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Enhancing Mental Health Counseling Support in Bangladesh using Culturally-Grounded Knowledge

arXiv 2604.14576 ↗First posted 16 Apr 2026cs.AIcited by 0

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Abstract (arXiv)

Large language models (LLMs) show promise in generating supportive responses for mental health and counseling applications. However, their responses often lack cultural sensitivity, contextual grounding, and clinically appropriate guidance. This work addresses the gap of how to systematically incorporate domain-specific, clinically validated knowledge into LLMs to improve counseling quality. We utilize and compare two approaches, retrieval-augmented generation (RAG) and a knowledge graph (KG)-based method, designed to support para-counselors. Our KG is constructed manually and clinically validated, capturing causal relationships between stressors, interventions, and outcomes, with contributions from multidisciplinary people. We evaluated multiple LLMs in both settings using BERTScore F1 and SBERT cosine similarity, as well as human evaluation across five metrics, which is designed to directly measure the effectiveness of counseling beyond similarity at the surface level. The results show that KG-based approaches consistently improve contextual relevance, clinical appropriateness, and practical usability compared to RAG alone, demonstrating that structured, expert-validated knowledge plays a critical role in addressing LLMs limitations in counseling tasks.

Key facts. No citing papers in the map yet (data through 14 Oct 2026). Builds on 11 of its 33 references that are in the map. First posted on arXiv 16 Apr 2026.

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11 of 33 references.

References · 11

  1. 2023Cognitive Reframing of Negative Thoughts through Human-Language Model Interactioncited by 77
  2. 2025Expressing stigma and inappropriate responses prevents LLMs from safely replacing mental health providerscited by 69
  3. 2022PAL: Persona-Augmented Emotional Support Conversation Generationcited by 39
  4. 2025AnnaAgent: Dynamic Evolution Agent System with Multi-Session Memory for Realistic Seeker Simulationcited by 21
  5. 2023An Integrative Survey on Mental Health Conversational Agents to Bridge Computer Science and Medical Perspectivescited by 16
  6. 2024Chinese MentalBERT: Domain-Adaptive Pre-training on Social Media for Chinese Mental Health Text Analysiscited by 12
  7. 2025ProMind-LLM: Proactive Mental Health Care via Causal Reasoning with Sensor Datacited by 6
  8. 2025Does Rationale Quality Matter? Enhancing Mental Disorder Detection via Selective Reasoning Distillationcited by 6
  9. 2025A Fully Generative Motivational Interviewing Counsellor Chatbot for Moving Smokers Towards the Decision to Quitcited by 5
  10. 2025Tailored Emotional LLM-Supporter: Enhancing Cultural Sensitivitycited by 5
  11. 2024ASHABot: An LLM-Powered Chatbot to Support the Informational Needs of Community Health Workerscited by 3

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  1. 2026Guiding Language Models to Be More Empathetic: Culturally Sensitive Mental Health Advice Generation Through Human-LLM Collaboration
  2. 2024Do Large Language Models Align with Core Mental Health Counseling Competencies?
  3. 2026Assessing the Effectiveness of LLMs in Delivering Cognitive Behavioral Therapy
  4. 2023Rethinking Large Language Models in Mental Health Applications
  5. 2026CARE: Counselor-Aligned Response Engine for Online Mental-Health Support
  6. 2025Psi-Arena: Interactive Assessment and Optimization of LLM-based Psychological Counselors with Tripartite Feedback
  7. 2025Beyond Empathy: Integrating Diagnostic and Therapeutic Reasoning with Large Language Models for Mental Health Counseling
  8. 2025Psy-Insight: Explainable Multi-turn Bilingual Dataset for Mental Health Counseling