mlsanityData to 14 Oct 2026

The Slow Drift of Support: Boundary Failures in Multi-Turn Mental Health LLM Dialogues

arXiv 2601.14269 ↗First posted 2 Jan 2026cs.CL cs.AIcited by 1

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Abstract (arXiv)

Large language models (LLMs) have been widely used for mental health support. However, current safety evaluations in this field are mostly limited to detecting whether LLMs output prohibited words in single-turn conversations, neglecting the gradual erosion of safety boundaries in long dialogues. Examples include making definitive guarantees, assuming responsibility, and playing professional roles. We believe that with the evolution of mainstream LLMs, words with obvious safety risks are easily filtered by their underlying systems, while the real danger lies in the gradual transgression of boundaries during multi-turn interactions, driven by the LLM's attempts at comfort and empathy. This paper proposes a multi-turn stress testing framework and conducts long-dialogue safety tests on three cutting-edge LLMs using two pressure methods: static progression and adaptive probing. We generated 50 virtual patient profiles and stress-tested each model through up to 20 rounds of virtual psychiatric dialogues. The experimental results show that violations are common, and both pressure modes produced similar violation rates. However, adaptive probing significantly advanced the time at which models crossed boundaries, reducing the average number of turns from 9.21 in static progression to 4.64. Under both mechanisms, making definitive or zero-risk promises was the primary way in which boundaries were breached. These findings suggest that the robustness of LLM safety boundaries cannot be inferred solely through single-turn tests; it is necessary to fully consider the wear and tear on safety boundaries caused by different interaction pressures and characteristics in extended dialogues.

Key facts. Cited by 1 paper in the map (data through 14 Oct 2026). Builds on 19 of its 35 references that are in the map. First posted on arXiv 2 Jan 2026.

Builds on

19 of 35 references.

References · 19

  1. 2022Training language models to follow instructions with human feedbackcited by 15,971
  2. 2023Llama 2: Open Foundation and Fine-Tuned Chat Modelscited by 13,028
  3. 2022Constitutional AI: Harmlessness from AI Feedbackcited by 3,050
  4. 2023Jailbroken: How Does LLM Safety Training Fail?cited by 1,651
  5. 2024HarmBench: A Standardized Evaluation Framework for Automated Red Teaming and Robust Refusalcited by 1,429
  6. 2023Jailbreaking Black Box Large Language Models in Twenty Queriescited by 1,420
  7. 2023Towards Understanding Sycophancy in Language Modelscited by 1,040
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  9. 2023Whose Opinions Do Language Models Reflect?cited by 773
  10. 2022Red Teaming Language Models to Reduce Harms: Methods, Scaling Behaviors, and Lessons Learnedcited by 729
  11. 2024How Johnny Can Persuade LLMs to Jailbreak Them: Rethinking Persuasion to Challenge AI Safety by Humanizing LLMscited by 573
  12. 2023Jailbreaking ChatGPT via Prompt Engineering: An Empirical Studycited by 498
7 more
  1. 2023Toxicity in ChatGPT: Analyzing Persona-assigned Language Modelscited by 360
  2. 2023Multilingual Jailbreak Challenges in Large Language Modelscited by 240
  3. 2023Benefits and Harms of Large Language Models in Digital Mental Healthcited by 40
  4. 2025From Personas to Talks: Revisiting the Impact of Personas on LLM-Synthesized Emotional Support Conversationscited by 23
  5. 2023An Integrative Survey on Mental Health Conversational Agents to Bridge Computer Science and Medical Perspectivescited by 16
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Citing papers per year: 2026: 1.

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  1. 2025Reasoning Is Not All You Need: Examining LLMs for Multi-Turn Mental Health Conversations
  2. 2024Speak Out of Turn: Safety Vulnerability of Large Language Models in Multi-turn Dialogue
  3. 2025Independent Clinical Evaluation of General-Purpose LLM Responses to Signals of Suicide Risk
  4. 2026Retrieval-Augmented Generation in LLMs for Mental Health: Quantifying the Incremental Contribution of Retrieval Within a Layered Safety Architecture
  5. 2024CoSafe: Evaluating Large Language Model Safety in Multi-Turn Dialogue Coreference
  6. 2025Exploring Safety Alignment Evaluation of LLMs in Chinese Mental Health Dialogues via LLM-as-Judge
  7. 2026OMIND: Framework for Knowledge Grounded Finetuning and Multi-Turn Dialogue Benchmark for Mental Health LLMs
  8. 2025MindEval: Benchmarking Language Models on Multi-turn Mental Health Support