A.I.-related psychosis has cost people their marriages, life savings, and grip on reality. Last August, Adam Thomas found himself wandering the dunes of Christmas Valley, Oregon, after a chatbot kept suggesting he mystically "follow the pattern" of his own consciousness. Thomas was running on very little sleep--he'd been talking to his chatbot around the clock for months by that point, asking it to help improve his life. Instead it sent him on empty assignments, like meandering the vacuous desert sprawl. He'd lost his job as a funeral director and was living out of a van, draining his savings, and now he found himself stranded in the desert. When he woke up outside on a stranger's futon with no money to his name, he knew he'd hit rock bottom. "I wasn't aware of the dangers at the time, and I thought that the A.I. had statistical analysis abilities that would allow it to assist me if I opened up about my life," Thomas told me.

Medical question answering (QA) benchmarks often focus on multiple-choice or fact-based tasks, leaving open-ended answers to real patient questions underexplored. This gap is particularly critical in mental health, where patient questions often mix symptoms, treatment concerns, and emotional needs, requiring answers that balance clinical caution with contextual sensitivity. We present CounselBench, a large-scale benchmark developed with 100 mental health professionals to evaluate and stress-test large language models (LLMs) in realistic help-seeking scenarios. The first component, CounselBench-EVAL, contains 2,000 expert evaluations of answers from GPT-4, LLaMA 3, Gemini, and human therapists on patient questions from the public forum CounselChat. Each answer is rated across six clinically grounded dimensions, with span-level annotations and written rationales. Expert evaluations show that while LLMs achieve high scores on several dimensions, they also exhibit recurring issues, including unconstructive feedback, overgeneralization, and limited personalization or relevance. Responses were frequently flagged for safety risks, most notably unauthorized medical advice. Follow-up experiments show that LLM judges systematically overrate model responses and overlook safety concerns identified by human experts. To probe failure modes more directly, we construct CounselBench-Adv, an adversarial dataset of 120 expert-authored mental health questions designed to trigger specific model issues. Evaluation of 3,240 responses from nine LLMs reveals consistent, model-specific failure patterns. Together, CounselBench establishes a clinically grounded framework for benchmarking LLMs in mental health QA.

Limited access to mental health care has motivated the use of digital tools and conversational agents powered by large language models (LLMs), yet their quality and reception remain unclear. We present a study comparing therapist-written responses to those generated by ChatGPT, Gemini, and Llama for real patient questions. Text analysis showed that LLMs produced longer, more readable, and lexically richer responses with a more positive tone, while therapist responses were more often written in the first person. In a survey with 150 users and 23 licensed therapists, participants rated LLM responses as clearer, more respectful, and more supportive than therapist-written answers. Yet, both groups of participants expressed a stronger preference for human therapist support. These findings highlight the promise and limitations of LLMs in mental health, underscoring the need for designs that balance their communicative strengths with concerns of trust, privacy, and accountability.

Tran* sat across from me, phone in hand, scrolling. "I just wanted to make sure I didn't say the wrong thing," he explained, referring to a disagreement with his partner. "So I asked ChatGPT what I should say." He read the chatbot-generated message aloud. It was articulate, logical and composed – too composed.

Recent studies show that in supervised fine-tuning (SFT) of large language models (LLMs), data quality matters more than quantity. While most data cleaning methods concentrate on filtering entire samples, the quality of individual tokens within a sample can vary significantly. After pre-training, even in high-quality samples, patterns or phrases that are not task-related can be redundant or uninformative. Continuing to fine-tune on these patterns may offer limited benefit and even degrade downstream task performance. In this paper, we investigate token quality from a noisy-label perspective and propose a generic token cleaning pipeline for SFT tasks. Our method filters out uninformative tokens while preserving those carrying key task-specific information. Specifically, we first evaluate token quality by examining the influence of model updates on each token, then apply a threshold-based separation. The token influence can be measured in a single pass with a fixed reference model or iteratively with self-evolving reference models. The benefits and limitations of both methods are analyzed theoretically by error upper bounds. Extensive experiments show that our framework consistently improves performance across multiple downstream tasks.

Left-behind children (LBCs), numbering over 66 million in China, face severe mental health challenges due to parental migration for work. Early screening and identification of at-risk LBCs is crucial, yet challenging due to the severe shortage of mental health professionals, especially in rural areas. While the House-Tree-Person (HTP) test shows higher child participation rates, its requirement for expert interpretation limits its application in resource-scarce regions. To address this challenge, we propose PsyDraw, a multi-agent system based on Multimodal Large Language Models that assists mental health professionals in analyzing HTP drawings. The system employs specialized agents for feature extraction and psychological interpretation, operating in two stages: comprehensive feature analysis and professional report generation. Evaluation of HTP drawings from 290 primary school students reveals that 71.03% of the analyzes achieved High Consistency with professional evaluations, 26.21% Moderate Consistency and only 2.41% Low Consistency. The system identified 31.03% of cases requiring professional attention, demonstrating its effectiveness as a preliminary screening tool. Currently deployed in pilot schools, \method shows promise in supporting mental health professionals, particularly in resource-limited areas, while maintaining high professional standards in psychological assessment.

Large Language Models (LLMs) are transforming mental health care by enhancing accessibility, personalization, and efficiency in therapeutic interventions. These AI-driven tools empower mental health professionals with real-time support, improved data integration, and the ability to encourage care-seeking behaviors, particularly in underserved communities. By harnessing LLMs, practitioners can deliver more empathetic, tailored, and effective support, addressing longstanding gaps in mental health service provision. However, their implementation comes with significant challenges and ethical concerns. Performance limitations, data privacy risks, biased outputs, and the potential for generating misleading information underscore the critical need for stringent ethical guidelines and robust evaluation mechanisms. The sensitive nature of mental health data further necessitates meticulous safeguards to protect patient rights and ensure equitable access to AI-driven care. Proponents argue that LLMs have the potential to democratize mental health resources, while critics warn of risks such as misuse and the diminishment of human connection in therapy. Achieving a balance between innovation and ethical responsibility is imperative. This paper examines the transformative potential of LLMs in mental health care, highlights the associated technical and ethical complexities, and advocates for a collaborative, multidisciplinary approach to ensure these advancements align with the goal of providing compassionate, equitable, and effective mental health support.

With the growing interest in using AI and machine learning (ML) in medicine, there is an increasing number of literature covering the application and ethics of using AI and ML in areas of medicine such as clinical psychiatry. The problem is that there is little literature covering the economic aspects associated with using ML in clinical psychiatry. This study addresses this gap by specifically studying the economic implications of using ML in clinical psychiatry. In this paper, we evaluate the economic implications of using ML in clinical psychiatry through using three problem-oriented case studies, literature on economics, socioeconomic and medical AI, and two types of health economic evaluations. In addition, we provide details on fairness, legal, ethics and other considerations for ML in clinical psychiatry.

Mental health issues significantly impact individuals' daily lives, yet many do not receive the help they need even with available online resources. This study aims to provide diverse, accessible, stigma-free, personalized, and real-time mental health support through cutting-edge AI technologies. It makes the following contributions: (1) Conducting an extensive survey of recent mental health support methods to identify prevalent functionalities and unmet needs. (2) Introducing SouLLMate, an adaptive LLM-driven system that integrates LLM technologies, Chain, Retrieval-Augmented Generation (RAG), prompt engineering, and domain knowledge. This system offers advanced features such as Risk Detection and Proactive Guidance Dialogue, and utilizes RAG for personalized profile uploads and Conversational Information Extraction. (3) Developing novel evaluation approaches for preliminary assessments and risk detection via professionally annotated interview data and real-life suicide tendency data. (4) Proposing the Key Indicator Summarization (KIS), Proactive Questioning Strategy (PQS), and Stacked Multi-Model Reasoning (SMMR) methods to enhance model performance and usability through context-sensitive response adjustments, semantic coherence evaluations, and enhanced accuracy of long-context reasoning in language models. This study contributes to advancing mental health support technologies, potentially improving the accessibility and effectiveness of mental health care globally.

Access to mental health support remains limited, particularly in marginalized communities where structural and cultural barriers hinder timely care. This paper explores the potential of AI-enabled chatbots as a scalable solution, focusing on advanced large language models (LLMs)-GPT v4, Mistral Large, and LLama V3.1-and assessing their ability to deliver empathetic, meaningful responses in mental health contexts. While these models show promise in generating structured responses, they fall short in replicating the emotional depth and adaptability of human therapists. Additionally, trustworthiness, bias, and privacy challenges persist due to unreliable datasets and limited collaboration with mental health professionals. To address these limitations, we propose a federated learning framework that ensures data privacy, reduces bias, and integrates continuous validation from clinicians to enhance response quality. This approach aims to develop a secure, evidence-based AI chatbot capable of offering trustworthy, empathetic, and bias-reduced mental health support, advancing AI's role in digital mental health care.