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D09 — Self-Harm Pathway

D09-E01

Self-Harm Disclosure to AI

Description

The person discloses suicidal ideation, self-harm urges, death themes, or hopelessness to AI.

Rationale

Disclosure of suicidal ideation or self-harm urges to AI rather than to a human is a clinically significant indicator for two reasons: it reflects the absence of trusted human relationships, and it routes the person's most critical content through a system that is not equipped to provide a safe crisis response. The content of the disclosure and the AI's response are both relevant.

Evidence Base

  • Performance of mental health chatbot agents in detecting and managing suicidal ideation

    W. Pichowicz, M. Kotas & P. Piotrowski, 2024. Performance of mental health chatbot agents in detecting and managing suicidal ideation. Scientific Reports, 15(31652), pages. https://doi.org/10.1038/s41598-025-17242-4

    Peer-reviewed study (original research)

  • Inside a Mass Shooter’s Harrowing History With ChatGPT

    Mark Follman, 2024. Inside a Mass Shooter’s Harrowing History With ChatGPT. Mother Jones.

    News / journalism

  • Evaluating Alignment between Large Language Models and Expert Clinicians in Suicide Risk Assessment

    McBain, R. K., Cantor, J. H., Zhang, L. A., Baker, O., Zhang, F., Burnett, A., Kofner, A., Breslau, J., Stein, B. D., Mehrotra, A., & Yu, H., 2024. Evaluating Alignment between Large Language Models and Expert Clinicians in Suicide Risk Assessment. Psychiatr Serv, 76(11), 944–950. doi:10.1176/appi.ps.20250086.

    Peer-reviewed study (original research)

  • THE NEW INFLUENCING MACHINE: CHATBOTS, AI PSYCHOSIS & BTAM

    Saragosa, P., 2024. THE NEW INFLUENCING MACHINE: CHATBOTS, AI PSYCHOSIS & BTAM. The New York Times, Vol. null, pages. null.

    Commentary / Editorial

  • Common Sense Media AI Risk Assessment: Character.AI

    Common Sense Media, 2024. Common Sense Media AI Risk Assessment: Character.AI. commonsense.org.

    Government / agency report

  • COMMON SENSE MEDIA YOUTH AI SAFETY INSTITUTE RISK ASSESSMENT AI Mental Health Apps

    COMMON SENSE MEDIA YOUTH AI SAFETY INSTITUTE RISK ASSESSMENT AI Mental Health Apps The AI mental health app market is unregulated, unstable, and in some cases actively harmful to teens. The productsthat get it right make better use of people and professional care systems. Last updated: May 5, 2026 Overall risk level: Varies Type of AI: Applied Use Type of Review: Use Case Review https://institute.commonsensemedia.org/sites/default/files/risk-assessments/csm-ai-risk-assessment-ai-mental-health-apps-05052026_1.pdf

    Government / agency report

  • 2026 | THE COMMON SENSE MEDIA CENSUS AI Use by Tweens and Teens

    The Common Sense Media Census: AI Use by Tweens and Teens, 2026 https://www.commonsensemedia.org/sites/default/files/research/report/2026-ai-use-by-tweens-and-teens-1.pdf

    Government / agency report

  • AI Chatbot Suicide Risk Detection and Response: Human Validation Study of the Open-Source VERA-MH Safety Evaluation

    Bentley K H, Belli L, Chekroud A M, Ward E J, Dworkin E R, Van Ark E, Johnston K M, Alexander W, Brown M, Hawrilenko M, 2024. AI Chatbot Suicide Risk Detection and Response: Human Validation Study of the Open-Source VERA-MH Safety Evaluation. JMIR AI, 5(e92817). doi: 10.2196/92817.

    Peer-reviewed study (original research)

  • Evaluating a Consumer LLM for Suicide Risk Response Calibration: A Pilot Study

    Keskin Y, Park T, Bozkurt S, 2024. Evaluating a Consumer LLM for Suicide Risk Response Calibration: A Pilot Study. IOS Press, 2026, pages 1009-1013. doi:10.3233/SHTI260331

    Peer-reviewed study (original research)

  • Teen and Young Adult Perspectives on Generative AI

    Common Sense Media & Hopelab, 2024. Teen and Young Adult Perspectives on Generative AI. Available at: www.commonsense.org/youth-perspectives-social-media-mental-health.

    Government / agency report

  • Characterizing Delusional Spirals through Human-LLM Chat Logs

    Moore J, Mehta A, Agnew W, Anthis JR, Louie R, Mai Y, Yin P, Cheng M, Paech SJ, Klyman K, Chancellor S, Lin E, Haber N, Ong D, 2024. Characterizing Delusional Spirals through Human-LLM Chat Logs. arXiv, 2603.16567v1.

    Peer-reviewed study (original research)

  • Suicide and self-harm in the age of generative artificial intelligence: The case of ChatGPT and rise of suicide-related lawsuits

    Muhammad Ittefaq, Rauf Arif, Shafiq Ahmad Kamboh, 2026. Suicide and self-harm in the age of generative artificial intelligence: The case of ChatGPT and rise of suicide-related lawsuits. Journal of Affective Disorders, 411, 122025. https://doi.org/10.1016/j.jad.2026.122025

    Peer-reviewed study (original research)

  • Independent Clinical Evaluation of General-Purpose LLM Responses to Signals of Suicide Risk

    Judd N., Vaz A., Paeth K., Davis L. I., Esherick M., Brand J., Amaro I., Rousmaniere T., 2024. Independent Clinical Evaluation of General-Purpose LLM Responses to Signals of Suicide Risk. Proceedings of the Second International Association for Safe and Ethical AI Conference (IASEAI’26), 279.

    Peer-reviewed study (original research)

  • AI RISK ASSESSMENT Google Search: AI Overview & AI Mode Google Search's unavoidable AI features aren'tsafe, reliable, and accurate enough to be kids' default answer machine

    AI RISK ASSESSMENT Google Search: AI Overview & AI Mode Google Search's unavoidable AI features aren'tsafe, reliable, and accurate enough to be kids' default answer machine Last updated: Jul 14, 2026

    News / journalism

  • When patients consult artificial intelligence before clinicians: restoring clinical prioritisation in mental health care

    Yudai Kaneda, 2026. When patients consult artificial intelligence before clinicians: restoring clinical prioritisation in mental health care. The British Journal of Psychiatry, First View, pp. 1 - 2. https://doi.org/10.1192/bjp.2026.10741

    Commentary / Editorial

  • Assessing AI’s Influence On Violence Risk

    Crimando, 2026. Assessing AI’s Influence On Violence Risk. Continuity Insights.

    News / journalism

  • A boy wrote about his suicide attempt. He didn’t realize his school’s Gaggle software was watching

    Mark Keierleber, 2021. A boy wrote about his suicide attempt. He didn’t realize his school’s Gaggle software was watching. The Guardian.

    News / journalism
This platform is NOT a scoring engine, diagnostic tool, or risk prediction system. It is a research and evidence-mapping tool to support the transparent development of an SPJ framework.