Applying and Evaluating Large Language Models in Mental Health Care: A Scoping Review of Human-Assessed Generative Tasks

TL;DR

This scoping review assesses the current use of large language models in mental health care, highlighting their potential and the need for standardized evaluation, ethical considerations, and transparency for clinical integration.

Contribution

It provides a comprehensive overview of human-assessed generative tasks involving LLMs in mental health, emphasizing gaps in evaluation and ethical issues.

Findings

Limited standardized evaluation methods used in studies

Concerns about privacy, safety, and fairness in applications

Reliance on proprietary models raises transparency issues

Abstract

Large language models (LLMs) are emerging as promising tools for mental health care, offering scalable support through their ability to generate human-like responses. However, the effectiveness of these models in clinical settings remains unclear. This scoping review aimed to assess the current generative applications of LLMs in mental health care, focusing on studies where these models were tested with human participants in real-world scenarios. A systematic search across APA PsycNet, Scopus, PubMed, and Web of Science identified 726 unique articles, of which 17 met the inclusion criteria. These studies encompassed applications such as clinical assistance, counseling, therapy, and emotional support. However, the evaluation methods were often non-standardized, with most studies relying on ad hoc scales that limit comparability and robustness. Privacy, safety, and fairness were also frequently underexplored. Moreover, reliance on proprietary models, such as OpenAI's GPT series, raises concerns about transparency and reproducibility. While LLMs show potential in expanding mental health care access, especially in underserved areas, the current evidence does not fully support their use as standalone interventions. More rigorous, standardized evaluations and ethical oversight are needed to ensure these tools can be safely and effectively integrated into clinical practice.