# Large Language Model for Mental Health: A Systematic Review

arXiv: https://arxiv.org/abs/2403.15401 · HTML: https://mlsanity.com/paper/2403.15401/

## Key facts

- Cited by 14 papers in the map (data through 14 Oct 2026).
- Builds on 35 of its 184 references that are in the map.
- First posted on arXiv 19 Feb 2024.

## Builds on (most cited first, 30 of 35)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [RoBERTa: A Robustly Optimized BERT Pretraining Approach](https://mlsanity.com/paper/1907.11692/) (2019)
- [DistilBERT, a distilled version of BERT: smaller, faster, cheaper and lighter](https://mlsanity.com/paper/1910.01108/) (2019)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [A Survey on Hallucination in Large Language Models: Principles, Taxonomy, Challenges, and Open Questions](https://mlsanity.com/paper/2311.05232/) (2023)
- [A Primer in BERTology: What we know about how BERT works](https://mlsanity.com/paper/2002.12327/) (2020)
- [Cross-Task Generalization via Natural Language Crowdsourcing Instructions](https://mlsanity.com/paper/2104.08773/) (2021)
- [Instruction Tuning for Large Language Models: A Survey](https://mlsanity.com/paper/2308.10792/) (2023)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [Universal Sentence Encoder](https://mlsanity.com/paper/1803.11175/) (2018)
- [A Survey on Large Language Model (LLM) Security and Privacy: The Good, the Bad, and the Ugly](https://mlsanity.com/paper/2312.02003/) (2023)
- [Towards Emotional Support Dialog Systems](https://mlsanity.com/paper/2106.01144/) (2021)
- [ARBERT & MARBERT: Deep Bidirectional Transformers for Arabic](https://mlsanity.com/paper/2101.01785/) (2020)
- [Self-contradictory Hallucinations of Large Language Models: Evaluation, Detection and Mitigation](https://mlsanity.com/paper/2305.15852/) (2023)
- [PsyQA: A Chinese Dataset for Generating Long Counseling Text for Mental Health Support](https://mlsanity.com/paper/2106.01702/) (2021)
- [AugESC: Dialogue Augmentation with Large Language Models for Emotional Support Conversation](https://mlsanity.com/paper/2202.13047/) (2022)
- [Understanding the Benefits and Challenges of Using Large Language Model-based Conversational Agents for Mental Well-being Support](https://mlsanity.com/paper/2307.15810/) (2023)
- [Evaluation of ChatGPT for NLP-based Mental Health Applications](https://mlsanity.com/paper/2303.15727/) (2023)
- [Towards Interpretable Mental Health Analysis with Large Language Models](https://mlsanity.com/paper/2304.03347/) (2023)
- [Leveraging Large Language Models to Power Chatbots for Collecting User Self-Reported Data](https://mlsanity.com/paper/2301.05843/) (2023)
- [SMILE: Single-turn to Multi-turn Inclusive Language Expansion via ChatGPT for Mental Health Support](https://mlsanity.com/paper/2305.00450/) (2023)
- [Psy-LLM: Scaling up Global Mental Health Psychological Services with AI-based Large Language Models](https://mlsanity.com/paper/2307.11991/) (2023)
- [CAMS: An Annotated Corpus for Causal Analysis of Mental Health Issues in Social Media Posts](https://mlsanity.com/paper/2207.04674/) (2022)
- [LLM-empowered Chatbots for Psychiatrist and Patient Simulation: Application and Evaluation](https://mlsanity.com/paper/2305.13614/) (2023)
- [Large Language Models in Mental Health Care: a Scoping Review](https://mlsanity.com/paper/2401.02984/) (2024)
- [Efficient Fine-Tuning of BERT Models on the Edge](https://mlsanity.com/paper/2205.01541/) (2022)
- [Suicidal Ideation and Mental Disorder Detection with Attentive Relation Networks](https://mlsanity.com/paper/2004.07601/) (2020)
- [Exploring The Design of Prompts For Applying GPT-3 based Chatbots: A Mental Wellbeing Case Study on Mechanical Turk](https://mlsanity.com/paper/2209.11344/) (2022)
- [Towards Healthy AI: Large Language Models Need Therapists Too](https://mlsanity.com/paper/2304.00416/) (2023)

## Built on by (most cited first, 14 of 14)

- [Building Trust in Mental Health Chatbots: Safety Metrics and LLM-Based Evaluation Tools](https://mlsanity.com/paper/2408.04650/) (2024)
- [Advancing Depression Detection on Social Media Platforms Through Fine-Tuned Large Language Models](https://mlsanity.com/paper/2409.14794/) (2024)
- [Copiloting Diagnosis of Autism in Real Clinical Scenarios via LLMs](https://mlsanity.com/paper/2410.05684/) (2024)
- [Pet-Bench: Benchmarking the Abilities of Large Language Models as E-Pets in Social Network Services](https://mlsanity.com/paper/2506.03761/) (2025)
- [H2HTalk: Evaluating Large Language Models as Emotional Companion](https://mlsanity.com/paper/2507.03543/) (2025)
- [Evaluating the Effectiveness of the Foundational Models for Q&A Classification in Mental Health care](https://mlsanity.com/paper/2406.15966/) (2024)
- [The use of GPT-4o and Other Large Language Models for the Improvement and Design of Self-Assessment Scales for Measurement of Interpersonal Communication Skills](https://mlsanity.com/paper/2409.14050/) (2024)
- [AI-Augmented LLMs Achieve Therapist-Level Responses in Motivational Interviewing](https://mlsanity.com/paper/2505.17380/) (2025)
- [A Confidence-Diversity Framework for Calibrating AI Judgement in Accessible Qualitative Coding Tasks](https://mlsanity.com/paper/2508.02029/) (2025)
- [Understanding Student Sentiment on Mental Health Support in Colleges Using Large Language Models](https://mlsanity.com/paper/2412.04326/) (2024)
- [When LLM Therapists Become Salespeople: Evaluating Large Language Models for Ethical Motivational Interviewing](https://mlsanity.com/paper/2503.23566/) (2025)
- [Artificial Empathy: AI based Mental Health](https://mlsanity.com/paper/2506.00081/) (2025)
- [Context-Emotion Aware Therapeutic Dialogue Generation: A Multi-component Reinforcement Learning Approach to Language Models for Mental Health Support](https://mlsanity.com/paper/2511.11884/) (2025)
- [Generative Confidants: How do People Experience Trust in Emotional Support from Generative AI?](https://mlsanity.com/paper/2601.16656/) (2026)

## Abstract (arXiv)

Large language models (LLMs) have attracted significant attention for potential applications in digital health, while their application in mental health is subject to ongoing debate. This systematic review aims to evaluate the usage of LLMs in mental health, focusing on their strengths and limitations in early screening, digital interventions, and clinical applications. Adhering to PRISMA guidelines, we searched PubMed, IEEE Xplore, Scopus, JMIR, and ACM using keywords: 'mental health OR mental illness OR mental disorder OR psychiatry' AND 'large language models'. We included articles published between January 1, 2017, and April 30, 2024, excluding non-English articles. 30 articles were evaluated, which included research on mental health conditions and suicidal ideation detection through text (n=15), usage of LLMs for mental health conversational agents (CAs) (n=7), and other applications and evaluations of LLMs in mental health (n=18). LLMs exhibit substantial effectiveness in detecting mental health issues and providing accessible, de-stigmatized eHealth services. However, the current risks associated with the clinical use might surpass their benefits. The study identifies several significant issues: the lack of multilingual datasets annotated by experts, concerns about the accuracy and reliability of the content generated, challenges in interpretability due to the 'black box' nature of LLMs, and persistent ethical dilemmas. These include the lack of a clear ethical framework, concerns about data privacy, and the potential for over-reliance on LLMs by both therapists and patients, which could compromise traditional medical practice. Despite these issues, the rapid development of LLMs underscores their potential as new clinical aids, emphasizing the need for continued research and development in this area.