PsychEthicsBench: Evaluating Large Language Models Against Australian Mental Health Ethics
On the map: LLM alignment / RLHF / preference optimisation → Medical LLM alignment
Abstract (arXiv)
The increasing integration of large language models (LLMs) into mental health applications necessitates robust frameworks for evaluating professional safety alignment. Current evaluative approaches primarily rely on refusal-based safety signals, which offer limited insight into the nuanced behaviors required in clinical practice. In mental health, clinically inadequate refusals can be perceived as unempathetic and discourage help-seeking. To address this gap, we move beyond refusal-centric metrics and introduce textttPsychEthicsBench, the first principle-grounded benchmark based on Australian psychology and psychiatry guidelines, designed to evaluate LLMs' ethical knowledge and behavioral responses through multiple-choice and open-ended tasks with fine-grained ethicality annotations. Empirical results across 14 models reveal that refusal rates are poor indicators of ethical behavior, revealing a significant divergence between safety triggers and clinical appropriateness. Notably, we find that domain-specific fine-tuning can degrade ethical robustness, as several specialized models underperform their base backbones in ethical alignment. PsychEthicsBench provides a foundation for systematic, jurisdiction-aware evaluation of LLMs in mental health, encouraging more responsible development in this domain.
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 21 of its 53 references that are in the map. First posted on arXiv 7 Jan 2026.
Builds on
21 of 53 references.
References · 21
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- 2023Fine-tuning Aligned Language Models Compromises Safety, Even When Users Do Not Intend To!cited by 1,154
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- 2024PsycoLLM: Enhancing LLM for Psychological Understanding and Evaluationcited by 26
9 more
- 2024SweetieChat: A Strategy-Enhanced Role-playing Framework for Diverse Scenarios Handling Emotional Support Agentcited by 24
- 2025EmoAgent: Assessing and Safeguarding Human-AI Interaction for Mental Health Safetycited by 21
- 2025Crisp: Cognitive Restructuring of Negative Thoughts through Multi-turn Supportive Dialoguescited by 11
- 2024PsyGUARD: An Automated System for Suicide Detection and Risk Assessment in Psychological Counselingcited by 10
- 2025MedEthicsQA: A Comprehensive Question Answering Benchmark for Medical Ethics Evaluation of LLMscited by 8
- 2025MedFact: A Large-scale Chinese Dataset for Evidence-based Medical Fact-checking of LLM Responsescited by 6
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- 2025Can LLMs Address Mental Health Questions? A Comparison with Human Therapistscited by 4
- 2025Roleplaying with Structure: Synthetic Therapist-Client Conversation Generation from Questionnairescited by 4
Built on by
Citing papers per year: 2026: 4.
4 papers.
- 2026Do No Harm: Exposing Hidden Vulnerabilities of LLMs via Persona-based Client Simulation Attack in Psychological Counselingcited by 4
- 2026SDARE-Bench: Evaluating Large Language Models on Conversational Stigma Detection and Response in Dyadic and Group Dialoguecited by 0
- 2026SAFARI: An Industrial Benchmark for LLM-Assisted Hazard Analysis and Risk Assessmentcited by 0
- 2026DistressBench: Evaluating Multi-Dimensional Crisis Support in Large Language Modelscited by 0
- 2026DistressBench: Evaluating Multi-Dimensional Crisis Support in Large Language Models8 Oct 2026
- 2026SAFARI: An Industrial Benchmark for LLM-Assisted Hazard Analysis and Risk Assessment17 Sep 2026
- 2026SDARE-Bench: Evaluating Large Language Models on Conversational Stigma Detection and Response in Dyadic and Group Dialogue1 Sep 2026
- 2026Do No Harm: Exposing Hidden Vulnerabilities of LLMs via Persona-based Client Simulation Attack in Psychological Counseling6 Apr 2026
Similar, not cited
Close in wording, no citation either way
- 2025EthicsMH: A Pilot Benchmark for Ethical Reasoning in Mental Health AI
- 2026Toward Contemplative LLM: A Modular Framework for Evaluating and Enhancing LLM Alignment in Mental Health
- 2025Exploring Safety Alignment Evaluation of LLMs in Chinese Mental Health Dialogues via LLM-as-Judge
- 2025Independent Clinical Evaluation of General-Purpose LLM Responses to Signals of Suicide Risk
- 2026Health-ORSC-Bench: A Benchmark for Measuring Over-Refusal and Safety Completion in Health Context
- 2026One Year Later...The Harms Persist, But So Do We!
- 2024Do Large Language Models Align with Core Mental Health Counseling Competencies?
- 2026Alignment Plausibility: A New Standard for Assuring AI in Healthcare