J. Kim
Publications
LLUMI: Improving LLM Writing Assistance for Mental Health Support with Online Community Feedback
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.
Towards Error-Free EHRs: Reasoning-Intensive Consistency Verification Between Clinical Notes and Structured Tables in Electronic Health Records
Data consistency between unstructured clinical notes and structured tables in Electronic Health Records (EHRs) is essential for patient safety and clinical decision-making. However, existing work on note-table consistency verification mainly relies on surface-level matching of numeric values or simple events. Such approaches fail to capture the reasoning underlying real-world EHR documentation, including clinical interpretation, event relations, and temporal changes. To address this gap, we introduce EHR-ReasonCon, a reasoning-intensive benchmark for note-table consistency verification. Built on MIMIC-III with expert-guided annotations, it comprises 8,048 entities derived from clinical notes and provides high-quality ground-truth labels. The annotation protocol is supported by specialized table-exploration tools to ensure systematic evidence retrieval and reliable consistency assessment. We also propose EHR-Inspector, an LLM-based framework that segments notes, extracts anchor entities and temporal references, and uses table-exploration tools to verify consistency against structured tables. Evaluated using expert-validated LLM-as-a-judge metrics under harsh and lenient criteria, EHR-Inspector achieves state-of-the-art performance across multiple model backbones. Analyses further demonstrate the effectiveness of its components and highlight differences from human verification.
AI Content Moderation in Therapy Conversations
Large language models (LLMs) are increasingly being used for emotional support. They are also being developed for formal therapy purposes. However, LLMs like ChaptGPT or Llama are often developed with content moderation guardrails that prevent them from discussing sensitive subjects with users for both liability and safety purposes, and this inability to broach these subjects may affect their capacity as therapists. In this study, we perform an algorithm audit on three state-of-the-art moderation systems (OpenAI's moderation endpoint, Meta's Llama Guard, and Google's Shield Gemma) to investigate the extent to which these systems flag the content of real-life therapy sessions as undesirable. Our results raise implications for the limitations that users and organizations may encounter when designing LLMs to play the part of a therapist.
AI Psychosis: Does Conversational AI Amplify Delusion-Related Language?
Conversational AI systems are increasingly used for personal reflection and emotional disclosure, raising concerns about their effects on vulnerable users. Recent anecdotal reports suggest that prolonged interactions with AI may reinforce delusional thinking -- a phenomenon sometimes described as AI Psychosis. However, empirical evidence on this phenomenon remains limited. In this work, we examine how delusion-related language evolves during multi-turn interactions with conversational AI. We construct simulated users (SimUsers) from Reddit users' longitudinal posting histories and generate extended conversations with three model families (GPT, LLaMA, and Qwen). We develop DelusionScore, a linguistic measure that quantifies the intensity of delusion-related language across conversational turns. We find that SimUsers derived from users with prior delusion-related discourse (Treatment) exhibit progressively increasing DelusionScore trajectories, whereas those derived from users without such discourse (Control) remain stable or decline. We further find that this amplification varies across themes, with reality skepticism and compulsive reasoning showing the strongest increases. Finally, conditioning AI responses on current DelusionScore substantially reduces these trajectories. These findings provide empirical evidence that conversational AI interactions can amplify delusion-related language over extended use and highlight the importance of state-aware safety mechanisms for mitigating such risks.
PAIR-SAFE: A Paired-Agent Approach for Runtime Auditing and Refining AI-Mediated Mental Health Support
Large language models (LLMs) are increasingly used for mental health support, yet they can produce responses that are overly directive, inconsistent, or clinically misaligned, particularly in sensitive or high-risk contexts. Existing approaches to mitigating these risks largely rely on implicit alignment through training or prompting, offering limited transparency and runtime accountability. We introduce PAIR-SAFE, a paired-agent framework for auditing and refining AI-generated mental health support that integrates a Responder agent with a supervisory Judge agent grounded in the clinically validated Motivational Interviewing Treatment Integrity (MITI-4) framework. The Judgeaudits each response and provides structuredALLOW or REVISE decisions that guide runtime response refinement. We simulate counseling interactions using a support-seeker simulator derived from human-annotated motivational interviewing data. We find that Judge-supervised interactions show significant improvements in key MITI dimensions, including Partnership, Seek Collaboration, and overall Relational quality. Our quantitative findings are supported by qualitative expert evaluation, which further highlights the nuances of runtime supervision. Together, our results reveal that such pairedagent approach can provide clinically grounded auditing and refinement for AI-assisted conversational mental health support.