Dana Atzil-Slonim

Hiba Arnaout, Anmol Goel, H. Andrew Schwartz et al.

Although artificial intelligence (AI) shows growing promise for mental health care, current approaches to evaluating AI tools in this domain remain fragmented and poorly aligned with clinical practice, social context, and first-hand user experience. This paper argues for a rethinking of responsible evaluation -- what is measured, by whom, and for what purpose -- by introducing an interdisciplinary framework that integrates clinical soundness, social context, and equity, providing a structured basis for evaluation. Through an analysis of 135 recent *CL publications, we identify recurring limitations, including over-reliance on generic metrics that do not capture clinical validity, therapeutic appropriateness, or user experience, limited participation from mental health professionals, and insufficient attention to safety and equity. To address these gaps, we propose a taxonomy of AI mental health support types -- assessment-, intervention-, and information synthesis-oriented -- each with distinct risks and evaluative requirements, and illustrate its use through case studies.

Chen Cecilia Liu, Hiba Arnaout, Nils Kovačić et al.

Large language models (LLMs) show promise in offering emotional support and generating empathetic responses for individuals in distress, but their ability to deliver culturally sensitive support remains underexplored due to lack of resources. In this work, we introduce CultureCare, the first dataset designed for this task, spanning four cultures and including 1729 distress messages, 1523 cultural signals, and 1041 support strategies with fine-grained emotional and cultural annotations. Leveraging CultureCare, we (i) develop and test four adaptation strategies for guiding three state-of-the-art LLMs toward culturally sensitive responses; (ii) conduct comprehensive evaluations using LLM judges, in-culture human annotators, and clinical psychologists; (iii) show that adapted LLMs outperform anonymous online peer responses, and that simple cultural role-play is insufficient for cultural sensitivity; and (iv) explore the application of LLMs in clinical training, where experts highlight their potential in fostering cultural competence in future therapists.