Trustworthy AI Psychotherapy: Multi-Agent LLM Workflow for Counseling and Explainable Mental Disorder Diagnosis

Abstract: LLM-based agents have emerged as transformative tools capable of executing complex tasks through iterative planning and action, achieving significant advancements in understanding and addressing user needs. Yet, their effectiveness remains limited in specialized domains such as mental health diagnosis, where they underperform compared to general applications. Current approaches to integrating diagnostic capabilities into LLMs rely on scarce, highly sensitive mental health datasets, which are challenging to acquire. These methods also fail to emulate clinicians' proactive inquiry skills, lack multi-turn conversational comprehension, and struggle to align outputs with expert clinical reasoning. To address these gaps, we propose DSM5AgentFlow, the first LLM-based agent workflow designed to autonomously generate DSM-5 Level-1 diagnostic questionnaires. By simulating therapist-client dialogues with specific client profiles, the framework delivers transparent, step-by-step disorder predictions, producing explainable and trustworthy results. This workflow serves as a complementary tool for mental health diagnosis, ensuring adherence to ethical and legal standards. Through comprehensive experiments, we evaluate leading LLMs across three critical dimensions: conversational realism, diagnostic accuracy, and explainability. Our datasets and implementations are fully open-sourced.