Tell Me: An LLM-powered Mental Well-being Assistant with RAG, Synthetic Dialogue Generation, and Agentic Planning

Large language models (LLMs) show promise in generating supportive responses for mental health queries, but improving their usefulness, empathy, and safety often requires substantial compute, expert input, and labeled data. At the same time, deploying proprietary, cloud-based models for mental health-related interactions raises important privacy and data-governance concerns, given the sensitivities. To address this challenge, we introduce LLUMI setup that can be hosted in-house within protected environments. LLUMI consists of two complementary components: a generation model (GM), which drafts supportive responses to mental health queries, and an improvement model (IM), which revises an initial human-crafted response. We leverage feedback signals from Reddit mental health communities, using community endorsement patterns such as upvotes and downvotes to construct chosen-rejected response pairs for Supervised Fine Tuning (SFT) and Direct Preference Optimization (DPO). We further align LLUMI using human evaluation across five dimensions: readability, empathy, connection, actionability, and safety. Our results show that, despite relying on smaller open-source models rather than proprietary cloud-based GPT models, LLUMI achieves comparable performance across linguistic analyses and human evaluations. These findings suggest that open-source models, when trained with community-derived preference signals, can support high-quality mental health support assistance while offering a more privacy-preserving alternative for sensitive support contexts.

This paper presents ECHO (Enhanced Care & Health Observer), a locally-deployable conversational health assistant for long-term chronic care management. ECHO integrates three complementary software modules developed under shared supervision as a unified system. The core module is an agentic chatbot built on a ReAct loop orchestrated via LangGraph, equipped with 17 clinical tools and a temporal knowledge graph for persistent cross-session memory; it achieves a 94.9% tool-execution pass rate across a 59-scenario benchmark with GPT-5 Mini. A two-stage hybrid safety layer intercepts all incoming queries: a rule-based layer handles explicit crisis signals and jailbreak attempts in under 1ms, while a signed graph neural network (GNN) with APPNP-style propagation classifies boundary cases by clinical intent, achieving 88.8% accuracy and 90.6% unsafe recall on a 2,537-query annotated Turkish health dataset while outperforming zero-shot LLM baselines including Llama 3.3 70B. A multimodal speech assessment module combining Whisper acoustic encoding and BERT text encoding with cross-attention fusion estimates emotion, depression, and pain, reaching a mean macro F1 of 0.652. The full system is implemented as a web application that can run entirely on consumer hardware, with no patient data transmitted to external services, supporting compliance with GDPR and KVKK.

Large language models show promise for mental health support, yet therapeutic quality improves only when evaluation functions as an actionable control signal rather than a passive metric. We introduce a framework that formulates therapeutic response generation as a decision-refinement problem driven by multi-dimensional, human-aligned evaluation. In Stage I, we introduce TheraJudge, an open-source therapeutic evaluator trained via preference-based optimization on human-annotated data to produce reliable judgments across 7 psychological dimensions. In Stage II, we introduce TheraAgent, which operationalizes TheraJudge's evaluations through a coordinated refinement process with specialized Critic, Coach, and Therapist roles that translate evaluative signals into targeted response revisions. Empirically, TheraJudge achieves strong agreement with clinician ratings, with intraclass correlation coefficients (ICC = 0.87-0.95), surpassing supervised baselines and strong closed-source judges, particularly on critical dimensions such as Safety, Relevance, and Empathy. Acting on these evaluations, TheraAgent yields a +0.43 improvement in human-rated therapeutic quality (on a 5-point scale) under blind evaluation, with 96% clinician inter-rater reliability. Low-quality responses ($\leq 3$) improve by +2.45 points with a 94% recovery rate, demonstrating targeted correction of unsafe outputs. Overall, our results indicate that effective alignment of mental-health LLMs stems from acting on human-aligned evaluation, rather than relying solely on stronger generation. We release code at https://github.com/vis-nlp/TheraAlign.