A Novel Nuanced Conversation Evaluation Framework for Large Language Models in Mental Health
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Abstract (arXiv)
Understanding the conversation abilities of Large Language Models (LLMs) can help lead to its more cautious and appropriate deployment. This is especially important for safety-critical domains like mental health, where someone's life may depend on the exact wording of a response to an urgent question. In this paper, we propose a novel framework for evaluating the nuanced conversation abilities of LLMs. Within it, we develop a series of quantitative metrics developed from literature on using psychotherapy conversation analysis literature. While we ensure that our framework and metrics are transferable by researchers to relevant adjacent domains, we apply them to the mental health field. We use our framework to evaluate several popular frontier LLMs, including some GPT and Llama models, through a verified mental health dataset. Our results show that GPT4 Turbo can perform significantly more similarly to verified therapists than other selected LLMs. We conduct additional analysis to examine how LLM conversation performance varies across specific mental health topics. Our results indicate that GPT4 Turbo performs well in achieving high correlation with verified therapists in particular topics such as Parenting and Relationships. We believe our contributions will help researchers develop better LLMs that, in turn, will more positively support people's lives.
Key facts. Cited by 7 papers in the map (data through 14 Oct 2026). Builds on 10 of its 37 references that are in the map. First posted on arXiv 8 Mar 2024.
Builds on
10 of 37 references.
References · 10
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- 2023LMSYS-Chat-1M: A Large-Scale Real-World LLM Conversation Datasetcited by 461
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- 2020A Computational Approach to Understanding Empathy Expressed in Text-Based Mental Health Supportcited by 182
- 2021MentalBERT: Publicly Available Pretrained Language Models for Mental Healthcarecited by 161
- 2023Emotionally Numb or Empathetic? Evaluating How LLMs Feel Using EmotionBenchcited by 54
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Built on by
Citing papers per year: 2024: 1; 2025: 4; 2026: 2.
7 papers.
- 2025When Can We Trust LLMs in Mental Health? Large-Scale Benchmarks for Reliable LLM Evaluationcited by 19
- 2024The Moral Turing Test: Evaluating Human-LLM Alignment in Moral Decision-Makingcited by 12
- 2025FedMentalCare: Towards Privacy-Preserving Fine-Tuned LLMs to Analyze Mental Health Status Using Federated Learning Frameworkcited by 8
- 2025The Pursuit of Empathy: Evaluating Small Language Models for PTSD Dialogue Supportcited by 6
- 2026Assessing the Quality of Mental Health Support in LLM Responses through Multi-Attribute Human Evaluationcited by 6
- 2026Assessing Risks of Large Language Models in Mental Health Support: A Framework for Automated Clinical AI Red Teamingcited by 3
- 2025Artificial Intelligence / Human Intelligence: Who Controls Whom?cited by 0
- 2026Assessing Risks of Large Language Models in Mental Health Support: A Framework for Automated Clinical AI Red Teaming23 Feb 2026
- 2026Assessing the Quality of Mental Health Support in LLM Responses through Multi-Attribute Human Evaluation26 Jan 2026
- 2025Artificial Intelligence / Human Intelligence: Who Controls Whom?3 Dec 2025
- 2025When Can We Trust LLMs in Mental Health? Large-Scale Benchmarks for Reliable LLM Evaluation21 Oct 2025
- 2025The Pursuit of Empathy: Evaluating Small Language Models for PTSD Dialogue Support21 May 2025
- 2025FedMentalCare: Towards Privacy-Preserving Fine-Tuned LLMs to Analyze Mental Health Status Using Federated Learning Framework27 Feb 2025
- 2024The Moral Turing Test: Evaluating Human-LLM Alignment in Moral Decision-Making9 Oct 2024