mlsanityData to 7 Oct 2026

Understanding the Benefits and Challenges of Using Large Language Model-based Conversational Agents for Mental Well-being Support

arXiv 2307.15810 ↗First posted 28 Jul 2023cs.HCcited by 75

On the map: LLM agents and tool use → Medical and scientific domain agents

Abstract (arXiv)

Conversational agents powered by large language models (LLM) have increasingly been utilized in the realm of mental well-being support. However, the implications and outcomes associated with their usage in such a critical field remain somewhat ambiguous and unexplored. We conducted a qualitative analysis of 120 posts, encompassing 2917 user comments, drawn from the most popular subreddit focused on mental health support applications powered by large language models (u/Replika). This exploration aimed to shed light on the advantages and potential pitfalls associated with the integration of these sophisticated models in conversational agents intended for mental health support. We found the app (Replika) beneficial in offering on-demand, non-judgmental support, boosting user confidence, and aiding self-discovery. Yet, it faced challenges in filtering harmful content, sustaining consistent communication, remembering new information, and mitigating users' overdependence. The stigma attached further risked isolating users socially. We strongly assert that future researchers and designers must thoroughly evaluate the appropriateness of employing LLMs for mental well-being support, ensuring their responsible and effective application.

Key facts. Cited by 75 papers in the map (data through 7 Oct 2026). Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use. Builds on 5 of its 37 references that are in the map. First posted on arXiv 28 Jul 2023.

Builds on

5 of 37 references.

References · 5

  1. 2020Language Models are Few-Shot Learnerscited by 32,199
  2. 2021Evaluating Large Language Models Trained on Codecited by 8,053
  3. 2021Pre-train, Prompt, and Predict: A Systematic Survey of Prompting Methods in Natural Language Processingcited by 2,222
  4. 2019Challenges in Building Intelligent Open-domain Dialog Systemscited by 147
  5. 2019On Extractive and Abstractive Neural Document Summarization with Transformer Language Modelscited by 83

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Cited by year (2026 to 7 Oct)

Citing papers per year: 2023: 12; 2024: 24; 2025: 28; 2026: 11.

75 papers.

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  1. 2023A Survey on Large Language Model based Autonomous Agentscited by 2,203
  2. 2023The Rise and Potential of Large Language Model Based Agents: A Surveycited by 1,422
  3. 2024Large Language Model based Multi-Agents: A Survey of Progress and Challengescited by 752
  4. 2023Cognitive Architectures for Language Agentscited by 422
  5. 2025Large Language Model Agent: A Survey on Methodology, Applications and Challengescited by 194
  6. 2023A Survey of Large Language Models in Medicine: Progress, Application, and Challengecited by 123
  7. 2024FOFO: A Benchmark to Evaluate LLMs' Format-Following Capabilitycited by 79
  8. 2023Igniting Language Intelligence: The Hitchhiker's Guide From Chain-of-Thought Reasoning to Language Agentscited by 72
  9. 2025MedAgent-Pro: Towards Evidence-based Multi-modal Medical Diagnosis via Reasoning Agentic Workflowcited by 71
  10. 2025Expressing stigma and inappropriate responses prevents LLMs from safely replacing mental health providerscited by 67
  11. 2024MLLM-Tool: A Multimodal Large Language Model For Tool Agent Learningcited by 66
  12. 2024(A)I Am Not a Lawyer, But...: Engaging Legal Experts towards Responsible LLM Policies for Legal Advicecited by 61
38 more
  1. 2024The opportunities and risks of large language models in mental healthcited by 54
  2. 2023MindfulDiary: Harnessing Large Language Model to Support Psychiatric Patients' Journalingcited by 50
  3. 2023Benefits and Harms of Large Language Models in Digital Mental Healthcited by 39
  4. 2024Large Language Models in Mental Health Care: a Scoping Reviewcited by 34
  5. 2025DarkBench: Benchmarking Dark Patterns in Large Language Modelscited by 25
  6. 2025Normative Evaluation of Large Language Models with Everyday Moral Dilemmascited by 23
  7. 2023ChoiceMates: Supporting Unfamiliar Online Decision-Making with Multi-Agent Conversational Interactionscited by 22
  8. 2024Evaluating Large Language Models with Psychometricscited by 22
  9. 2026Characterizing Delusional Spirals through Human-LLM Chat Logscited by 22
  10. 2023Generative Agent-Based Modeling: Unveiling Social System Dynamics through Coupling Mechanistic Models with Generative Artificial Intelligencecited by 19
  11. 2025When Can We Trust LLMs in Mental Health? Large-Scale Benchmarks for Reliable LLM Evaluationcited by 19
  12. 2024Large Action Models: From Inception to Implementationcited by 18
  13. 2024Understanding the Impact of Long-Term Memory on Self-Disclosure with Large Language Model-Driven Chatbots for Public Health Interventioncited by 15
  14. 2024Large Language Model for Mental Health: A Systematic Reviewcited by 14
  15. 2025GuideBench: Benchmarking Domain-Oriented Guideline Following for LLM Agentscited by 14
  16. 2024Depression Diagnosis Dialogue Simulation: Self-improving Psychiatrist with Tertiary Memorycited by 13
  17. 2025AI Chatbots for Mental Health: Values and Harms from Lived Experiences of Depressioncited by 13
  18. 2025Exploring User Security and Privacy Attitudes and Concerns Toward the Use of General-Purpose LLM Chatbots for Mental Healthcited by 12
  19. 2023LLMs-Healthcare : Current Applications and Challenges of Large Language Models in various Medical Specialtiescited by 10
  20. 2025Longitudinal Study on Social and Emotional Use of AI Conversational Agentcited by 10
  21. 2024Particip-AI: A Democratic Surveying Framework for Anticipating Future AI Use Cases, Harms and Benefitscited by 9
  22. 2024ProgressGym: Alignment with a Millennium of Moral Progresscited by 9
  23. 2023Towards a Psychological Generalist AI: A Survey of Current Applications of Large Language Models and Future Prospectscited by 8
  24. 2024Private Yet Social: How LLM Chatbots Support and Challenge Eating Disorder Recoverycited by 8
  25. 2025Mental Health Impacts of AI Companions: Triangulating Social Media Quasi-Experiments, User Perspectives, and Relational Theorycited by 8
  26. 2024"I Like Sunnie More Than I Expected!": Exploring User Expectation and Perception of an Anthropomorphic LLM-based Conversational Agent for Well-Being Supportcited by 5
  27. 2024ExploreSelf: Fostering User-driven Exploration and Reflection on Personal Challenges with Adaptive Guidance by Large Language Modelscited by 5
  28. 2025AI-induced sexual harassment: Investigating Contextual Characteristics and User Reactions of Sexual Harassment by a Companion Chatbotcited by 5
  29. 2023Thinking Assistants: LLM-Based Conversational Assistants that Help Users Think By Asking rather than Answeringcited by 4
  30. 2024Automating PTSD Diagnostics in Clinical Interviews: Leveraging Large Language Models for Trauma Assessmentscited by 4
  31. 2024Normative Modules: A Generative Agent Architecture for Learning Norms that Supports Multi-Agent Cooperationcited by 4
  32. 2024We Care: Multimodal Depression Detection and Knowledge Infused Mental Health Therapeutic Response Generationcited by 4
  33. 2025From Conversation to Automation: Leveraging LLMs for Problem-Solving Therapy Analysiscited by 4
  34. 2025Deconstructing Depression Stigma: Integrating AI-driven Data Collection and Analysis with Causal Knowledge Graphscited by 4
  35. 2025Can LLMs Address Mental Health Questions? A Comparison with Human Therapistscited by 4
  36. 2025Chain-of-Trigger: An Agentic Backdoor that Paradoxically Enhances Agentic Robustnesscited by 4
  37. 2024Large Language Model Agents for Improving Engagement with Behavior Change Interventions: Application to Digital Mindfulnesscited by 3
  38. 2024Large Language Models for Automatic Detection of Sensitive Topicscited by 3

50 most cited of 75 All 75 (JSON)

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  1. 2026Can Virtual Agents Care? Designing an Empathetic and Personalized LLM-Driven Conversational Agent
  2. 2023An Integrative Survey on Mental Health Conversational Agents to Bridge Computer Science and Medical Perspectives
  3. 2026LLUMI: Improving LLM Writing Assistance for Mental Health Support with Online Community Feedback
  4. 2025Mentalic Net: Development of RAG-based Conversational AI and Evaluation Framework for Mental Health Support
  5. 2025MindBenchAI: An Actionable Platform to Evaluate the Profile and Performance of Large Language Models in a Mental Healthcare Context
  6. 2023Rethinking Large Language Models in Mental Health Applications
  7. 2025An Offline Mobile Conversational Agent for Mental Health Support: Learning from Emotional Dialogues and Psychological Texts with Student-Centered Evaluation
  8. 2025ESC-Judge: A Framework for Comparing Emotional Support Conversational Agents