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

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abstract

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.

fields

cs.AI 1

years

2026 1

verdicts

UNVERDICTED 1

representative citing papers

Mental Health AI Safety Claims Must Preserve Temporal Evidence

cs.AI · 2026-05-09 · unverdicted · novelty 5.0

Mental health AI safety evaluations that discard temporal sequence and accumulation produce invalid conclusions; the paper formalizes this as Temporal Safety Non-Identifiability and proposes SCOPE-MH as a reporting standard that preserves evidence.

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  • Mental Health AI Safety Claims Must Preserve Temporal Evidence cs.AI · 2026-05-09 · unverdicted · none · ref 3 · internal anchor

    Mental health AI safety evaluations that discard temporal sequence and accumulation produce invalid conclusions; the paper formalizes this as Temporal Safety Non-Identifiability and proposes SCOPE-MH as a reporting standard that preserves evidence.