Trust Stack for Mental Health AI: A Survey of Calibration across Human, Interaction, and AI Layers

Authors:Xin Sun, Yue Su, Yifan Mo, Qingyu Meng, Yuxuan Li, Min Chen, Mengyuan Zhang, Saku Sugawara, Charlotte Gerritsen, Sander L. Koole, Koen Hindriks, Jiahuan Pei

Abstract:Language-based AI is increasingly deployed for mental health support, yet trust is evaluated in interdisciplinary but operationally misaligned ways: NLP and AI work measures robustness, safety, privacy, and explanations, while psychotherapy, HCI, and regulatory work emphasize therapeutic fidelity, lived experience, empathy, and reliance. Empathetic chatbots can elicit strong user trust without commensurate safety, while safer systems are under-trusted when their boundaries are opaque, a calibration gap no single community owns. Through a structured scoping synthesis of 61 papers, we survey this landscape into a three-layer framework separating (L1) human-oriented trust, (L2) interaction-oriented trustworthiness, and (L3) AI-oriented trustworthiness, and map five stakeholder perspectives onto these layers. We outline a research agenda for building socio-technically aligned trustworthy AI for mental health support, highlighting that the central objective should shift from maximizing perceived trust to calibrating human trust to demonstrated interaction- and AI-level trustworthiness.

Computation and Language (cs.CL); Human-Computer Interaction (cs.HC)

arXiv:2604.20166 [cs.CL]

(or arXiv:2604.20166v3 [cs.CL] for this version)