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Published as a conference paper at NeurIPS 2026

MindGuard: Guardrail Classifiers for Multi-Turn Mental Health Support

António Farinhas, Nuno M Guerreiro, José Pombal, Pedro Henrique Martins, Laura Melton, Alexandra Conway, Cara Dochat, Maya D'Eon, Ricardo Rei

Abstract

Large language models are increasingly used for mental health support, yet their conversational coherence alone does not ensure clinical appropriateness. Existing general-purpose safeguards often fail to distinguish therapeutic disclosures from genuine clinical crises, and progress on developing better ones is bottlenecked by a lack of clinically grounded evaluation resources. To address this gap, we introduce a risk taxonomy, developed in collaboration with PhD-level clinical psychologists, that identifies actionable harm (self-harm and harm to others) while preserving space for safe, non-crisis therapeutic content. We release MindGuard-testset, a dataset of multi-turn conversations annotated at the turn level by clinical experts, which is, to our knowledge, the first public benchmark with turn-level clinical risk labels for multi-turn mental health support. We also release an automated red-teaming (ART) framework designed to measure how safety classifiers affect downstream model behavior in adversarial multi-turn interactions. Using synthetic dialogues generated via a controlled two-agent setup, we train MindGuard, a family of lightweight safety classifiers (with 4B and 8B parameters). Our classifiers reduce false positives at high-recall operating points and, when paired with clinician language models, help achieve lower attack success and harmful engagement rates compared to general-purpose safeguards. We release all models, human evaluation data, and the ART framework.

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