Jihyun An

Daeun Lee, Dongje Yoo, Migyeong Yang et al.

Mental health remains a major public health concern, while access to timely psychological support is often limited. AI-based dialogue systems have emerged as promising tools to address these barriers, and recent advances in large language models (LLMs) have significantly transformed this research area. However, a systematic understanding of this technological transition is still limited. This study reviews the technological evolution of AI-driven dialogue systems for mental health, focusing on the shift from task-specific deep learning models to LLM-based approaches. We conducted a bibliometric analysis and qualitative trend review of studies published between 2020 and May 2024 using Web of Science, Scopus, and the ACM Digital Library. The qualitative analysis compared research conducted before and after the widespread adoption of LLMs. Pre-LLM research was represented by highly cited studies and work based on the ESConv dataset, while post-LLM research included highly cited dialogue systems built on LLMs. A total of 146 studies met the inclusion criteria, showing a steady growth in publications over time. Before the widespread use of LLMs, empathetic response generation mainly relied on task-specific deep learning models. Highly cited and ESConv-based studies commonly focused on multi-task learning and the integration of external knowledge. In contrast, recent LLM-based dialogue systems demonstrate improved linguistic flexibility and generalization for emotional support. However, these systems also raise concerns related to reliability and safety in mental health applications. This review highlights the technological transition of AI-based dialogue systems for mental health in the LLM era. By identifying current research trends and limitations, the findings provide guidance for developing more effective and reliable AI-driven counseling systems.

Hoyun Song, Migyeong Kang, Jisu Shin et al.

We introduce MentalBench, a benchmark for evaluating psychiatric diagnostic decision-making in large language models (LLMs). Existing mental health benchmarks largely rely on social media data, limiting their ability to assess DSM-grounded diagnostic judgments. At the core of MentalBench is MentalKG, a psychiatrist-built and validated knowledge graph encoding DSM-5 diagnostic criteria and differential diagnostic rules for 23 psychiatric disorders. Using MentalKG as a golden-standard logical backbone, we generate 24,750 synthetic clinical cases that systematically vary in information completeness and diagnostic complexity, enabling low-noise and interpretable evaluation. Our experiments show that while state-of-the-art LLMs perform well on structured queries probing DSM-5 knowledge, they struggle to calibrate confidence in diagnostic decision-making when distinguishing between clinically overlapping disorders. These findings reveal evaluation gaps not captured by existing benchmarks.