ResearchResearch paperLarge Language Models · Safety & Alignment · Interpretability1 source · Oct 15, 2026

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.

Key points

  • 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.
  • Mechanistic analyses suggest that models may refuse SI disclosures through the same direction that mediates their refusals of harmful requests.

Sources (1)

  • [1]Risk and Refusal: Mechanisms of LLM Responses to Suicidal Ideation
    arXiv (AI, ML, NLP, CV, robotics, multi-agent) · Oct 15, 10:34 PM
    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.

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