Adam C. Frank

Yahan Li, Chaohao Du, Zeyang Li et al.

Mental-health support is increasingly mediated by conversational systems (e.g., LLM-based tools), but users often lack structured ways to audit the quality and potential risks of the support they receive. We introduce CounselReflect, an end-to-end toolkit for auditing mental-health support dialogues. Rather than producing a single opaque quality score, CounselReflect provides structured, multi-dimensional reports with session-level summaries, turn-level scores, and evidence-linked excerpts to support transparent inspection. The system integrates two families of evaluation signals: (i) 12 model-based metrics produced by task-specific predictors, and (ii) rubric-based metrics that extend coverage via a literature-derived library (69 metrics) and user-defined custom metrics, operationalized with configurable LLM judges. CounselReflect is available as a web application, browser extension, and command-line interface (CLI), enabling use in real-time settings as well as at scale. Human evaluation includes a user study with 20 participants and an expert review with 6 mental-health professionals, suggesting that CounselReflect supports understandable, usable, and trustworthy auditing. A demo video and full source code are also provided.

Yahan Li, Jifan Yao, John Bosco S. Bunyi et al.

Medical question answering (QA) benchmarks often focus on multiple-choice or fact-based tasks, leaving open-ended answers to real patient questions underexplored. This gap is particularly critical in mental health, where patient questions often mix symptoms, treatment concerns, and emotional needs, requiring answers that balance clinical caution with contextual sensitivity. We present CounselBench, a large-scale benchmark developed with 100 mental health professionals to evaluate and stress-test large language models (LLMs) in realistic help-seeking scenarios. The first component, CounselBench-EVAL, contains 2,000 expert evaluations of answers from GPT-4, LLaMA 3, Gemini, and human therapists on patient questions from the public forum CounselChat. Each answer is rated across six clinically grounded dimensions, with span-level annotations and written rationales. Expert evaluations show that while LLMs achieve high scores on several dimensions, they also exhibit recurring issues, including unconstructive feedback, overgeneralization, and limited personalization or relevance. Responses were frequently flagged for safety risks, most notably unauthorized medical advice. Follow-up experiments show that LLM judges systematically overrate model responses and overlook safety concerns identified by human experts. To probe failure modes more directly, we construct CounselBench-Adv, an adversarial dataset of 120 expert-authored mental health questions designed to trigger specific model issues. Evaluation of 3,240 responses from nine LLMs reveals consistent, model-specific failure patterns. Together, CounselBench establishes a clinically grounded framework for benchmarking LLMs in mental health QA.