# Mental Health Equity in LLMs: Leveraging Multi-Hop Question Answering to Detect Amplified and Silenced Perspectives

arXiv: https://arxiv.org/abs/2506.18116 · HTML: https://mlsanity.com/paper/2506.18116/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 11 of its 39 references that are in the map.
- First posted on arXiv 22 Jun 2025.

## Builds on (most cited first, 11 of 11)

- [RULER: What's the Real Context Size of Your Long-Context Language Models?](https://mlsanity.com/paper/2404.06654/) (2024)
- [BBQ: A Hand-Built Bias Benchmark for Question Answering](https://mlsanity.com/paper/2110.08193/) (2021)
- [Bias and Fairness in Large Language Models: A Survey](https://mlsanity.com/paper/2309.00770/) (2023)
- [Dreaddit: A Reddit Dataset for Stress Analysis in Social Media](https://mlsanity.com/paper/1911.00133/) (2019)
- [The opportunities and risks of large language models in mental health](https://mlsanity.com/paper/2403.14814/) (2024)
- [Bias Against 93 Stigmatized Groups in Masked Language Models and Downstream Sentiment Classification Tasks](https://mlsanity.com/paper/2306.05550/) (2023)
- [Dated Data: Tracing Knowledge Cutoffs in Large Language Models](https://mlsanity.com/paper/2403.12958/) (2024)
- [Decoding Biases: Automated Methods and LLM Judges for Gender Bias Detection in Language Models](https://mlsanity.com/paper/2408.03907/) (2024)
- [Building Trustworthy NeuroSymbolic AI Systems: Consistency, Reliability, Explainability, and Safety](https://mlsanity.com/paper/2312.06798/) (2023)
- [WellDunn: On the Robustness and Explainability of Language Models and Large Language Models in Identifying Wellness Dimensions](https://mlsanity.com/paper/2406.12058/) (2024)
- [Unveiling and Mitigating Bias in Mental Health Analysis with Large Language Models](https://mlsanity.com/paper/2406.12033/) (2024)

## Built on by (most cited first, 3 of 3)

- [FedMentor: Domain-Aware Differential Privacy for Heterogeneous Federated LLMs in Mental Health](https://mlsanity.com/paper/2509.14275/) (2025)
- [Intersectional Fairness in Large Language Models](https://mlsanity.com/paper/2604.20677/) (2026)
- [From Pattern Recognizers to Personalized Companions: A Survey of Large Language Models in Mental Health](https://mlsanity.com/paper/2609.25186/) (2026)

## Abstract (arXiv)

Large Language Models (LLMs) in mental healthcare risk propagating biases that reinforce stigma and harm marginalized groups. While previous research identified concerning trends, systematic methods for detecting intersectional biases remain limited. This work introduces a multi-hop question answering (MHQA) framework to explore LLM response biases in mental health discourse. We analyze content from the Interpretable Mental Health Instruction (IMHI) dataset across symptom presentation, coping mechanisms, and treatment approaches. Using systematic tagging across age, race, gender, and socioeconomic status, we investigate bias patterns at demographic intersections. We evaluate four LLMs: Claude 3.5 Sonnet, Jamba 1.6, Gemma 3, and Llama 4, revealing systematic disparities across sentiment, demographics, and mental health conditions. Our MHQA approach demonstrates superior detection compared to conventional methods, identifying amplification points where biases magnify through sequential reasoning. We implement two debiasing techniques: Roleplay Simulation and Explicit Bias Reduction, achieving 66-94% bias reductions through few-shot prompting with BBQ dataset examples. These findings highlight critical areas where LLMs reproduce mental healthcare biases, providing actionable insights for equitable AI development.