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This study investigates the critical safety and fidelity gaps between human peer supporters and mental health experts when using LLMs to simulate distressed clients. The findings reveal a significant misalignment where experts identified missed distress cues and premature advice-giving in interactions that peers found meaningful, highlighting risks in scaling AI-augmented psychosocial support without rigorous psychological grounding.
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"Is This Really a Human Peer Supporter?": Misalignments Between Peer Supporters and Experts in LLM-Supported Interactions

arXiv3 min read

arXiv:2506.09354v5 Announce Type: replace-cross Abstract: Mental health is a growing global concern, prompting interest in AI-driven solutions to expand access to psychosocial support. Peer support, grounded in lived experience, offers a valuable complement to professional care. However, variability in training, effectiveness, and definitions raises concerns about quality, consistency, and safety. Large Language Models (LLMs) present new opportunities to enhance peer support interactions, particularly in real-time, text-based interactions. We present and evaluate an AI-supported system with an LLM-simulated distressed client (SimClient), context-sensitive LLM-generated suggestions (Suggestions), and real-time emotion visualisations. 2 mixed-methods studies with 12 peer supporters and 6 mental health professionals (i.e., experts) examined the system's effectiveness and implications for practice. Both groups recognised its potential to enhance training and improve interaction quality. However, we found a key tension emerged: while peer supporters engaged meaningfully, experts consistently flagged critical issues in peer supporter responses, such as missed distress cues and premature advice-giving. This misalignment highlights potential limitations in current peer support training, especially in emotionally charged contexts where safety and fidelity to best practices are essential. Our findings underscore the need for standardised, psychologically grounded training, especially as peer support scales globally. They also demonstrate how LLM-supported systems can scaffold this development--if designed with care and guided by expert oversight. This work contributes to emerging conversations on responsible AI integration in mental health and the evolving role of LLMs in augmenting peer-delivered care.

Title:"Is This Really a Human Peer Supporter?": Misalignments Between Peer Supporters and Experts in LLM-Supported Interactions

Abstract:Mental health is a growing global concern, prompting interest in AI-driven solutions to expand access to psychosocial support. Peer support, grounded in lived experience, offers a valuable complement to professional care. However, variability in training, effectiveness, and definitions raises concerns about quality, consistency, and safety. Large Language Models (LLMs) present new opportunities to enhance peer support interactions, particularly in real-time, text-based interactions. We present and evaluate an AI-supported system with an LLM-simulated distressed client (SimClient), context-sensitive LLM-generated suggestions (Suggestions), and real-time emotion visualisations. 2 mixed-methods studies with 12 peer supporters and 6 mental health professionals (i.e., experts) examined the system's effectiveness and implications for practice. Both groups recognised its potential to enhance training and improve interaction quality. However, we found a key tension emerged: while peer supporters engaged meaningfully, experts consistently flagged critical issues in peer supporter responses, such as missed distress cues and premature advice-giving. This misalignment highlights potential limitations in current peer support training, especially in emotionally charged contexts where safety and fidelity to best practices are essential. Our findings underscore the need for standardised, psychologically grounded training, especially as peer support scales globally. They also demonstrate how LLM-supported systems can scaffold this development--if designed with care and guided by expert oversight. This work contributes to emerging conversations on responsible AI integration in mental health and the evolving role of LLMs in augmenting peer-delivered care.

Accepted at CSCW 2026. 52 pages, 12 figures, 17 tables

Human-Computer Interaction (cs.HC); Artificial Intelligence (cs.AI)

arXiv:2506.09354 [cs.HC]

(or arXiv:2506.09354v5 [cs.HC] for this version)

https://doi.org/10.48550/arXiv.2506.09354 Focus to learn more arXiv-issued DOI via DataCite

https://doi.org/10.1145/3816956 Focus to learn more DOI(s) linking to related resources

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Full text under the publisher's open licence · 358 words

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