explicitly integrates emotion shift tracking and safety risk analysis for psychological counseling. Specifically, we employ interactive role-playing to synthesize counselor--seeker dialogues, incorporating two modules: Emotion Management Module, to capture seekers' current emotions and emotion shifts; and Risk Control Module, to anticipate seekers' subsequent reactions and identify potential risks. Furthermore, we introduce two modeling paradigms. The Agent Mode structures emotion management, risk control, and counselor responses into a collaborative multi-agent pipeline. The LLM Mode integrates these stages into a unified chain-of-thought for end-to-end inference, balancing efficiency and performance. Extensive experiments, including interactive scoring, dialogue-level evaluation, and human assessment, demonstrate that PsychēChat outperforms existing methods for emotional insight and safety control.

The detection of depression through non-verbal cues has gained significant attention. Previous research predominantly centred on identifying depression within the confines of controlled laboratory environments, often with the supervision of psychologists or counsellors. Unfortunately, datasets generated in such controlled settings may struggle to account for individual behaviours in real-life situations. In response to this limitation, we present the Extended D-vlog dataset, encompassing a collection of 1, 261 YouTube vlogs. Additionally, the emergence of large language models (LLMs) like GPT3.5, and GPT4 has sparked interest in their potential they can act like mental health professionals. Yet, the readiness of these LLM models to be used in real-life settings is still a concern as they can give wrong responses that can harm the users. We introduce a virtual agent serving as an initial contact for mental health patients, offering Cognitive Behavioral Therapy (CBT)-based responses. It comprises two core functions: 1. Identifying depression in individuals, and 2. Delivering CBT-based therapeutic responses. Our Mistral model achieved impressive scores of 70.1% and 30.9% for distortion assessment and classification, along with a Bert score of 88.7%. Moreover, utilizing the TVLT model on our Multimodal Extended D-vlog Dataset yielded outstanding results, with an impressive F1-score of 67.8%

This study quantifies the association between non-adherence to antipsychotic medications and adverse outcomes in individuals with schizophrenia. We frame the problem using survival analysis, focusing on the time to the earliest of several adverse events (early death, involuntary hospitalization, jail booking). We extend standard causal inference methods (T-learner, S-learner, nearest neighbor matching) to utilize various survival models to estimate individual and average treatment effects, where treatment corresponds to medication non-adherence. Analyses are repeated using different amounts of longitudinal information (3, 6, 9, and 12 months). Using data from Allegheny County in western Pennsylvania, we find strong evidence that non-adherence advances adverse outcomes by approximately 1 to 4 months. Ablation studies confirm that county-provided risk scores adjust for key confounders, as their removal amplifies the estimated effects. Subgroup analyses by medication formulation (injectable vs. oral) and medication type consistently show that non-adherence is associated with earlier adverse events. These findings highlight the clinical importance of adherence in delaying psychiatric crises and show that integrating survival analysis with causal inference tools can yield policy-relevant insights. We caution that although we apply causal inference, we only make associative claims and discuss assumptions needed for causal interpretation.

Suicide is an important but often misunderstood problem, one that researchers are now seeking to better understand through social media. Due in large part to the fuzzy nature of what constitutes suicidal risks, most supervised approaches for learning to automatically detect suicide-related activity in social media require a great deal of human labor to train. However, humans themselves have diverse or conflicting views on what constitutes suicidal thoughts. So how to obtain reliable gold standard labels is fundamentally challenging and, we hypothesize, depends largely on what is asked of the annotators and what slice of the data they label. We conducted multiple rounds of data labeling and collected annotations from crowdsourcing workers and domain experts. We aggregated the resulting labels in various ways to train a series of supervised models. Our preliminary evaluations show that using unanimously agreed labels from multiple annotators is helpful to achieve robust machine models.

This paper aims to help structure the risk landscape associated with large-scale Language Models (LMs). In order to foster advances in responsible innovation, an in-depth understanding of the potential risks posed by these models is needed. A wide range of established and anticipated risks are analysed in detail, drawing on multidisciplinary expertise and literature from computer science, linguistics, and social sciences. We outline six specific risk areas: I. Discrimination, Exclusion and Toxicity, II. Information Hazards, III. Misinformation Harms, V. Malicious Uses, V. Human-Computer Interaction Harms, VI. Automation, Access, and Environmental Harms. The first area concerns the perpetuation of stereotypes, unfair discrimination, exclusionary norms, toxic language, and lower performance by social group for LMs. The second focuses on risks from private data leaks or LMs correctly inferring sensitive information. The third addresses risks arising from poor, false or misleading information including in sensitive domains, and knock-on risks such as the erosion of trust in shared information. The fourth considers risks from actors who try to use LMs to cause harm. The fifth focuses on risks specific to LLMs used to underpin conversational agents that interact with human users, including unsafe use, manipulation or deception. The sixth discusses the risk of environmental harm, job automation, and other challenges that may have a disparate effect on different social groups or communities. In total, we review 21 risks in-depth. We discuss the points of origin of different risks and point to potential mitigation approaches. Lastly, we discuss organisational responsibilities in implementing mitigations, and the role of collaboration and participation. We highlight directions for further research, particularly on expanding the toolkit for assessing and evaluating the outlined risks in LMs.

This paper introduces RiskCards, a framework for structured assessment and documentation of risks associated with an application of language models. As with all language, text generated by language models can be harmful, or used to bring about harm. Automating language generation adds both an element of scale and also more subtle or emergent undesirable tendencies to the generated text. Prior work establishes a wide variety of language model harms to many different actors: existing taxonomies identify categories of harms posed by language models; benchmarks establish automated tests of these harms; and documentation standards for models, tasks and datasets encourage transparent reporting. However, there is no risk-centric framework for documenting the complexity of a landscape in which some risks are shared across models and contexts, while others are specific, and where certain conditions may be required for risks to manifest as harms. RiskCards address this methodological gap by providing a generic framework for assessing the use of a given language model in a given scenario. Each RiskCard makes clear the routes for the risk to manifest harm, their placement in harm taxonomies, and example prompt-output pairs. While RiskCards are designed to be open-source, dynamic and participatory, we present a "starter set" of RiskCards taken from a broad literature survey, each of which details a concrete risk presentation. Language model RiskCards initiate a community knowledge base which permits the mapping of risks and harms to a specific model or its application scenario, ultimately contributing to a better, safer and shared understanding of the risk landscape.

Purpose. We present an approach for forecasting mental health conditions and emotions of a given population during the COVID-19 pandemic in Argentina based on language expressions used in social media. This approach permits anticipating high prevalence periods in short- to medium-term time horizons. Design. Mental health conditions and emotions are captured via markers, which link social media contents with lexicons. First, we build descriptive timelines for decision makers to monitor the evolution of markers, and their correlation with crisis events. Second, we model the timelines as time series, and support their forecasting, which in turn serve to identify high prevalence points for the estimated markers. Findings. Results showed that different time series forecasting strategies offer different capabilities. In the best scenario, the emergence of high prevalence periods of emotions and mental health disorders can be satisfactorily predicted with a neural network strategy, even when limited data is available in early stages of a crisis (e.g., 7 days). Originality. Although there have been efforts in the literature to predict mental states of individuals, the analysis of mental health at the collective level has received scarce attention. We take a step forward by proposing a forecasting approach for analyzing the mental health of a given population (or group of individuals) at a larger scale. Practical implications. We believe that this work contributes to a better understanding of how psychological processes related to crisis manifest in social media, being a valuable asset for the design, implementation and monitoring of health prevention and communication policies.

In today's digital world, cyberbullying is a serious problem that can harm the mental and physical health of people who use social media. This paper explains just how serious cyberbullying is and how it really affects indi-viduals exposed to it. It also stresses how important it is to find better ways to detect cyberbullying so that online spaces can be safer. Plus, it talks about how making more accurate tools to spot cyberbullying will be really helpful in the future. Our paper introduces a deep learning-based ap-proach, primarily employing BERT and BiLSTM architectures, to effective-ly address cyberbullying. This approach is designed to analyse large vol-umes of posts and predict potential instances of cyberbullying in online spaces. Our results demonstrate the superiority of the hateBERT model, an extension of BERT focused on hate speech detection, among the five mod-els, achieving an accuracy rate of 89.16%. This research is a significant con-tribution to "Computational Intelligence for Social Transformation," prom-ising a safer and more inclusive digital landscape.

Mental health is a critical issue in modern society, and mental disorders could sometimes turn to suicidal ideation without adequate treatment. Early detection of mental disorders and suicidal ideation from social content provides a potential way for effective social intervention. Recent advances in pretrained contextualized language representations have promoted the development of several domain-specific pretrained models and facilitated several downstream applications. However, there are no existing pretrained language models for mental healthcare. This paper trains and release two pretrained masked language models, i.e., MentalBERT and MentalRoBERTa, to benefit machine learning for the mental healthcare research community. Besides, we evaluate our trained domain-specific models and several variants of pretrained language models on several mental disorder detection benchmarks and demonstrate that language representations pretrained in the target domain improve the performance of mental health detection tasks.

As LLMs are increasingly deployed in global applications, the importance of cultural sensitivity becomes paramount, ensuring that users from diverse backgrounds feel respected and understood. Cultural harm can arise when these models fail to align with specific cultural norms, resulting in misrepresentations or violations of cultural values. This work addresses the challenges of ensuring cultural sensitivity in LLMs, especially in small-parameter models that often lack the extensive training data needed to capture global cultural nuances. We present two key contributions: (1) A cultural harm test dataset, created to assess model outputs across different cultural contexts through scenarios that expose potential cultural insensitivities, and (2) A culturally aligned preference dataset, aimed at restoring cultural sensitivity through fine-tuning based on feedback from diverse annotators. These datasets facilitate the evaluation and enhancement of LLMs, ensuring their ethical and safe deployment across different cultural landscapes. Our results show that integrating culturally aligned feedback leads to a marked improvement in model behavior, significantly reducing the likelihood of generating culturally insensitive or harmful content. Ultimately, this work paves the way for more inclusive and respectful AI systems, fostering a future where LLMs can safely and ethically navigate the complexities of diverse cultural landscapes.

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

Mental health is a significant and growing public health concern. As language usage can be leveraged to obtain crucial insights into mental health conditions, there is a need for large-scale, labeled, mental health-related datasets of users who have been diagnosed with one or more of such conditions. In this paper, we investigate the creation of high-precision patterns to identify self-reported diagnoses of nine different mental health conditions, and obtain high-quality labeled data without the need for manual labelling. We introduce the SMHD (Self-reported Mental Health Diagnoses) dataset and make it available. SMHD is a novel large dataset of social media posts from users with one or multiple mental health conditions along with matched control users. We examine distinctions in users' language, as measured by linguistic and psychological variables. We further explore text classification methods to identify individuals with mental conditions through their language.

This article details the advances made to a system that uses artificial intelligence to identify alarming student responses. This system is built into our assessment platform to assess whether a student's response indicates they are a threat to themselves or others. Such responses may include details concerning threats of violence, severe depression, suicide risks, and descriptions of abuse. Driven by advances in natural language processing, the latest model is a fine-tuned language model trained on a large corpus consisting of student responses and supplementary texts. We demonstrate that the use of a language model delivers a substantial improvement in accuracy over the previous iterations of this system.

When a phone-use agent avoids harm, does that show safety, or simply inability to act? Existing evaluations often cannot tell. A harmful outcome may be avoided because the agent recognized the risk and chose the safe action, or because it failed to understand the screen or execute any relevant action at all. These cases have different causes and call for different fixes, yet current benchmarks often merge them under task success, refusal, or final harmful outcome. We address this problem with PhoneSafety, a benchmark of 700 safety-critical moments drawn from real phone interactions across more than 130 apps. Each instance isolates the next decision at a risky moment and asks a simple question: does the model take the safe action, take the unsafe action, or fail to do anything useful? We evaluate eight representative phone-use agents under this framework. Our results reveal two main patterns. First, stronger general phone-use ability does not reliably imply safer choices at risky moments. Models that perform better on ordinary app tasks are not always the ones that behave more safely when the next action matters. Second, failures to do anything useful behave like a capability signal rather than a safety signal: they are concentrated in more visually and operationally demanding settings and remain stable when the evaluation protocol changes. Across models, failures split into two recurring patterns: unsafe choices in settings where the model can act but chooses wrongly, and inability to act in more visually and operationally demanding screens. Overall, a harmless outcome is not enough to count as evidence of safety. Evaluating phone-use agents requires separating unsafe judgment from inability to act.

Mobile mental health applications are seen as a promising way to fulfill the growing need for mental health care. Although there are more than ten thousand mental health apps available on app marketplaces, such as Google Play and Apple App Store, many of them are not evidence-based, or have been minimally evaluated or regulated. The real-life experience and concerns of the app users are largely unknown. To address this knowledge gap, we analyzed 2159 user reviews from 117 Android apps and 2764 user reviews from 76 iOS apps. Our findings include the critiques around inconsistent moderation standards and lack of transparency. App-embedded social features and chatbots were criticized for providing little support during crises. We provide research and design implications for future mental health app developers, discuss the necessity of developing a comprehensive and centralized app development guideline, and the opportunities of incorporating existing AI technology in mental health chatbots.

The Identifiable Victim Effect (IVE) - the tendency to allocate greater resources to a specific, narratively described victim than to a statistically characterized group facing equivalent hardship - is one of the most robust findings in moral psychology and behavioural economics. As large language models (LLMs) assume consequential roles in humanitarian triage, automated grant evaluation, and content moderation, a critical question arises: do these systems inherit the affective irrationalities present in human moral reasoning? We present the first systematic, large-scale empirical investigation of the IVE in LLMs, comprising N=51,955 validated API trials across 16 frontier models spanning nine organizational lineages (Google, Anthropic, OpenAI, Meta, DeepSeek, xAI, Alibaba, IBM, and Moonshot). Using a suite of ten experiments - porting and extending canonical paradigms from Small et al. (2007) and Kogut and Ritov (2005) - we find that the IVE is prevalent but strongly modulated by alignment training. Instruction-tuned models exhibit extreme IVE (Cohen's d up to 1.56), while reasoning-specialized models invert the effect (down to d=-0.85). The pooled effect (d=0.223, p=2e-6) is approximately twice the single-victim human meta-analytic baseline (dapprox0.10) reported by Lee and Feeley (2016) - and likely exceeds the overall human pooled effect by a larger margin, given that the group-victim human effect is near zero. Standard Chain-of-Thought (CoT) prompting - contrary to its role as a deliberative corrective - nearly triples the IVE effect size (from d=0.15 to d=0.41), while only utilitarian CoT reliably eliminates it. We further document psychophysical numbing, perfect quantity neglect, and marginal in-group/out-group cultural bias, with implications for AI deployment in humanitarian and ethical decision-making contexts.