PAIR-SAFE: A Paired-Agent Approach for Runtime Auditing and Refining AI-Mediated Mental Health Support

Fuente: arXiv
Gespeichert in:
Bibliographische Detailangaben
Hauptverfasser: Kim, Jiwon, Rodriguez, Violeta J., Yoo, Dong Whi, Chandrasekharan, Eshwar, Saha, Koustuv
Format: Preprint
Veröffentlicht: 2026
Schlagworte:
Online-Zugang:
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
_version_ 1866914263341203456
author Kim, Jiwon
Rodriguez, Violeta J.
Yoo, Dong Whi
Chandrasekharan, Eshwar
Saha, Koustuv
author_facet Kim, Jiwon
Rodriguez, Violeta J.
Yoo, Dong Whi
Chandrasekharan, Eshwar
Saha, Koustuv
contents Large language models (LLMs) are increasingly used for mental health support, yet they can produce responses that are overly directive, inconsistent, or clinically misaligned, particularly in sensitive or high-risk contexts. Existing approaches to mitigating these risks largely rely on implicit alignment through training or prompting, offering limited transparency and runtime accountability. We introduce PAIR-SAFE, a paired-agent framework for auditing and refining AI-generated mental health support that integrates a Responder agent with a supervisory Judge agent grounded in the clinically validated Motivational Interviewing Treatment Integrity (MITI-4) framework. The Judgeaudits each response and provides structuredALLOW or REVISE decisions that guide runtime response refinement. We simulate counseling interactions using a support-seeker simulator derived from human-annotated motivational interviewing data. We find that Judge-supervised interactions show significant improvements in key MITI dimensions, including Partnership, Seek Collaboration, and overall Relational quality. Our quantitative findings are supported by qualitative expert evaluation, which further highlights the nuances of runtime supervision. Together, our results reveal that such pairedagent approach can provide clinically grounded auditing and refinement for AI-assisted conversational mental health support.
format Preprint
id arxiv_https___arxiv_org_abs_2601_12754
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle PAIR-SAFE: A Paired-Agent Approach for Runtime Auditing and Refining AI-Mediated Mental Health Support
Kim, Jiwon
Rodriguez, Violeta J.
Yoo, Dong Whi
Chandrasekharan, Eshwar
Saha, Koustuv
Human-Computer Interaction
Artificial Intelligence
Computation and Language
Computers and Society
Large language models (LLMs) are increasingly used for mental health support, yet they can produce responses that are overly directive, inconsistent, or clinically misaligned, particularly in sensitive or high-risk contexts. Existing approaches to mitigating these risks largely rely on implicit alignment through training or prompting, offering limited transparency and runtime accountability. We introduce PAIR-SAFE, a paired-agent framework for auditing and refining AI-generated mental health support that integrates a Responder agent with a supervisory Judge agent grounded in the clinically validated Motivational Interviewing Treatment Integrity (MITI-4) framework. The Judgeaudits each response and provides structuredALLOW or REVISE decisions that guide runtime response refinement. We simulate counseling interactions using a support-seeker simulator derived from human-annotated motivational interviewing data. We find that Judge-supervised interactions show significant improvements in key MITI dimensions, including Partnership, Seek Collaboration, and overall Relational quality. Our quantitative findings are supported by qualitative expert evaluation, which further highlights the nuances of runtime supervision. Together, our results reveal that such pairedagent approach can provide clinically grounded auditing and refinement for AI-assisted conversational mental health support.
title PAIR-SAFE: A Paired-Agent Approach for Runtime Auditing and Refining AI-Mediated Mental Health Support
topic Human-Computer Interaction
Artificial Intelligence
Computation and Language
Computers and Society
url https://arxiv.org/abs/2601.12754