Cited by 151Artificial Intelligence in Healthcare and EducationDigital Mental Health InterventionsEthics and Social Impacts of AI

A scoping review of large language models for generative tasks in mental health care

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Hua, Yining, Na, Hongbin, Li, Zehan, Liu, Fenglin, Fang, Xiao, Clifton, David, Torous, John·2025·npj Digital Medicine

Abstract

Large language models (LLMs) show promise in mental health care for handling human-like conversations, but their effectiveness remains uncertain. This scoping review synthesizes existing research on LLM applications in mental health care, reviews model performance and clinical effectiveness, identifies gaps in current evaluation methods following a structured evaluation framework, and provides recommendations for future development. A systematic search identified 726 unique articles, of which 16 met the inclusion criteria. These studies, encompassing applications such as clinical assistance, counseling, therapy, and emotional support, show initial promises. However, the evaluation methods were often non-standardized, with most studies relying on ad-hoc scales that limit comparability and robustness. A reliance on prompt-tuning proprietary models, such as OpenAI's GPT series, also raises concerns about transparency and reproducibility. As current evidence does not fully support their use as standalone interventions, more rigorous development and evaluation guidelines are needed for safe, effective clinical integration.

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  • Existing reviews and meta-analyses of LLM-CBs for mental health focus on applications of LLM-CBs as clinical intervention tools, often under research-protocol conditions.

    “Although reviews and meta-analyses of LLM-CBs for mental health exist13,14,29,30, as well as scoping reviews on the implementation of LLM-CBs in mental health31,32, their focus is narrowed to applications of LLM-CBs as clinical intervention tools.”

    From A scoping review on the mental health harms of LLM-based chatbots (2026) · cites this paper as [31]

    The Results (Applications and model information; page not provided) classify the applications reviewed into six types, including clinical assistants and education as well as counselling and therapy. The review therefore does not narrow its focus to clinical intervention tools. The cited passages do not establish the added characterization that applications were often studied under research-protocol conditions. (LLM, conf=0.87)

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Authors
Hua, Y., Na, H., Li, Z., Liu, F., Fang, X., Clifton, D., & Torous, J.
Affiliations
  • Beth Israel Deaconess Medical Center (US)
  • University of Technology Sydney (AU)
  • The University of Texas Health Science Center at Houston (US)
  • University of Oxford (GB)
  • MIT Media Lab (US)
Corresponding author
Torous, John
Venue
npj Digital Medicine
Published
2025-04-30
Volume
8
Issue
1
Pages
230-230
ISSN
2398-6352 (ISSN-L)
OpenAlex
W4409967501
Cited by
151
References
45
Citations by year
2026: 128 · 2025: 23
FWCI
36.35
Type
journal article
Language
en
Open access
Locations
  • npj Digital Medicine (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Safety Research › Ethics and Social Impacts of AI
Keywords
large language models, mental health services, generative AI, counseling, treatment, emotional support, evaluation framework, prompt tuning, reproducibility, clinical effectiveness, clinical integration

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