Large Language Models in Mental Health Care: a Scoping Review
Yining Hua, Fenglin Liu, Kailai Yang, Zehan Li, Hongbin Na, Yi-han Sheu, Peilin Zhou, Lauren V. Moran, Sophia Ananiadou, David A. Clifton, Andrew Beam, John Torous
TL;DR
This scoping review maps the recent emergence of post-T5 large language models in mental health care, detailing three main application areas (conversational agents, resource/enrichment tools, and diagnostic/classification tasks) and summarizing model practices, datasets, and evaluation approaches. It finds that while LLMs can improve accessibility and support, significant gaps remain in data quality, clinically valid labeling, and standardized assessments, alongside privacy and ethical concerns. The authors advocate for robust, clinically grounded datasets, transparent evaluation frameworks, and cross-disciplinary collaboration to translate LLM capabilities into safe, effective mental health care tools. Overall, the paper emphasizes cautious optimism: LLMs hold promise, but rigorous data, governance, and translation frameworks are essential for real-world impact.
Abstract
Objectieve:This review aims to deliver a comprehensive analysis of Large Language Models (LLMs) utilization in mental health care, evaluating their effectiveness, identifying challenges, and exploring their potential for future application. Materials and Methods: A systematic search was performed across multiple databases including PubMed, Web of Science, Google Scholar, arXiv, medRxiv, and PsyArXiv in November 2023. The review includes all types of original research, regardless of peer-review status, published or disseminated between October 1, 2019, and December 2, 2023. Studies were included without language restrictions if they employed LLMs developed after T5 and directly investigated research questions within mental health care settings. Results: Out of an initial 313 articles, 34 were selected based on their relevance to LLMs applications in mental health care and the rigor of their reported outcomes. The review identified various LLMs applications in mental health care, including diagnostics, therapy, and enhancing patient engagement. Key challenges highlighted were related to data availability and reliability, the nuanced handling of mental states, and effective evaluation methods. While LLMs showed promise in improving accuracy and accessibility, significant gaps in clinical applicability and ethical considerations were noted. Conclusion: LLMs hold substantial promise for enhancing mental health care. For their full potential to be realized, emphasis must be placed on developing robust datasets, development and evaluation frameworks, ethical guidelines, and interdisciplinary collaborations to address current limitations.