Not Safe for All: Auditing the Dialect Penalty in Text-to-Image Safety Pipelines

Text-to-image (T2I) safety guardrails fail to generalize equitably to non-standard dialects. Evaluating 23,080 paired prompts across five English dialects, we formalize this failure as the dialect penalty, where filters trigger based on linguistic surface features rather than semantic intent. Text-level filters fail in opposing directions: NSFW-T over-flags benign dialect prompts and LatentGuard over-flags toxic ones (bias gaps up to +28.29 pp), while the OpenAI Moderation API under-detects them. A controlled typo ablation confirms this penalty originates from flagging dialectal features, not generic out-of-distribution sensitivity. The pixel-level generator is largely dialect-agnostic; the penalty enters at text processing and cascades unevenly to post-hoc guardrails. We show this bias tracks training data imbalance and is mitigable via group-balanced retraining, with an ablation attributing the gain to balanced exposure rather than to the worst-group objective of GroupDRO (group distributionally robust optimization). Current pipelines systematically fail dialect speakers, an equity failure masked by mean accuracy benchmarks. Our official code and dataset are publicly available at https://github.com/minguinho26/dialect-penalty-t2i. Content Warning: This paper contains offensive, toxic, or disturbing text prompts and generated images.

LongGuard: Mechanistic Analysis and Training-Free Mitigation of Long-Context Failure in Safety Guardrails

Safety guardrails serve as the last line of defense against harmful inputs and outputs of large language models (LLMs), yet they are trained and evaluated almost exclusively on short text. We present LongGuard, a framework that evaluates, mechanistically analyzes, and mitigates long-context guardrail failure. We formulate the task as Safety Needle-in-a-Haystack (SafetyNIAH) over a 0.25k-32k length grid; across 15 mainstream guardrails, unsafe recall drops monotonically by more than 50% on average, and a paired Benign-Fill vs. Needle-Repeat design attributes the failure to proportional dilution of the unsafe needle rather than to absolute length. A three-layer attention-logit-behavior analysis on six guardrails locates the mechanism: attention mass on the unsafe needle is diluted, the unsafe-over-safe logit margin is compressed in lockstep, and the detection decision collapses accordingly, with this attention->logit->behavior chain remaining consistent after partialling out length. We further isolate a sparse set of guard-specialized retrieval heads that exhibit partial specificity relative to their base models. Building on the analysis, we propose two training-free mitigations - Chunked Detection (CD) and Attention-Head Sharpening (AHS) - and a deployment protocol, Context-Aware Hyperparameter Routing (CAHR), that selects configurations by context length and audit side. Across five benchmarks spanning synthetic data, long-context attacks, and reasoning-model outputs, CAHR-CD and CAHR-AHS improve the six-guardrail average by 22% and 13%, respectively. Code and data are available online.

ECHO: A Locally-Deployable Agentic Health Assistant with Temporal Memory, Safety Guardrails, and Speech Assessment

This paper presents ECHO (Enhanced Care \& Health Observer), a locally-deployable conversational health assistant for long-term chronic care management. ECHO integrates three complementary software modules developed under shared supervision as a unified system. The core module is an agentic chatbot built on a ReAct loop orchestrated via LangGraph, equipped with 17 clinical tools and a temporal knowledge graph for persistent cross-session memory; it achieves a 94.9\% tool-execution pass rate across a 59-scenario benchmark with GPT-5 Mini. A two-stage hybrid safety layer intercepts all incoming queries: a rule-based layer handles explicit crisis signals and jailbreak attempts in under 1ms, while a signed graph neural network (GNN) with APPNP-style propagation classifies boundary cases by clinical intent, achieving 88.8\% accuracy and 90.6\% unsafe recall on a 2,537-query annotated Turkish health dataset while outperforming zero-shot LLM baselines including Llama 3.3 70B. A multimodal speech assessment module combining Whisper acoustic encoding and BERT text encoding with cross-attention fusion estimates emotion, depression, and pain, reaching a mean macro F1 of 0.652. The full system is implemented as a web application that can run entirely on consumer hardware, with no patient data transmitted to external services, supporting compliance with GDPR and KVKK.

Trivial Prompt Reframing Bypasses Safety Guardrails in Googleś MedGemma-4B

Open-weight medical language models are increasingly used as the base of patient-facing and clinician-support applications. Their model cards prohibit specific behaviors -- recommending exact drug dosages, issuing definitive diagnoses, prescribing treatments, adjudicating drug-drug interactions, and advising that emergency care can be skipped -- yet a model card describes intended behavior, not robust behavior. We quantify that gap for MedGemma-4B-it under attacks that require no technical sophistication. We build a fully factorial benchmark of 5 guarded-behavior concepts x 50 deterministically templated questions x 6 lay-accessible attack manners x 3 repetitions (4,500 generations), serve the model locally through Ollama under default sampling, and code every response refuse/hedge/comply with three independent judges (an LLM judge, a transparent regex judge, and an NLI-entailment judge). Under the primary LLM judge the overall Attack Success Rate (ASR, the fraction coded comply) is 38.0%. The two framings that reinterpret the request as legitimate dominate: recasting a question as a "medical board exam" item raises ASR from a 29.0% baseline to 53.1% (+24.0 points), and an appeal to an alleged doctor's authority raises it to 43.7% (+14.7); crude instruction-override prefixes have no significant effect. Robustness is dominated by topic: the drug-interaction guardrail is nearly absent (83.2% ASR) while the emergency-deferral guardrail is strong (4.7%) -- and the authority framing is the only attack that breaches it. We report Wilson confidence intervals, cluster-bootstrap effect sizes, a cluster-robust logistic regression, Cochran's Q, per-manner McNemar tests, and inter-judge reliability (Fleiss' kappa = 0.26); absolute ASR is judge-dependent while the ordering of attacks and topics is not. Our findings motivate stronger deployment-time guardrails for open medical models.

Toward Trustworthy Large Language Model Agents in Healthcare

Healthcare appointment scheduling remains a persistent operational bottleneck, driven by manual coordination, fragmented legacy systems, and high administrative overhead. These inefficiencies constrain provider availability and degrade patient access to care. This paper presents CareConnect, a safety-first conversational agent for healthcare logistics automation that leverages large language model (LLM) function calling, retrieval-augmented generation (RAG), and layered deterministic safety guardrails. The system orchestrates eight domain-specific tools to support appointment booking, modification, cancellation, and facility information retrieval, while enforcing strict scope constraints that prohibit medical advice or diagnosis. Safety-critical situations are handled through deterministic short-circuit mechanisms for emergency detection and medical intent refusal. We evaluate CareConnect on a comprehensive benchmark of 680 task-oriented scenarios spanning end-to-end workflows, multi-turn interactions, and edge cases. Experimental results demonstrate a 91.8% task completion rate with a median per-request latency of 2.2 seconds, 96.0% safety compliance on the dedicated safety-critical evaluation subset, and an average operational cost of $0.0324 per appointment, yielding a significant cost reduction compared to manual human scheduling. These findings show that carefully scoped and rigorously safeguarded LLM-based agents can reliably automate complex healthcare operational workflows while maintaining safety guarantees and achieving substantial cost efficiency. The source code and system implementation are publicly available at https://github.com/Hadi-Hsn/CareConnect.

One Year Later...The Harms Persist, But So Do We!

General-purpose large language models (LLMs) are increasingly used for mental health-related conversations, yet safety guardrails remain inadequate and inconsistent across clinical conditions. This study evaluates eight 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 publicly available settings (e.g., schools, search engines, and consumer chatbots) are particularly concerning.

Safe responses matter: Output-aware safety guardrail mitigate over-refusal in MLLMs

Existing safety mechanisms for multimodal large language models (MLLMs) face a fundamental trade-off between safety and utility. Model fine-tuning achieves robust safety but compromises general utility. Input-side safety guardrails offer a lightweight alternative, yet they suffer from severe over-refusal, indiscriminately blocking benign queries or those the model could have safely answered through refusal or advisory responses. We identify that the root cause of over-refusal lies in the input-aware paradigm: safety guardrails make safety decisions without considering whether the model itself is capable of generating safe responses. Usually, MLLMs already possess intrinsic safety mechanisms that can transform harmful inputs into harmless outputs, but input-side safety guardrails override this capability, degrading user experience. Motivated by this insight, we propose a paradigm shift toward output-aware safety guardrails. Our method operates within the model's hidden state space to predict whether the forthcoming generation will be unsafe before it is fully produced. By training a lightweight classifier via multi-instance contrastive learning on hidden state representations, our approach distinguishes between inputs that will lead to unsafe outputs and those that will not, even when the inputs themselves contain risky elements. This enables precise intervention only when the model's actual response would be harmful. Extensive experiments demonstrate that our output-aware safety guardrail matches the safety performance of existing methods while drastically reducing over-refusal, preserving the model's utility and built-in safety capabilities. Code is available at: https://github.com/kunzhan/OutGuard