Large Language Models (LLMs) have shown remarkable capabilities for complex tasks, yet adaptation in medical domain, specifically mental health, poses specific challenges. Mental health is a rising concern globally with LLMs having large potential to help address the same. We highlight three primary challenges for LLMs in mental health - lack of high quality interpretable and knowledge grounded training data; training paradigms restricted to core capabilities, and evaluation of multi turn dialogue settings. Addressing it, we present oMind framework which includes training and aligning LLM agents for diverse capabilities including conversations; high quality ~164k multi-task SFT dataset, as a result of our generation pipeline based on Structured Knowledge retrieval, LLM based pruning, and review actions. We also introduce oMind-Chat - a novel multi turn benchmark dataset with expert annotated turn level and conversation level rubrics. Our diverse experiments on both core capabilities and conversations shows oMind LLMs consistently outperform baselines. oMind-LLM also shows significantly better reasoning with up to 80% win rate.
Figures & tables
Figure 1: Complete pipeline for oMind SFT and model training. (A) Generation Pipeline consisting of retrieval stage, pruning & generation stage, and review stage. (B) Generation of support QA and conversations using LLM. (c) LLM finetuning and preference learning.
Type
Dataset
# Train
# Test
MCQA
MHQA Racha et al. (2025)
25,000
500
MedMCQA Pal et al. (2022)
2,750
594
MMLU-hsp Hendrycks et al. (2021)
441
150
MMLU-pp Hendrycks et al. (2021)
462
150
USMLE-Mental Jin et al. (2023)
498
219
Disorder
ANGST Hengle et al. (2024)
6,990
500
Table 1: Datasets statistics used for SFT
Figure 2: Illustration of oMind-Chat with rubrics.
Model
Method
Classification
MCQA
ANGST
dreaddit
CAMS
SAD
AVG
MHQA
MedMCQA
MMLU-hsp
MMLU-pp
USMLE
AVG
Llama 3.1 8B
Zero Shot
31.0
63.8
30.7
49.3
43.7
63.6
84.8
89.9
62.8
60.5
72.3
LLM+KG
35.4
71.3
33.8
63.8
51.1
75.4
85.5
88.5
69.0
63.1
76.3
LLM+Books
39.4
75.1
25.5
60.0
50.0
70.2
84.4
83.3
62.9
34.9
67.1
MentaLLaMA 13B
Zero Shot
40.7
75.8
36.9
63.7
54.3
63.2
52.4
75.9
45.1
30.1
53.3
LLM+KG
39.2
66.8
26.2
60.0
48.1
66.0
59.2
75.4
47.1
28.0
55.2
Table 2: Performance comparison (% F1 scores) of oMind models and baselines across Classification and MCQA tasks. AVG is the average score. Best and second best performance are in bold and underline respectively. We also report average % gain/dip for oMind models compared with base models. LLM+KG and LLM+Books is baseline with retrieved KG and Books Chunks respectively.
Model
Turn Level
Conversation Level
Binary
Scale 0-10
Likert 1-5
Binary
Scale 0-10
Likert 1-5
Llama 3.1 8B
0.64
5.2
3.7
0.76
6.2
3.9
MentaLLaMA 13B
0.36
2.8
2.6
0.45
3.4
2.8
Mistral 7B
0.61
4.9
3.7
0.76
6.0
3.9
Qwen 2.5 7B
0.60
4.8
3.7
0.74
5.9
3.9
PMC-Llama 13B
0.40
3.0
2.7
0.51
3.8
2.8
Table 3: Conversational performance on oMind-Chat benchmark. Models are evaluated at turn-level and conversation-level using three metrics: Binary rubric Coverage, 0-10 Scale, and Likert (1-5).
Figure 3: Impact of Supporting QA removal (wosq) and DPO alignment on Qwen-2.5-7B and Mistral-7B performance across classification, MCQA, and conversational tasks.
Models
Win (%)
Tie (%)
Lose (%)
oMind-Llama vs Llama
77.0
10.5
12.5
oMind-Mistral vs Mistral
76.0
23.0
1.0
oMind-Qwen vs Qwen
80.0
4.0
16.0
oMind-Mistral vs wosq
24.5
73.5
2.0
oMind-Qwen vs wosq
6.0
66.0
28.0
oMind-Mistral-dpo vs oMind-Mistral
14.0
71.5
14.5
Table 4: Pairwise win-rate comparison for generated explanations.
Factual Richness
Faithfulness
Clarity
oMind Win
0.67/ 0.58
0.49 / 0.32
0.38 / 0.31
Tie
0.23/ 0.28
0.36/ 0.56
0.29/ 0.24
GPT Win
0.10/ 0.14
0.15/ 0.12
0.33/ 0.45
Table 5: Win Rate scores by annotator 1/annotator 2 for oMind and only GPT.
General-purpose health benchmarks increasingly anchor claims about LLM medical performance, but they are not always resolved by clinical specialty, making domain-specific performance hard to isolate. Mental health is of acute public-health concern as millions of people turn to LLMs for psychological support, and most existing evaluations are bespoke academic benchmarks that are difficult to integrate into developer workflows. We introduce HealthBench-Psych and HealthBench-Psych-Hard. We screened HealthBench's 5,000 physician-rubric conversations for mental-health relevance with a transparent LLM-applied rubric, then validated the subset through two rounds of blinded clinician review with concealed known-exclude controls, yielding 610 conversations (12.2% of the corpus). Evaluating 20 frontier and open models under a cross-vendor panel of three LLM judges, we find a statistically tied frontier cluster, measurable refusal behavior in two models, and near-identical rankings across judges (τ≥0.92). We release the subset, pipeline, model responses, grades, and analysis code as a reusable resource.
Matthew Flathers, Phuong Anh Nguyen, Jill Noorily +7
Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA · Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA
In this work, the task and domain interaction of reasoning and mental health are investigated. As large language models (LLMs) present exceptional text understanding and fluent text generation capability, we analyze whether they can reason in the high-stakes domain of mental health. We begin by introducing three datasets and three tasks leveraging the existing work in pragmatic reasoning. The analysis constitutes an evaluation of 12 LLMs, including MentaLLaMA, which is a mental health reasoning and explanation generation model. The performance of the models remains on par with human evaluation, with the Mistral-7B model giving the best performance. We further analyze the performance of the models with error asymmetry ratio and conduct first-order attention rollout experiment with MentaLLaMA-7B. We present the results for the community reporting the architectural behaviour of the models for the input text and recommend further careful analysis for the high-stakes domain.
With people increasingly turning to AI chatbots for mental health support, the need to evaluate these tools is becoming more pressing. Recent benchmarks attempt to mimic a realistic setting by simulating multi-turn interactions with synthetic patients and evaluating them with an LLM-as-a-judge. However, the usefulness of these methods is limited because simulated patients can be overly forthcoming and self-reflective, and judgments typically involve opaque Likert scales with unclear practical utility. To bridge these gaps, we introduce MindEval2, an evaluation framework that consists of two components: Mental Health Quality Rubrics (MHQR), for evaluation, and MindSim, for patient simulation. For MHQR, we collaborate with PhD-level psychologists to develop a set of rubrics that break down response quality into explicit operational criteria that are more interpretable and actionable than existing evaluation taxonomies. MindSim, in turn, is an LLM harness that combines carefully-designed patient profiles with tools, enabling more varied, challenging, and realistic interactions than existing baselines. The harness also contains a memory component that is updated between each interaction, enabling MindEval2 to model the longitudinal aspect of mental health. We evaluate 18 proprietary and open-weight models on MindEval2, finding that while frontier models have largely improved on issues related to surface level quality and boundaries, guidance calibration remains the dominant failure mode across all models, accounting for most of the quality gap.
John Mendonça, Daniel Tschernutter, José Pombal +6
Sword Health · Instituto Superior Técnico · Yale University +1