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Apr 29

Assessing Risks of Large Language Models in Mental Health Support: A Framework for Automated Clinical AI Red Teaming

Large Language Models (LLMs) are increasingly utilized for mental health support; however, current safety benchmarks often fail to detect the complex, longitudinal risks inherent in therapeutic dialogue. We introduce an evaluation framework that pairs AI psychotherapists with simulated patient agents equipped with dynamic cognitive-affective models and assesses therapy session simulations against a comprehensive quality of care and risk ontology. We apply this framework to a high-impact test case, Alcohol Use Disorder, evaluating six AI agents (including ChatGPT, Gemini, and Character.AI) against a clinically-validated cohort of 15 patient personas representing diverse clinical phenotypes. Our large-scale simulation (N=369 sessions) reveals critical safety gaps in the use of AI for mental health support. We identify specific iatrogenic risks, including the validation of patient delusions ("AI Psychosis") and failure to de-escalate suicide risk. Finally, we validate an interactive data visualization dashboard with diverse stakeholders, including AI engineers and red teamers, mental health professionals, and policy experts (N=9), demonstrating that this framework effectively enables stakeholders to audit the "black box" of AI psychotherapy. These findings underscore the critical safety risks of AI-provided mental health support and the necessity of simulation-based clinical red teaming before deployment.

Be Your Own Red Teamer: Safety Alignment via Self-Play and Reflective Experience Replay

Large Language Models (LLMs) have achieved remarkable capabilities but remain vulnerable to adversarial ``jailbreak'' attacks designed to bypass safety guardrails. Current safety alignment methods depend heavily on static external red teaming, utilizing fixed defense prompts or pre-collected adversarial datasets. This leads to a rigid defense that overfits known patterns and fails to generalize to novel, sophisticated threats. To address this critical limitation, we propose empowering the model to be its own red teamer, capable of achieving autonomous and evolving adversarial attacks. Specifically, we introduce Safety Self- Play (SSP), a system that utilizes a single LLM to act concurrently as both the Attacker (generating jailbreaks) and the Defender (refusing harmful requests) within a unified Reinforcement Learning (RL) loop, dynamically evolving attack strategies to uncover vulnerabilities while simultaneously strengthening defense mechanisms. To ensure the Defender effectively addresses critical safety issues during the self-play, we introduce an advanced Reflective Experience Replay Mechanism, which uses an experience pool accumulated throughout the process. The mechanism employs a Upper Confidence Bound (UCB) sampling strategy to focus on failure cases with low rewards, helping the model learn from past hard mistakes while balancing exploration and exploitation. Extensive experiments demonstrate that our SSP approach autonomously evolves robust defense capabilities, significantly outperforming baselines trained on static adversarial datasets and establishing a new benchmark for proactive safety alignment.

  • 5 authors
·
Jan 14