Ratna Kandala

Srimonti Dutta, Ratna Kandala

The safety of mental health AI is often judged at the wrong temporal scale. Current evaluations typically score isolated responses, endpoint outcomes, or aggregate dialogue quality, while clinically consequential failures may arise from the order and accumulation of interactions themselves, including delayed escalation, repeated reinforcement, dependency formation, failed repair, and gradual deterioration across turns. This paper argues that this mismatch is not merely a limitation of evaluation coverage but a source of invalid safety conclusions. We introduce Temporal Safety Non-Identifiability, a formal account of why safety properties that depend on sequence, timing, accumulation, or recovery cannot be certified by protocols that discard those features. From this formalization, we develop SCOPE (Safety Claims Over Preserved Evidence) as a general principle for aligning safety claims with the evidence an evaluation actually retains, and instantiate it as SCOPE-MH, a mental-health instantiation of this reporting standard. We operationalize SCOPE-MH through a proof-of-concept on the AnnoMI dataset of expert-annotated motivational interviewing conversations, which reveals mechanisms of failure that per-turn behavior scoring does not represent. We propose SCOPE-MH as a diagnostic complement to existing evaluation infrastructure and argue that evaluation preserving temporal evidence is necessary, not optional, for safety-critical mental health AI deployment.

Ratna Kandala, Akshata Kishore Moharir, Divya Arvinda Nayak

Explainable Artificial Intelligence (XAI) has been presented as the critical component for unlocking the potential of machine learning in mental health screening (MHS). However, a persistent lab-to-clinic gap remains. Current XAI techniques, such as SHAP and LIME, excel at producing technically faithful outputs such as feature importance scores, but fail to deliver clinically relevant, actionable insights that can be used by clinicians or understood by patients. This disconnect between technical transparency and human utility is the primary barrier to real-world adoption. This paper argues that this gap is a translation problem and proposes the Generative Operational Framework, a novel system architecture that leverages Large Language Models (LLMs) as a central translation engine. This framework is designed to ingest the raw, technical outputs from diverse XAI tools and synthesize them with clinical guidelines (via RAG) to automatically generate human-readable, evidence-backed clinical narratives. To justify our solution, we provide a systematic analysis of the components it integrates, tracing the evolution from intrinsic models to generative XAI. We demonstrate how this framework directly addresses key operational barriers, including workflow integration, bias mitigation, and stakeholder-specific communication. This paper also provides a strategic roadmap for moving the field beyond the generation of isolated data points toward the delivery of integrated, actionable, and trustworthy AI in clinical practice.