{"paper":{"title":"Engagement-Optimized Care: When LLMs become Mental Health Infrastructure","license":"http://creativecommons.org/licenses/by/4.0/","headline":"","cross_cats":["cs.HC"],"primary_cat":"cs.CY","authors_text":"Briana Vecchione, Livia Garofalo, Meryl Ye, Ranjit Singh","submitted_at":"2026-05-22T15:50:26Z","abstract_excerpt":"General-purpose LLMs are increasingly functioning as mental health infrastructure due to gaps in care left by provider shortages, inadequate insurance coverage, social isolation, and stigma around formal help-seeking. This shift poses a distinct problem for AI ethics: systems neither designed nor governed as care technologies are being used as such, while their dominant design incentives optimize for engagement rather than user well-being. We present findings from a qualitative, longitudinal study with 18 US-based participants who use general-purpose LLMs for socioemotional support and partici"},"claims":{"count":0,"items":[],"snapshot_sha256":"258153158e38e3291e3d48162225fcdb2d5a3ed65a07baac614ab91432fd4f57"},"source":{"id":"2605.23787","kind":"arxiv","version":1},"verdict":{"id":null,"model_set":{},"created_at":null,"strongest_claim":"","one_line_summary":"","pipeline_version":null,"weakest_assumption":"","pith_extraction_headline":""},"integrity":{"clean":true,"summary":{"advisory":0,"critical":0,"by_detector":{},"informational":0},"endpoint":"/pith/2605.23787/integrity.json","findings":[],"available":true,"detectors_run":[],"snapshot_sha256":"c28c3603d3b5d939e8dc4c7e95fa8dfce3d595e45f758748cecf8e644a296938"},"references":{"count":0,"sample":[],"resolved_work":0,"snapshot_sha256":"258153158e38e3291e3d48162225fcdb2d5a3ed65a07baac614ab91432fd4f57","internal_anchors":0},"formal_canon":{"evidence_count":0,"snapshot_sha256":"258153158e38e3291e3d48162225fcdb2d5a3ed65a07baac614ab91432fd4f57"},"author_claims":{"count":0,"strong_count":0,"snapshot_sha256":"258153158e38e3291e3d48162225fcdb2d5a3ed65a07baac614ab91432fd4f57"},"builder_version":"pith-number-builder-2026-05-17-v1"}