mlsanityData to 14 Oct 2026

MHSafeEval: Role-Aware Interaction-Level Evaluation of Mental Health Safety in Large Language Models

arXiv 2604.17730 ↗First posted 20 Apr 2026cs.CL cs.AI cs.HCcited by 3

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Abstract (arXiv)

Large language models (LLMs) are increasingly explored as scalable tools for mental health counseling, yet evaluating their safety remains challenging due to the interactional and context-dependent nature of clinical harm. Existing evaluation frameworks predominantly assess isolated responses using coarse-grained taxonomies or static datasets, limiting their ability to diagnose how harms emerge and accumulate over multi-turn counseling interactions. In this work, we introduce R-MHSafe, a role-aware mental health safety taxonomy that characterizes clinically significant harm in terms of the interactional roles an AI counselor adopts, including perpetrator, instigator, facilitator, or enabler, combined with clinically grounded harm categories. Then, we propose MHSafeEval, a closed-loop, agent-based evaluation framework that formulates safety assessment as trajectory-level discovery of harm through adversarial multi-turn interactions, guided by role-aware modeling. Using R-MHSafe and MHSafeEval, we conduct a large-scale evaluation across state-of-the-art LLMs. Our results reveal substantial role-dependent and cumulative safety failures that are systematically missed by existing static benchmarks, and show that our framework significantly improves failure-mode coverage and diagnostic granularity.

Key facts. Cited by 3 papers in the map (data through 14 Oct 2026). Builds on 37 of its 71 references that are in the map. First posted on arXiv 20 Apr 2026.

Builds on

37 of 71 references.

References · 37

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25 more
  1. 2023Mental-LLM: Leveraging Large Language Models for Mental Health Prediction via Online Text Datacited by 66
  2. 2024The Dark Side of AI Companionship: A Taxonomy of Harmful Algorithmic Behaviors in Human-AI Relationshipscited by 62
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  20. 2025MindEval: Benchmarking Language Models on Multi-turn Mental Health Supportcited by 10
  21. 2024MindGuard: Towards Accessible and Sitgma-free Mental Health First Aid via Edge LLMcited by 7
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  23. 2024A Framework for Evaluating Appropriateness, Trustworthiness, and Safety in Mental Wellness AI Chatbotscited by 5
  24. 2024Can a large language model be a gaslighter?cited by 5
  25. 2025A Risk Ontology for Evaluating AI-Powered Psychotherapy Virtual Agentscited by 5

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Cited by year (2026 to 14 Oct)

Citing papers per year: 2026: 3.

3 papers.