Abstract
BACKGROUND: As adolescent suicide rates continue to rise, innovation in risk identification is warranted. Machine learning can identify suicidal individuals based on their language samples. This feasibility pilot was conducted to explore this technology's use in adolescent therapy sessions and assess machine learning model performance. METHOD: Natural language processing machine learning models to identify level of suicide risk using a smartphone app were tested in outpatient therapy sessions. Data collection included language samples, depression and suicidality standardized scale scores, and therapist impression of the client's mental state. Previously developed models were used to predict suicidal risk. RESULTS: 267 interviews were collected from 60 students in eight schools by ten therapists, with 29 students indicating suicide or self-harm risk. During external validation, models were trained on suicidal speech samples collected from two separate studies. We found that support vector machines (AUC: 0.75; 95% CI: 0.69-0.81) and logistic regression (AUC: 0.76; 95% CI: 0.70-0.82) lead to good discriminative ability, with an extreme gradient boosting model performing the best (AUC: 0.78; 95% CI: 0.72-0.84). CONCLUSION: Voice collection technology and associated procedures can be integrated into mental health therapists' workflow. Collected language samples could be classified with good discrimination using machine learning methods.