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Show HN: Psychosis Guard – Safety for long LLM conversations

Developer nwjang released psychosis-guard, an open-source, model-agnostic safety middleware that tracks cumulative risk across long LLM conversations and escalates graduated interventions when a conversation drifts toward delusional reinforcement. On the preliminary psychosis-bench evaluation (n=16, one repetition), an unguarded chatbot scored 42% on "delusion not confirmed," 60% on "harm not enabled," and 15% on "safety intervention offered," while a safety prompt plus psychosis-guard scored 71%, 91%, and 87% respectively. The tool runs as an HTTP proxy or Python library in front of OpenAI, Anthropic, or OpenAI-compatible servers such as Ollama and vLLM, and its authors label it a research and educational tool that is not a medical device and whose intervention copy requires mental-health professional review before use with real users.

read10 min views4 publishedSep 23, 2026
Show HN: Psychosis Guard – Safety for long LLM conversations
Image: Michielbdejong (auto-discovered)

Trajectory-aware safety middleware for long-running LLM conversations.

English | 한국어

A chatbot can validate a user's delusional belief a little more on every turn while no single message ever trips a content filter. psychosis-guard tracks the whole conversation, scores where it is heading, and steps in with a graduated intervention before that drift compounds. Open source, model-agnostic, runs as an HTTP proxy or a Python library, and works with no API key on deterministic mocks.

psychosis-bench metric unguarded chatbot safety prompt + psychosis-guard
Delusion not confirmed 42 % 71 %
Harm not enabled 60 % 91 %
Safety intervention offered 15 % 87 %

<sub>psychosis-bench · n=16 · one repetition · preliminary evaluation. Share of the ideal score; full table, ablation and limitations in Evaluation.</sub>

Conventional guardrails inspect one message at a time. psychosis-guard adds a Trajectory Rail: a pipeline stage that tracks cumulative risk over the whole conversation and escalates a graduated, clinically-informed intervention when the conversation is heading the wrong way, even when every individual turn looks harmless.

It runs as an HTTP middleware in front of any chatbot (OpenAI, Anthropic, any OpenAI-compatible server such as Ollama or vLLM, or a bot you already operate), or as a Python library.

Disclaimer. Research/educational tool. NOT a medical device, NOT diagnosis or crisis support. In an emergency contact local emergency services or a crisis line. Intervention copy and prompts are marked ADVISER-REVIEW in the source and must be reviewed by a mental-health professional before use with real users.

  • Python 3.10+
  • Optional: an OpenAI or Anthropic API key, or any OpenAI-compatible endpoint. Without one, the whole pipeline runs on deterministic mocks.
pip install psychosis-guard                            # core library (mocks only)
pip install "psychosis-guard[server,openai,anthropic]" # HTTP server + real LLM adapters

Extras: server (FastAPI/uvicorn), openai, anthropic, all.

From source, for development (tests, lint):

git clone https://github.com/nwjang/psychosis-guard.git
cd psychosis-guard
pip install -e ".[dev]"

Every user turn passes through five rail stages. Stages 1–3 and 5 mirror the input / dialog / output / action rails of NVIDIA NeMo Guardrails; Stage 4 is the new, cumulative-state stage.

Stage Rail What it does
1 Input Rail Pre-response risk estimate from the user turn plus the prior trajectory slope. HIGH short-circuits the chatbot and returns a safe response.
2 Dialog Rail Mode A: injects a graduated system prompt into the chatbot call.
3 Output Rail A judge scores the reply: reinforcement, sycophancy, pushback, escalation, help-referral.
4 Trajectory Rail Folds the turn into cumulative state and computes the least-squares slope of delusion density over the conversation.
5 Action Rail Composite risk → NONE / LOW / MEDIUM / HIGH ; Mode B rewrites the reply.

composite_risk = Σ wᵢ · signalᵢ + slope_boost · max(slope, 0)

Only an escalating trajectory raises risk. A falling slope is not rewarded, so interventions do not switch off while density is still high.

Key benefits:

  • Trajectory awareness. Catches slow drift that turn-local filters cannot see.
  • Model-agnostic. Works with any chatbot behind a singlerespond() interface, or with replies your application already has (check-only mode).
  • Graduated, not binary. A grounding question at LOW, an honest alternative explanation at MEDIUM, de-escalation and referral at HIGH.
  • Fail-safe by construction. Judge and rewriter failures never fail a turn; they degrade to lexical signals and a deterministic intervention.
  • Config-driven. Modes, thresholds and weights live in YAML, NeMo-style.
from psychosis_guard import PsychosisGuard

guard = PsychosisGuard.from_config("config.yml")     # deterministic mocks, no API key
reply = guard.send("Lately I keep noticing patterns that feel like signals meant for me.")
print(reply)
print(guard.log[-1].level.name, guard.summary()["delusion_slope"])

With a real model:

from psychosis_guard import PsychosisGuard
from psychosis_guard.adapters.llm import LLMChatbot, LLMJudge, LLMRewriter
from psychosis_guard.adapters.openai_adapter import OpenAICompleter

llm = OpenAICompleter("gpt-4o-mini")                 # or base_url="http://localhost:11434/v1"
guard = PsychosisGuard(
    chatbot=LLMChatbot(llm, base_system_prompt="You are a friendly assistant."),
    judge=LLMJudge(llm),
    rewriter=LLMRewriter(llm),
    mode="combined",
)
reply = guard.send("user message")

Check-only, when your application already has a reply from any chatbot:

final = guard.send(user_message, bot_reply=draft_reply)   # always show `final`, not the draft

Any object with respond(history, system_prompt) is a chatbot, any object with score(history, reply) is a judge, any object with rewrite(...) is a rewriter. See src/psychosis_guard/interfaces.py.

export PG_CHAT_PROVIDER=openai PG_CHAT_MODEL=gpt-4o-mini OPENAI_API_KEY=sk-...
psychosis-guard check-config      # prints the resolved setup; fails loudly on mistakes
psychosis-guard serve             # http://0.0.0.0:8080, OpenAPI docs at /docs

Three integration shapes:

1. Drop-in OpenAI-compatible proxy. Point any OpenAI SDK at the server; nothing else changes.

from openai import OpenAI
client = OpenAI(base_url="http://localhost:8080/v1", api_key="<PG_AUTH_TOKEN or anything>")

raw = client.chat.completions.with_raw_response.create(
    model="guarded", messages=history, extra_headers={"X-Session-Id": session_id},
)
reply = raw.parse().choices[0].message.content
raw.headers["X-Guard-Level"]          # NONE | LOW | MEDIUM | HIGH

Without a session id the request is stateless: the trajectory is rebuilt from the message history the client sent, so the proxy scales horizontally with no shared state.

2. Guarded turn. The middleware calls the upstream chatbot for you.

curl -X POST localhost:8080/v1/guard/turn -H 'content-type: application/json' \
  -d '{"session_id": "abc", "message": "I keep seeing signs meant only for me"}'

3. Check-only (bring your own reply). Score and, if needed, rewrite a reply produced by any chatbot.

curl -X POST localhost:8080/v1/guard/check -H 'content-type: application/json' \
  -d '{"session_id": "abc", "user_message": "...", "bot_reply": "...draft..."}'

Every guarded response carries the assessment:

{
  "reply": "...final reply the user should see...",
  "intervened": true,
  "level": "MEDIUM",
  "risk": 0.61,
  "signals": {"delusion_density": 0.5, "reinforcement": 0.0, "...": 0.0},
  "trajectory": {"turn_count": 4, "delusion_slope": 0.08, "bot_validation_count": 1},
  "trace": ["[stage1:input] ...", "[stage2:dialog] ...", "..."]
}

Full endpoint reference: docs/http-api.md.

cp .env.example .env              # provider, model, keys
docker compose up --build         # http://localhost:8080
curl localhost:8080/healthz
Role Providers
Chatbot under guard OpenAI, any OpenAI-compatible server (Ollama, vLLM, LM Studio, Groq, OpenRouter, …), Anthropic, or your own Chatbot implementation, or none (check-only)
Judge (risk rubric) Same set; can be a different, cheaper model than the chatbot
Rewriter (Mode B) Same set, or none for a deterministic appended intervention

Set them independently with PG_CHAT_*, PG_JUDGE_*, PG_REWRITER_*.

The condition key in config.yml (or PG_CONDITION) selects the mode. Presets for each live in configs/.

Mode Behaviour
combined Mode A + Mode B + Trajectory Rail. The default.
A System-prompt injection only (needs a steerable chatbot).
B Post-hoc rewrite only (fully model-agnostic).
single-turn-filter A + B with the Trajectory Rail off. A turn-local baseline.
detect-only Score and decide levels, never intervene. Shadow mode for rollout.
none Observe and log only.

Policy lives in YAML, outside code:

condition: combined
policy:
  low: 0.25          # composite-risk thresholds -> LOW / MEDIUM / HIGH
  medium: 0.50
  high: 0.75
  w_reinforcement: 0.35
  w_sycophancy: 0.20
  w_delusion: 0.20
  w_conviction: 0.15
  w_isolation: 0.10
  slope_boost: 3.0   # how strongly an escalating trajectory raises risk
  slope_window: 4    # turns the policy looks back over

Runtime settings are environment variables (PG_*, see .env.example and docs/configuration.md).

  • Calls per guarded turn: 1 chatbot + 1 judge, plus 1 rewriter only when the level is aboveNONE . Use a cheap judge model andPG_REWRITER_PROVIDER=none for the minimum.
  • Failure handling: judge errors degrade to lexical signals; rewriter errors degrade to a deterministic appended intervention. Upstream chatbot errors surface as HTTP 502.
  • State: sessions are process-local, TTL and LRU bounded. Run one replica, use sticky sessions, or use the stateless proxy path.
  • Languages: the judge rubric is language-independent and also estimates the user-side signals, so session-keyed conversations in any language get a full trajectory. The API-free lexicons used before the chatbot is called are English only; prefer session ids for non-English deployments.
psychosis-guard serve [--host H] [--port P] [--workers N]   run the HTTP middleware
psychosis-guard check-config                                validate env + config
psychosis-guard demo [--turns N]                            offline unguarded-vs-guarded demo
Turn-local guardrails (e.g. NeMo Guardrails) psychosis-guard
Unit of analysis one message the conversation trajectory
Sees slow drift no yes, via the delusion-density slope
Intervention block / replace graduated: ground → explain → de-escalate + refer
Placement before or after the model before (Mode A), after (Mode B), or check-only

psychosis-guard is complementary: it slots behind or beside content rails rather than replacing them.

Measured on psychosis-bench (Dohnány et al. 2025, arXiv:2509.10970), a public benchmark of 16 scripted 12-turn conversations that progress from loneliness to a delusional belief to a harmful act. Every turn is scored with the benchmark's own LLM-judge rubric: DCS delusion confirmation (0-2, lower is better), HES harm enablement (0-2, lower is better), SIS whether a safety intervention was offered (0-1, higher is better). All targets use the same chatbot model (gpt-4o-mini, temperature 0.7), judge ( gpt-4o-mini) and user script, so the contrasts between rows are like-for-like. n = 16 cases, one repetition, mean ± 95 % CI. Run 2026-09-07.

target DCS ↓ HES ↓ SIS ↑
unguarded chatbot 1.17 ± 0.23 0.79 ± 0.18 0.15 ± 0.13
+ one-paragraph safety system prompt 0.74 ± 0.15 0.33 ± 0.18 0.76 ± 0.18
psychosis-guard, Trajectory Rail off (turn-local) 0.98 ± 0.13 0.72 ± 0.17 0.20 ± 0.17
psychosis-guard, B (rail + rewrite) 0.82 ± 0.10 0.39 ± 0.17 0.89 ± 0.14
psychosis-guard, combined 0.85 ± 0.09 0.40 ± 0.16 0.74 ± 0.21
safety system prompt + psychosis-guardcombined 0.58 ± 0.18 0.19 ± 0.15 0.87 ± 0.11

Paired Wilcoxon on the 16 matched cases, Holm-corrected:

  • vs the unguarded chatbot ,B andcombined improve all three metrics (d = 0.8-2.1, all p < .02) and eliminate every full-validation (DCS = 2) and full-compliance (HES = 2) turn.
  • Trajectory Rail ablation.B vs the same pipeline with the rail off differs only in the rail; the rail accounts for DCS −0.16, HES −0.33, SIS +0.69 (all p < .05). Turn-local scoring under-calls risk on a slowly escalating script, so the rewriter fires at the wrong level.
  • vs a safety system prompt alone , the middleware is statistically indistinguishable: parity, obtained without access to the chatbot's prompt. Stacking the two is the best row on every metric (significant vscombined ; directionally better than the prompt alone, not significant at n = 16).
  • Utility. 0 interventions in 520 turns of benign control conversations.

What this does not show. These are scores on the chatbot's replies to a fixed script. In a separate reactive simulation, where an LLM-played user adjusts their next message to the reply, the middleware's referral and pushback rates rise just as here, but the simulated user's delusion density and conviction do not improve (combined ≈ unguarded); interventions that insert the most safety language, the post-hoc rewriter alone and the safety system prompt, make that simulated user worse. The intervention text is real; the framing around it is what still needs work (the ADVISER-REVIEW prompts). That simulator is unvalidated and the judge is an LLM checked only against another LLM (κ ≈ 0.5), so treat the table above as a bot-side benchmark, not evidence of user outcomes. Runner, scripts and per-turn transcripts are in the research repository; three repetitions and human judge labels are the planned next step.

Contributions are welcome. Please read CONTRIBUTING.md and the Code of Conduct. Changes to any text marked ADVISER-REVIEW (intervention copy, judge and rewriter prompts) need sign-off from a mental-health professional before they are merged.

Apache License 2.0. See LICENSE and NOTICE. This is an independent clean-room implementation; it is architecturally inspired by NVIDIA NeMo Guardrails but contains no NeMo source code.

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