{"id":"https://openalex.org/W7131409346","doi":"https://doi.org/10.48550/arxiv.2602.19948","title":"Assessing Risks of Large Language Models in Mental Health Support: A Framework for Automated Clinical AI Red Teaming","display_name":"Assessing Risks of Large Language Models in Mental Health Support: A Framework for Automated Clinical AI Red Teaming","publication_year":2026,"publication_date":"2026-02-23","ids":{"openalex":"https://openalex.org/W7131409346","doi":"https://doi.org/10.48550/arxiv.2602.19948"},"language":null,"primary_location":{"id":"doi:10.48550/arxiv.2602.19948","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2602.19948","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article"},"type":"preprint","indexed_in":["datacite"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.48550/arxiv.2602.19948","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5040270827","display_name":"Ian Steenstra","orcid":"https://orcid.org/0000-0002-2514-3302"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Steenstra, Ian","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5020380792","display_name":"Paola Pedrelli","orcid":"https://orcid.org/0000-0002-2865-2583"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Pedrelli, Paola","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5089522357","display_name":"Weiyan Shi","orcid":"https://orcid.org/0000-0003-0850-5831"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Shi, Weiyan","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5058433199","display_name":"Stacy Marsella","orcid":"https://orcid.org/0000-0002-5711-7934"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Marsella, Stacy","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5005469838","display_name":"Timothy Bickmore","orcid":"https://orcid.org/0000-0002-2676-9788"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Bickmore, Timothy W.","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":5,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11519","display_name":"Digital Mental Health Interventions","score":0.6230000257492065,"subfield":{"id":"https://openalex.org/subfields/3202","display_name":"Applied Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T11519","display_name":"Digital Mental Health Interventions","score":0.6230000257492065,"subfield":{"id":"https://openalex.org/subfields/3202","display_name":"Applied Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12488","display_name":"Mental Health via Writing","score":0.17170000076293945,"subfield":{"id":"https://openalex.org/subfields/3207","display_name":"Social Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.09769999980926514,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/mental-health","display_name":"Mental health","score":0.663100004196167},{"id":"https://openalex.org/keywords/audit","display_name":"Audit","score":0.5580999851226807},{"id":"https://openalex.org/keywords/patient-safety","display_name":"Patient safety","score":0.47189998626708984},{"id":"https://openalex.org/keywords/dashboard","display_name":"Dashboard","score":0.453000009059906},{"id":"https://openalex.org/keywords/quality","display_name":"Quality (philosophy)","score":0.4392000138759613},{"id":"https://openalex.org/keywords/session","display_name":"Session (web analytics)","score":0.40540000796318054},{"id":"https://openalex.org/keywords/occupational-safety-and-health","display_name":"Occupational safety and health","score":0.39070001244544983},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.3837999999523163},{"id":"https://openalex.org/keywords/poison-control","display_name":"Poison control","score":0.37049999833106995}],"concepts":[{"id":"https://openalex.org/C134362201","wikidata":"https://www.wikidata.org/wiki/Q317309","display_name":"Mental health","level":2,"score":0.663100004196167},{"id":"https://openalex.org/C199521495","wikidata":"https://www.wikidata.org/wiki/Q181487","display_name":"Audit","level":2,"score":0.5580999851226807},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.47189998626708984},{"id":"https://openalex.org/C33499554","wikidata":"https://www.wikidata.org/wiki/Q1417134","display_name":"Dashboard","level":2,"score":0.453000009059906},{"id":"https://openalex.org/C2779530757","wikidata":"https://www.wikidata.org/wiki/Q1207505","display_name":"Quality (philosophy)","level":2,"score":0.4392000138759613},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.41839998960494995},{"id":"https://openalex.org/C2779182362","wikidata":"https://www.wikidata.org/wiki/Q17126187","display_name":"Session (web analytics)","level":2,"score":0.40540000796318054},{"id":"https://openalex.org/C187155963","wikidata":"https://www.wikidata.org/wiki/Q629029","display_name":"Occupational safety and health","level":2,"score":0.39070001244544983},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.3837999999523163},{"id":"https://openalex.org/C75630572","wikidata":"https://www.wikidata.org/wiki/Q538904","display_name":"Applied psychology","level":1,"score":0.3709000051021576},{"id":"https://openalex.org/C3017944768","wikidata":"https://www.wikidata.org/wiki/Q1450463","display_name":"Poison control","level":2,"score":0.37049999833106995},{"id":"https://openalex.org/C166735990","wikidata":"https://www.wikidata.org/wiki/Q1750812","display_name":"Human factors and ergonomics","level":3,"score":0.35839998722076416},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.35830000042915344},{"id":"https://openalex.org/C2777267654","wikidata":"https://www.wikidata.org/wiki/Q3519023","display_name":"Test (biology)","level":2,"score":0.3319999873638153},{"id":"https://openalex.org/C526869908","wikidata":"https://www.wikidata.org/wiki/Q3298118","display_name":"Suicide prevention","level":3,"score":0.3319000005722046},{"id":"https://openalex.org/C202695956","wikidata":"https://www.wikidata.org/wiki/Q2669680","display_name":"Debriefing","level":2,"score":0.33180001378059387},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3197999894618988},{"id":"https://openalex.org/C2776674806","wikidata":"https://www.wikidata.org/wiki/Q12135","display_name":"Mental illness","level":3,"score":0.31769999861717224},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.3174000084400177},{"id":"https://openalex.org/C36464697","wikidata":"https://www.wikidata.org/wiki/Q451553","display_name":"Visualization","level":2,"score":0.30140000581741333},{"id":"https://openalex.org/C63527458","wikidata":"https://www.wikidata.org/wiki/Q5133829","display_name":"Clinical decision support system","level":3,"score":0.30140000581741333},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.2915000021457672},{"id":"https://openalex.org/C313442","wikidata":"https://www.wikidata.org/wiki/Q778556","display_name":"Persona","level":2,"score":0.28610000014305115},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.27799999713897705},{"id":"https://openalex.org/C147494362","wikidata":"https://www.wikidata.org/wiki/Q2078905","display_name":"Troubleshooting","level":2,"score":0.2619999945163727},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.25519999861717224},{"id":"https://openalex.org/C509550671","wikidata":"https://www.wikidata.org/wiki/Q126945","display_name":"Medical education","level":1,"score":0.25270000100135803},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.2515000104904175},{"id":"https://openalex.org/C190385971","wikidata":"https://www.wikidata.org/wiki/Q373494","display_name":"Injury prevention","level":3,"score":0.25110000371932983}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.48550/arxiv.2602.19948","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2602.19948","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":null,"raw_source_name":null,"raw_type":"article"}],"best_oa_location":{"id":"doi:10.48550/arxiv.2602.19948","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2602.19948","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.744966447353363,"display_name":"Good health and well-being"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Large":[0],"Language":[1],"Models":[2],"(LLMs)":[3],"are":[4],"increasingly":[5],"utilized":[6],"for":[7,107],"mental":[8,108,147,178],"health":[9,109,148,179],"support;":[10],"however,":[11],"current":[12],"safety":[13,100,174],"benchmarks":[14],"often":[15],"fail":[16],"to":[17,63,126,161],"detect":[18],"the":[19,103,117,163,172,182],"complex,":[20],"longitudinal":[21],"risks":[22,175],"inherent":[23],"in":[24,102],"therapeutic":[25],"dialogue.":[26],"We":[27,59,111],"introduce":[28],"an":[29,133],"evaluation":[30],"framework":[31,62,157],"that":[32,155],"pairs":[33],"AI":[34,73,106,142,167],"psychotherapists":[35],"with":[36,41,138],"simulated":[37],"patient":[38,87,120],"agents":[39,74],"equipped":[40],"dynamic":[42],"cognitive-affective":[43],"models":[44],"and":[45,56,78,124,144,150,181],"assesses":[46],"therapy":[47],"session":[48],"simulations":[49],"against":[50,81],"a":[51,64,82],"comprehensive":[52],"quality":[53],"of":[54,85,105,119,166,176,184],"care":[55],"risk":[57],"ontology.":[58],"apply":[60],"this":[61,156],"high-impact":[65],"test":[66],"case,":[67],"Alcohol":[68],"Use":[69],"Disorder,":[70],"evaluating":[71],"six":[72],"(including":[75],"ChatGPT,":[76],"Gemini,":[77],"Character":[79],"AI)":[80],"clinically-validated":[83],"cohort":[84],"15":[86],"personas":[88],"representing":[89],"diverse":[90,139],"clinical":[91,186],"phenotypes.":[92],"Our":[93],"large-scale":[94],"simulation":[95],"(N=369":[96],"sessions)":[97],"reveals":[98],"critical":[99,173],"gaps":[101],"use":[104],"support.":[110],"identify":[112],"specific":[113],"iatrogenic":[114],"risks,":[115],"including":[116,141],"validation":[118],"delusions":[121],"(\"AI":[122],"Psychosis\")":[123],"failure":[125],"de-escalate":[127],"suicide":[128],"risk.":[129],"Finally,":[130],"we":[131],"validate":[132],"interactive":[134],"data":[135],"visualization":[136],"dashboard":[137],"stakeholders,":[140],"engineers":[143],"red":[145,187],"teamers,":[146],"professionals,":[149],"policy":[151],"experts":[152],"(N=9),":[153],"demonstrating":[154],"effectively":[158],"enables":[159],"stakeholders":[160],"audit":[162],"\"black":[164],"box\"":[165],"psychotherapy.":[168],"These":[169],"findings":[170],"underscore":[171],"AI-provided":[177],"support":[180],"necessity":[183],"simulation-based":[185],"teaming":[188],"before":[189],"deployment.":[190]},"counts_by_year":[],"updated_date":"2026-06-11T09:08:48.828518","created_date":"2026-02-26T00:00:00"}