Nina Vasan

Kiana Jafari, Paul Ulrich Nikolaus Rust, Duncan Eddy et al.

Learning from human feedback~(LHF) assumes that expert judgments, appropriately aggregated, yield valid ground truth for training and evaluating AI systems. We tested this assumption in mental health, where high safety stakes make expert consensus essential. Three certified psychiatrists independently evaluated LLM-generated responses using a calibrated rubric. Despite similar training and shared instructions, inter-rater reliability was consistently poor ($ICC$ $0.087$--$0.295$), falling below thresholds considered acceptable for consequential assessment. Disagreement was highest on the most safety-critical items. Suicide and self-harm responses produced greater divergence than any other category, and was systematic rather than random. One factor yielded negative reliability (Krippendorff's $α= -0.203$), indicating structured disagreement worse than chance. Qualitative interviews revealed that disagreement reflects coherent but incompatible individual clinical frameworks, safety-first, engagement-centered, and culturally-informed orientations, rather than measurement error. By demonstrating that experts rely on holistic risk heuristics rather than granular factor discrimination, these findings suggest that aggregated labels function as arithmetic compromises that effectively erase grounded professional philosophies. Our results characterize expert disagreement in safety-critical AI as a sociotechnical phenomenon where professional experience introduces sophisticated layers of principled divergence. We discuss implications for reward modeling, safety classification, and evaluation benchmarks, recommending that practitioners shift from consensus-based aggregation to alignment methods that preserve and learn from expert disagreement.

Declan Grabb, Max Lamparth, Nina Vasan · stanford

Amidst the growing interest in developing task-autonomous AI for automated mental health care, this paper addresses the ethical and practical challenges associated with the issue and proposes a structured framework that delineates levels of autonomy, outlines ethical requirements, and defines beneficial default behaviors for AI agents in the context of mental health support. We also evaluate fourteen state-of-the-art language models (ten off-the-shelf, four fine-tuned) using 16 mental health-related questionnaires designed to reflect various mental health conditions, such as psychosis, mania, depression, suicidal thoughts, and homicidal tendencies. The questionnaire design and response evaluations were conducted by mental health clinicians (M.D.s). We find that existing language models are insufficient to match the standard provided by human professionals who can navigate nuances and appreciate context. This is due to a range of issues, including overly cautious or sycophantic responses and the absence of necessary safeguards. Alarmingly, we find that most of the tested models could cause harm if accessed in mental health emergencies, failing to protect users and potentially exacerbating existing symptoms. We explore solutions to enhance the safety of current models. Before the release of increasingly task-autonomous AI systems in mental health, it is crucial to ensure that these models can reliably detect and manage symptoms of common psychiatric disorders to prevent harm to users. This involves aligning with the ethical framework and default behaviors outlined in our study. We contend that model developers are responsible for refining their systems per these guidelines to safeguard against the risks posed by current AI technologies to user mental health and safety. Trigger warning: Contains and discusses examples of sensitive mental health topics, including suicide and self-harm.

Shaona Ghosh, Heather Frase, Adina Williams et al. · deepmind, stanford

The rapid advancement and deployment of AI systems have created an urgent need for standard safety-evaluation frameworks. This paper introduces AILuminate v1.0, the first comprehensive industry-standard benchmark for assessing AI-product risk and reliability. Its development employed an open process that included participants from multiple fields. The benchmark evaluates an AI system's resistance to prompts designed to elicit dangerous, illegal, or undesirable behavior in 12 hazard categories, including violent crimes, nonviolent crimes, sex-related crimes, child sexual exploitation, indiscriminate weapons, suicide and self-harm, intellectual property, privacy, defamation, hate, sexual content, and specialized advice (election, financial, health, legal). Our method incorporates a complete assessment standard, extensive prompt datasets, a novel evaluation framework, a grading and reporting system, and the technical as well as organizational infrastructure for long-term support and evolution. In particular, the benchmark employs an understandable five-tier grading scale (Poor to Excellent) and incorporates an innovative entropy-based system-response evaluation. In addition to unveiling the benchmark, this report also identifies limitations of our method and of building safety benchmarks generally, including evaluator uncertainty and the constraints of single-turn interactions. This work represents a crucial step toward establishing global standards for AI risk and reliability evaluation while acknowledging the need for continued development in areas such as multiturn interactions, multimodal understanding, coverage of additional languages, and emerging hazard categories. Our findings provide valuable insights for model developers, system integrators, and policymakers working to promote safer AI deployment.

Max Lamparth, Declan Grabb, Amy Franks et al. · stanford

Current medical language model (LM) benchmarks often over-simplify the complexities of day-to-day clinical practice tasks and instead rely on evaluating LMs on multiple-choice board exam questions. Thus, we present an expert-created and annotated dataset spanning five critical domains of decision-making in mental healthcare: treatment, diagnosis, documentation, monitoring, and triage. This dataset - created without any LM assistance - is designed to capture the nuanced clinical reasoning and daily ambiguities mental health practitioners encounter, reflecting the inherent complexities of care delivery that are missing from existing datasets. Almost all 203 base questions with five answer options each have had the decision-irrelevant demographic patient information removed and replaced with variables (e.g., AGE), and are available for male, female, or non-binary-coded patients. For question categories dealing with ambiguity and multiple valid answer options, we create a preference dataset with uncertainties from the expert annotations. We outline a series of intended use cases and demonstrate the usability of our dataset by evaluating eleven off-the-shelf and four mental health fine-tuned LMs on category-specific task accuracy, on the impact of patient demographic information on decision-making, and how consistently free-form responses deviate from human annotated samples.