MindEval2: Clinically Grounded Patients and Rubrics for Evaluating Language Models in Mental Health Support

Abstract

With people increasingly turning to AI chatbots for mental health support, the need to evaluate these tools is becoming more pressing. Recent benchmarks attempt to mimic a realistic setting by simulating multi-turn interactions with synthetic patients and evaluating them with an LLM-as-a-judge. However, the usefulness of these methods is limited because simulated patients can be overly forthcoming and self-reflective, and judgments typically involve opaque Likert scales with unclear practical utility. To bridge these gaps, we introduce MindEval2, an evaluation framework that consists of two components: Mental Health Quality Rubrics (MHQR), for evaluation, and MindSim, for patient simulation. For MHQR, we collaborate with PhD-level psychologists to develop a set of rubrics that break down response quality into explicit operational criteria that are more interpretable and actionable than existing evaluation taxonomies. MindSim, in turn, is an LLM harness that combines carefully-designed patient profiles with tools, enabling more varied, challenging, and realistic interactions than existing baselines. The harness also contains a memory component that is updated between each interaction, enabling MindEval2 to model the longitudinal aspect of mental health. We evaluate 18 proprietary and open-weight models on MindEval2, finding that while frontier models have largely improved on issues related to surface level quality and boundaries, guidance calibration remains the dominant failure mode across all models, accounting for most of the quality gap.