Risk and Refusal: Mechanisms of LLM Responses to Suicidal Ideation
Refusal is a common safety mechanism in large language models (LLMs), yet in contexts of suicidal ideation (SI), refusing to engage can itself constitute a safety failure. We evaluate how eight instruction-tuned LLMs respond to SI and self-harm disclosures across three datasets, varying whether models are informed that a disclosure expresses SI and whether they receive a clinician-developed response protocol, and complement this with mechanistic analyses in six open-weight models. Our results reveal a nuanced relationship between refusal and response-level risk. At baseline, elevated risk in model responses is driven primarily by inattention to the disclosure, alongside refusal to engage....
| Authors | Drishti Goel, Soorya Ram Shimgekar, Jeongah Lee et al. |
|---|---|
| Primary category | cs.HC |
| Published | 15 October 2026 |
| Last updated at source | 15 October 2026 |
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