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This paper is in the following e-collection/theme issue:

Reviews in AI (211) Digital Mental Health Interventions, e-Mental Health and Cyberpsychology (3375) Innovations in Mental Health Systems (686) Generative Language Models Including ChatGPT (1646) AI Language Models in Health Care (839)

Published on in Vol 5 (2026)

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/80348, first published .
Doctor's gloved hand touches futuristic medical interface displaying brain scans and heart monitor.

Large Language Model–Based Chatbots and Agentic AI for Mental Health Counseling: Systematic Review of Methodologies, Evaluation Frameworks, and Ethical Safeguards

Large Language Model–Based Chatbots and Agentic AI for Mental Health Counseling: Systematic Review of Methodologies, Evaluation Frameworks, and Ethical Safeguards

Authors of this article:

Ha Na Cho1 Author Orcid Image ;   Jiayuan Wang1 Author Orcid Image ;   Di Hu1 Author Orcid Image ;   Kai Zheng1 Author Orcid Image
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Journals

  1. Moya-Sanchez D. Artificial Intelligence in Psychiatry: A Clinical Framework for the Supervised Integration of Large Language Models when Patients Are Already Using Them. AI in Neuroscience 2026;2(2-3):45 View
  2. Li A, Yao S, Chen B, Li X, Guo S. Prompt engineering a large language model with evidence-based persuasive features to improve confidence in mental health professionals: a pilot randomized experiment. Frontiers in Public Health 2026;14 View
  3. Larrison C, Sinha G, Kursuncu U. Responsible AI in mental health services. Social Work in Mental Health 2026:1 View
  4. Wang X, Wang R, Wang W, Zhao X, Yang W, Pan W, Jia M, Gao S. A Multistage Finetuning and Empathy Alignment Approach for an Emotional Support Dialogue System: Development and Evaluation Study (Preprint). Journal of Medical Internet Research 2026 View
  5. McCalla D, Li B, Jaeger S, Jacques J, Gonzalez Jr L, Silber C, Dykeman C. Implicit Bias in Large Language Model Diagnosis of Eating Disorders: Experimental Vignette Study. JMIR AI 2026;5:e93498 View
  6. Hang Y, Wu W, Feng Y, Yan K, Liu Y, Xiao X, Qiao Z. The effectiveness of CBT-based NLP-enabled AI conversational agents for mental health intervention: a systematic review and meta-analysis. npj Digital Medicine 2026;9(1) View
  7. Latif M, Li G, Wang J, Shahzad M. Does Social Support from Persona-Driven Chatbots Encourage Continued Help-Seeking? The Role of Emotional Relief in Online Mental Health Communities. International Journal of Human–Computer Interaction 2026:1 View
  8. Liu J, Chen X, Cai J, Luo X, Xiao W, Deng J. Context presentation and native conversation structure in large language model responses to escalating suicide risk: a controlled multimodel evaluation. Frontiers in Psychiatry 2026;17 View

Conference Proceedings

  1. Lopatovska I, Murad C. Proceedings of the 8th ACM Conference on Conversational User Interfaces. Designed for Interfaces, Not Conversations: The Limits of Usability Heuristics in GenAI Chatbot Assessment View
  2. Albikawi Z, Abuadas M, Saifan A, Ahmed F. 2026 IEEE 50th Annual Computers, Software, and Applications Conference (COMPSAC). Large Language Models for Mental Health Support in Arabic-Speaking Populations: Cultural Adaptation, Challenges, and Ethical Considerations: A Perspective View