A Counsellor-in-the-loop Evaluation Framework for Multi-model Assessment of LLM-generated Mental Health Advisories

Abstract

The demand for scalable and empathetic mental health support is driving increased interest in the use of large language models (LLMs) as advisory tools. Very few studies have been published that show how LLMs perform psychologically and demonstrate cross-model variation. We introduce DASS21-EvaLLM, a counsellor-in-the-loop evaluation system as an advisory appropriateness screening instrument for DASS-21 integration with four prominent LLMs (ChatGPT, Gemini, LLaMA and Mistral). The DASS21-EvaLLM provides the ability to rate, annotate and compare responses within a single interface. Using 65 simulated cases of clients and 13 licensed counsellors’ assessments, we considered the advisory quality of LLMs based upon each client’s profile for depression, anxiety and stress according to three specific criteria (accuracy, empathy and clarity), including a novel Weighted Score Index (WSI), for comprehensive and multi-dimensional comparison of advisory performance among LLMs. Overall results show that Gemini gives the highest quality overall as well as the highest level of empathy among LLMs while ChatGPT has the next highest level of advisory quality. Mistral and LLaMA both had specific strengths in certain scenarios, but both lacked emotional engagement and low levels of interpretability overall. Our contributions are: (i) a replicable evaluation protocol and workflow for evaluating LLM-based psychological advisories with counsellor oversight, (ii) a transparent WSI rubric and audit trail for per-criterion scoring and commentary, and (iii) evidence-based guidance for model selection and governance in digital mental health applications. DASS21-EvaLLM is an evaluation and training tool not a diagnostic system that supports safer deployment, improves counselling practice and supervision, and informs the design of responsible, human-centred advisory systems.