Exploring Safety Alignment Evaluation of LLMs in Chinese Mental Health Dialogues via LLM-as-Judge
On the map: LLM alignment / RLHF / preference optimisation → Medical LLM alignment
Abstract (arXiv)
Evaluating the safety alignment of LLM responses in high-risk mental health dialogues is particularly difficult due to missing gold-standard answers and the ethically sensitive nature of these interactions. To address this challenge, we propose PsyCrisis-Bench, a reference-free evaluation benchmark based on real-world Chinese mental health dialogues. It evaluates whether the model responses align with the safety principles defined by experts. Specifically designed for settings without standard references, our method adopts a prompt-based LLM-as-Judge approach that conducts in-context evaluation using expert-defined reasoning chains grounded in psychological intervention principles. We employ binary point-wise scoring across multiple safety dimensions to enhance the explainability and traceability of the evaluation. Additionally, we present a manually curated, high-quality Chinese-language dataset covering self-harm, suicidal ideation, and existential distress, derived from real-world online discourse. Experiments on 3600 judgments show that our method achieves the highest agreement with expert assessments and produces more interpretable evaluation rationales compared to existing approaches. Our dataset and evaluation tool are publicly available to facilitate further research.
Key facts. Cited by 4 papers in the map (data through 14 Oct 2026). Placed in Medical LLM alignment, one of 10 directions in LLM alignment / RLHF / preference optimisation. Builds on 19 of its 47 references that are in the map. First posted on arXiv 11 Aug 2025.
Builds on
19 of 47 references.
References · 19
- 2023Judging LLM-as-a-Judge with MT-Bench and Chatbot Arenacited by 8,626
- 2024Length-Controlled AlpacaEval: A Simple Way to Debias Automatic Evaluatorscited by 897
- 2023BeaverTails: Towards Improved Safety Alignment of LLM via a Human-Preference Datasetcited by 860
- 2025HealthBench: Evaluating Large Language Models Towards Improved Human Healthcited by 429
- 2024Humans or LLMs as the Judge? A Study on Judgement Biasescited by 323
- 2024Judging the Judges: Evaluating Alignment and Vulnerabilities in LLMs-as-Judgescited by 205
- 2023SoulChat: Improving LLMs' Empathy, Listening, and Comfort Abilities through Fine-tuning with Multi-turn Empathy Conversationscited by 110
- 2021PsyQA: A Chinese Dataset for Generating Long Counseling Text for Mental Health Supportcited by 92
- 2024CPsyCoun: A Report-based Multi-turn Dialogue Reconstruction and Evaluation Framework for Chinese Psychological Counselingcited by 89
- 2022Out of the BLEU: how should we assess quality of the Code Generation models?cited by 65
- 2024HealMe: Harnessing Cognitive Reframing in Large Language Models for Psychotherapycited by 47
- 2025EmoAgent: Assessing and Safeguarding Human-AI Interaction for Mental Health Safetycited by 21
7 more
- 2023PsyEval: A Suite of Mental Health Related Tasks for Evaluating Large Language Modelscited by 13
- 2023Supervised Learning and Large Language Model Benchmarks on Mental Health Datasets: Cognitive Distortions and Suicidal Risks in Chinese Social Mediacited by 9
- 2025MoodAngels: A Retrieval-augmented Multi-agent Framework for Psychiatry Diagnosiscited by 6
- 2024A Framework for Evaluating Appropriateness, Trustworthiness, and Safety in Mental Wellness AI Chatbotscited by 5
- 2024Unlocking LLMs: Addressing Scarce Data and Bias Challenges in Mental Healthcited by 5
- 2025PsychBench: A comprehensive and professional benchmark for evaluating the performance of LLM-assisted psychiatric clinical practicecited by 5
- 2025Evaluating Large Language Models in Crisis Detection: A Real-World Benchmark from Psychological Support Hotlinescited by 3
Built on by
Citing papers per year: 2026: 4.
4 papers.
- 2026The Supportiveness-Safety Tradeoff in LLM Well-Being Agentscited by 0
- 2026Towards Understanding and Measuring COGNITIVE ATROPHY in LLM Behaviourcited by 0
- 2026Move by Move: Measuring and Steering How LLMs Conduct Psychotherapycited by 0
- 2026From Pattern Recognizers to Personalized Companions: A Survey of Large Language Models in Mental Healthcited by 0
- 2026From Pattern Recognizers to Personalized Companions: A Survey of Large Language Models in Mental Health21 Sep 2026
- 2026Move by Move: Measuring and Steering How LLMs Conduct Psychotherapy21 Aug 2026
- 2026Towards Understanding and Measuring COGNITIVE ATROPHY in LLM Behaviour16 Jun 2026
- 2026The Supportiveness-Safety Tradeoff in LLM Well-Being Agents4 Feb 2026
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- 2026PsychEthicsBench: Evaluating Large Language Models Against Australian Mental Health Ethics
- 2024Building Trust in Mental Health Chatbots: Safety Metrics and LLM-Based Evaluation Tools
- 2026The Slow Drift of Support: Boundary Failures in Multi-Turn Mental Health LLM Dialogues
- 2025Evaluating Reasoning LLMs for Suicide Screening with the Columbia-Suicide Severity Rating Scale
- 2026Analyzing LLM Reasoning to Uncover Mental Health Stigma
- 2026One Year Later...The Harms Persist, But So Do We!
- 2025MiraMind: Benchmarking Reliable Mental Health Reasoning beyond Answer Accuracy