Abstract:Over the past decade, responsible AI (RAI) has produced a substantial body of practice for identifying and mitigating the risks AI poses in high-stakes settings. Yet this work has not produced a market that rewards trustworthiness. Firms that invest seriously in safety, fairness, and oversight cannot consistently prove to consumers, regulators, and shareholders that their systems go beyond the bare minimum of compliance. What is missing is a way for society to recognize or compare the difference. The result is a trust gap: a structural condition in which responsible development efforts happen inside organizations but produce no external, independently recognized and verifiable signal of trustworthy outcomes. We argue this gap is sustained in part because of a focus on responsible AI (a matter of internal process) as opposed to trustworthy AI (a matter of independently verifiable real-world outcomes), and that it persists because of three compounding failures: (1) the market cannot distinguish trustworthy systems from their imitations; (2) evaluation targets models and outputs rather than deployed sociotechnical systems and their outcomes; (3) the measurement ecosystem is oriented toward avoiding harm rather than demonstrating benefit. Reviewing existing AI governance instruments and comparing them to certification regimes in healthcare, sustainability, and security, we show that none integrate a governance baseline, independently verified positive-outcome evidence, and market signaling in a single framework. We propose independent, outcome-oriented certification as the connective layer that can close the trust gap, complementing regulation and internal governance by making trustworthiness measurable, comparable, and commercially rewarded.
Abstract:General-purpose large language models (LLMs) are increasingly used for mental health-related conversations, yet safety safeguards remain inadequate and inconsistent across clinical conditions. This study evaluates six proprietary LLMs across 16 DSM-5 conditions using four adversarial attack variants, introducing an eight-dimension harm taxonomy and a multi-dimensional evaluation framework. Results show that safeguards hold reliably only for suicide and self-harm, while conditions such as eating disorders, substance use disorder, and major depressive disorder exhibit failure rates of up to 100%. We argue that ethical design and deployment of these LLMs demand clearly defined harm categories across clinical conditions and implementation of safeguards accordingly. Until such safeguards are in place, these models pose significant risks to vulnerable populations, making their growing integration into educational settings a particularly concerning.