TrustMH-Bench: A Comprehensive Benchmark for Evaluating the Trustworthiness of Large Language Models in Mental Health

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Main Authors: Xiong, Zixin, Wang, Ziteng, Fan, Haotian, Zhang, Xinjie, Wang, Wenxuan
Format: Preprint
Published: 2026
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author Xiong, Zixin
Wang, Ziteng
Fan, Haotian
Zhang, Xinjie
Wang, Wenxuan
author_facet Xiong, Zixin
Wang, Ziteng
Fan, Haotian
Zhang, Xinjie
Wang, Wenxuan
contents While Large Language Models (LLMs) demonstrate significant potential in providing accessible mental health support, their practical deployment raises critical trustworthiness concerns due to the domains high-stakes and safety-sensitive nature. Existing evaluation paradigms for general-purpose LLMs fail to capture mental health-specific requirements, highlighting an urgent need to prioritize and enhance their trustworthiness. To address this, we propose TrustMH-Bench, a holistic framework designed to systematically quantify the trustworthiness of mental health LLMs. By establishing a deep mapping from domain-specific norms to quantitative evaluation metrics, TrustMH-Bench evaluates models across eight core pillars: Reliability, Crisis Identification and Escalation, Safety, Fairness, Privacy, Robustness, Anti-sycophancy, and Ethics. We conduct extensive experiments across six general-purpose LLMs and six specialized mental health models. Experimental results indicate that the evaluated models underperform across various trustworthiness dimensions in mental health scenarios, revealing significant deficiencies. Notably, even generally powerful models (e.g., GPT-5.1) fail to maintain consistently high performance across all dimensions. Consequently, systematically improving the trustworthiness of LLMs has become a critical task. Our data and code are released.
format Preprint
id arxiv_https___arxiv_org_abs_2603_03047
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle TrustMH-Bench: A Comprehensive Benchmark for Evaluating the Trustworthiness of Large Language Models in Mental Health
Xiong, Zixin
Wang, Ziteng
Fan, Haotian
Zhang, Xinjie
Wang, Wenxuan
Computation and Language
Artificial Intelligence
While Large Language Models (LLMs) demonstrate significant potential in providing accessible mental health support, their practical deployment raises critical trustworthiness concerns due to the domains high-stakes and safety-sensitive nature. Existing evaluation paradigms for general-purpose LLMs fail to capture mental health-specific requirements, highlighting an urgent need to prioritize and enhance their trustworthiness. To address this, we propose TrustMH-Bench, a holistic framework designed to systematically quantify the trustworthiness of mental health LLMs. By establishing a deep mapping from domain-specific norms to quantitative evaluation metrics, TrustMH-Bench evaluates models across eight core pillars: Reliability, Crisis Identification and Escalation, Safety, Fairness, Privacy, Robustness, Anti-sycophancy, and Ethics. We conduct extensive experiments across six general-purpose LLMs and six specialized mental health models. Experimental results indicate that the evaluated models underperform across various trustworthiness dimensions in mental health scenarios, revealing significant deficiencies. Notably, even generally powerful models (e.g., GPT-5.1) fail to maintain consistently high performance across all dimensions. Consequently, systematically improving the trustworthiness of LLMs has become a critical task. Our data and code are released.
title TrustMH-Bench: A Comprehensive Benchmark for Evaluating the Trustworthiness of Large Language Models in Mental Health
topic Computation and Language
Artificial Intelligence
url https://arxiv.org/abs/2603.03047