Daily Papers

Medical question answering (QA) benchmarks often focus on multiple-choice or fact-based tasks, leaving open-ended answers to real patient questions underexplored. This gap is particularly critical in mental health, where patient questions often mix symptoms, treatment concerns, and emotional needs, requiring answers that balance clinical caution with contextual sensitivity. We present CounselBench, a large-scale benchmark developed with 100 mental health professionals to evaluate and stress-test large language models (LLMs) in realistic help-seeking scenarios. The first component, CounselBench-EVAL, contains 2,000 expert evaluations of answers from GPT-4, LLaMA 3, Gemini, and online human therapists on patient questions from the public forum CounselChat. Each answer is rated across six clinically grounded dimensions, with span-level annotations and written rationales. Expert evaluations show that while LLMs achieve high scores on several dimensions, they also exhibit recurring issues, including unconstructive feedback, overgeneralization, and limited personalization or relevance. Responses were frequently flagged for safety risks, most notably unauthorized medical advice. Follow-up experiments show that LLM judges systematically overrate model responses and overlook safety concerns identified by human experts. To probe failure modes more directly, we construct CounselBench-Adv, an adversarial dataset of 120 expert-authored mental health questions designed to trigger specific model issues. Expert evaluation of 1,080 responses from nine LLMs reveals consistent, model-specific failure patterns. Together, CounselBench establishes a clinically grounded framework for benchmarking LLMs in mental health QA.

Rising demand for mental health support has increased interest in using Large Language Models (LLMs) for counseling. However, adapting LLMs to this high-risk safety-critical domain is hindered by the scarcity of real-world counseling data due to privacy constraints. Synthetic datasets provide a promising alternative, but existing approaches often rely on unstructured or semi-structured text inputs and overlook structural dependencies between a client's cognitive, emotional, and behavioral states, often producing psychologically inconsistent interactions and reducing data realism and quality. We introduce Graph2Counsel, a framework for generating synthetic counseling sessions grounded in Client Psychological Graphs (CPGs) that encode relationships among clients' thoughts, emotions, and behaviors. Graph2Counsel employs a structured prompting pipeline guided by counselor strategies and CPG, and explores prompting strategies including CoT (Wei et al., 2022) and Multi-Agent Feedback (Li et al., 2025a). Graph2Counsel produces 760 sessions from 76 CPGs across diverse client profiles. In expert evaluation, our dataset outperforms prior datasets on specificity, counselor competence, authenticity, conversational flow, and safety, with substantial inter-annotator agreement (Krippendorff's α = 0.70). Fine-tuning an open-source model on this dataset improves performance on CounselingBench (Nguyen et al., 2025) and CounselBench (Li et al., 2025b), showing downstream utility. We also make our code and data public.