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

Journal: NPJ digital medicine
Published Date: Apr 30, 2025

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.

Authors

  • Yining Hua
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Hongbin Na
    Australian Artificial Intelligence Institute, University of Technology Sydney, Sydney, NSW, Australia.
  • Zehan Li
    McWilliams School of Biomedical Informatics, UTHealth Houston, Houston, TX, USA.
  • Fenglin Liu
    Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK.
  • Xiao Fang
    MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA.
  • David Clifton
    Computational Health Informatics Lab, Oxford Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom.
  • John Torous
    Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

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