CounselReflect: Opportunities and Challenges for Designing Tools to Support Self-Reflection on Mental Health and Well-Being Conversations with AI

We present Tell Me, a mental well-being system that leverages advances in large language models to provide accessible, context-aware support for users and researchers. The system integrates three components: (i) a retrieval-augmented generation (RAG) assistant for personalized, knowledge-grounded dialogue; (ii) a synthetic client-therapist dialogue generator conditioned on client profiles to facilitate research on therapeutic language and data augmentation; and (iii) a Well-being AI crew, implemented with CrewAI, that produces weekly self-care plans and guided meditation audio. The system is designed as a reflective space for emotional processing rather than a substitute for professional therapy. It illustrates how conversational assistants can lower barriers to support, complement existing care, and broaden access to mental health resources. To address the shortage of confidential therapeutic data, we introduce synthetic client-therapist dialogue generation conditioned on client profiles. Finally, the planner demonstrates an innovative agentic workflow for dynamically adaptive, personalized self-care, bridging the limitations of static well-being tools. We describe the architecture, demonstrate its functionalities, and report evaluation of the RAG assistant in curated well-being scenarios using both automatic LLM-based judgments and a human-user study. This work highlights opportunities for interdisciplinary collaboration between NLP researchers and mental health professionals to advance responsible innovation in human-AI interaction for well-being.

As conversational AI systems become increasingly integrated into daily life, their potential effects on user well-being require ongoing attention. While consumer-facing generalist models can provide benefits, including improved access to information, learning, productivity, self-reflection, and companionship, they also introduce risks, such as emotional entanglement, unhealthy dependence, and the amplification of psychological vulnerabilities. Drawing on prior research and empirical observations of AI chatbot behavior, we propose a set of aspirational directions for guiding the behavior of general-purpose AI systems in ways that may reduce potential psychological harms and support user well-being. We acknowledge the difficulty of systematically assessing the long-term impacts of AI chatbot use and frame these directions as hypotheses for studying how AI behavior may influence users across general interactions, role-playing scenarios, and contexts that could be characterized as providing psychological support. While some proposed directions are supported by existing research and expert insights, others identify open questions and areas requiring deeper study. We hope that this formulation and these hypotheses encourage further discussion, empirical investigation, and exploration of interactive design approaches aimed at better accommodating users' psychological needs and promoting their well-being.

Chatbot usage has increased, including in fields for which they were never developed for--notably mental health support. To that end, we introduce Validations of Ethical and Responsible AI in Mental Health (VERA-MH), a novel clinically-validated evaluation for safety of chatbots in the context of mental health support. The first iteration of VERA-MH focuses on Suicidal Ideation (SI) risks, by assessing how well chatbots can responds to users that might be in crisis. VERA-MH is comprised of three steps: conversation simulation, conversation judging and model rating. First, to simulate conversations with the chatbot under evaluation, another chatbot is tasked with role-playing users based on specific personas. Such user personas have been developed under clinical guidance, to make sure that, among others, multiple risk factors, demographic characteristics and disclosure factors were represented. In the judging step, a second support model is used as an LLM-as-a-Judge, together with a clinically-developed rubric. The rubric is structured as a flow, with a single Yes/No question asked each time, to improve answers' consistency and highlight models' failure modes. In the last stage, results of each conversation are aggregated to present the final evaluation of the chatbot. Together with the framework, we present the result of the evaluations for four leading LLM providers.