Suicide Risk Modeling

We present BEACON-SP, an ontology-grounded Graph Retrieval-Augmented Generation (GraphRAG) framework for clinician-facing decision support in behavioral health settings such as suicide prevention, where effective assessment requires integrating heterogeneous clinical, behavioral, social, and temporal evidence. BEACON-SP combines patient knowledge graphs with ontology-guided retrieval to support multi-hop reasoning across diagnoses, medications, risk and protective factors, life events, and temporal relationships. The framework is enabled by a comprehensive suicide prevention ontology that integrates the Three-Step Theory, the Integrated Motivational-Volitional Model, and the Suicide Social Determinants of Health Ontology into a unified representation of patient risk factors. We construct ontology-grounded patient knowledge graphs and evaluate BEACON-SP for clinician-facing question answering. Compared with a vector-based retrieval-augmented generation (RAG) baseline on a 1,500-query benchmark spanning 15 clinical categories and 100 patients, BEACON-SP improves completeness, clinical relevance, and evidence grounding under a corrected comparative evaluation protocol, with a small gain on factual accuracy. In paired criterion-level comparisons, GraphRAG is preferred in 76.4% of cases. These results demonstrate the potential of ontology-guided GraphRAG to provide structured, contextualized patient evidence for clinical decision support.

Forecasting suicide risk is difficult due to the high heterogeneity of patients and the low base rate of suicide-related events (SREs). We present Latent Similarity Gaussian Processes (LSGPs), which embed patients in a continuous latent space to jointly model similarity and forecast risk. By selectively drawing information from latent peers, LSGPs better capture individualized risk trajectories, generalizing nomothetic (pooled), idiographic (per-patient), and hierarchical frameworks. Our contributions are: (1) an identifiable two-channel Similarity Kernel; (2) proof that the standard model-fitting algorithm, mean-field variational inference, collapses LSGPs to nomothetic models, along with a fix; and (3) empirical results on intensive longitudinal suicide data showing LSGPs outperform nomothetic, idiographic, and hierarchical models for next-week risk forecasting, with the largest gains in forecasting first-occurrence SREs.

Explainable suicide-risk assessment requires models not only to estimate risk severity, but also to identify supporting language and the risk and protective factors expressed in a post. We present our system for the IEEE BigData 2026 Cup on Explainable Suicide Risk Assessment on Social Media, which addresses three tasks: risk-level classification, evidence phrase extraction, and multi-label factor identification. Our approach adapts Qwen2.5-Instruct models using quantized low-rank adaptation (QLoRA) and an answer-masked causal language-model objective. We jointly train across all three tasks for risk classification, jointly train on Tasks1a and 1b for evidence extraction, and adapt Task2 separately for factor identification. We also tailor aggregation to each output: we average risk-level probabilities from the 32B and 72B models, combine evidence phrases through cross-fold consensus, and calibrate factor-specific decisions through rate matching based on out-of-fold operating points. On the official leaderboard, the final system achieved a composite score of 0.7738, with 0.8089 on Task1 and 0.6919 on Task2. Across the evaluated configurations, three-task training performed best for Task1a, joint training on Tasks1a and 1b performed best for Task1b, and task-specific training performed best for Task2. Probability averaging further improved Task~1a when component models had complementary errors. These findings highlight the value of tailoring both training objectives and aggregation strategies to the output structure of each task within a unified language-model framework.

Assessing suicide risk from social media text is a small-data, high-stakes setting requiring not only severity prediction but also supporting evidence and clinically relevant risk and protective factors. Yet common NLP techniques, including model scaling, synthetic data, loss reweighting, ensembling, and threshold tuning, are often applied without testing whether their gains hold up under severe class imbalance, coupled outputs, and limited author-level data. We study 1,635 clinician-annotated posts and audit 31 pre-specified techniques from 7 methodological families through roughly 300 controlled experiments on author-disjoint partitions. We found no prior audit of this playbook in this regime. The findings guide a task-grounded system for three outputs: 4-level suicide risk, evidence spans, and 24 clinical risk and protective factors. Only 5 of 31 comparisons produced reliable gains. We reformulate factor prediction as entailment between each post and its codebook definitions, using an architecturally diverse ensemble with class-balanced training and score rescaling. Risk predictions condition a 7-model evidence tagger ensemble; evidence restricts symbolic risk rules; and a difficult risk class is routed separately. The factor predictor remains independent because risk evidence provides no additional factor signal. We also correct a mismatch between validation scores used for threshold fitting and test-time ensemble scores through deployment-consistent calibration, yielding the largest improvement to the factor system. The final system achieves 0.8203 for risk, 0.7953 for evidence, and 0.7045 macro-F1 for factors, with a 0.7781 composite, ranking third among 53 teams. We call the underlying principle task-conditioned technique selection: retain techniques only when task-specific knowledge, structure, or empirical evidence justifies them.

Crisis helplines assess suicide risk through structured interviews, a process that is slow and dependent on operator training and workload. Natural language processing could support risk assessment and call prioritization, but almost no work addresses Arabic-language helpline calls or operates within the privacy constraints of real helpline data. We analysed de-identified transcripts from Lebanon's National Lifeline for Emotional Support and Suicide Prevention. Audio never left the helpline: calls were transcribed on site with a speech recognition model for Levantine Arabic, and an Arabic named-entity recognition model removed identifying information locally. Only the de-identified transcripts were shared with the research team. Operators recorded the five suicidal ideation items of the Columbia Suicide Severity Rating Scale, which we combined into two binary outcomes: at-risk and high-risk. We also machine-translated the transcripts into English, giving a paired Arabic/English comparison. On each corpus, we fine-tuned five instruction-tuned large language models alongside six transformer encoder baselines (four Arabic, two English) and evaluated all models on a held-out test set. We included 383 calls: 373 for the at-risk task (52.3% positive) and 297 for the high-risk task (30.0% positive). The best Arabic model reached a macro-F1 of 81.19 and a ROC-AUC of 90.61 on high-risk; the best English model reached 85.00 and 92.59, identifying 88.9% of high-risk calls. In both languages, high-risk calls separated more cleanly than at-risk calls, and translation to English did not reduce the best observed performance. Suicide risk can be classified from de-identified Arabic transcripts without sending audio outside the helpline. The high-risk results support further testing as an operator-facing tool; lower-severity ideation proved the harder case.

The suicide is a terrifying act of a person who is misled by his own mental state. This problem arises across many countries. Sadly, Russia also has quite high number of persons who committed suicide. Luckily, a subset of these people writes their struggles in social media, allowing a way to find them and help. However, these valuable texts disappearing in many irrelevant texts which is considerably slowing down the decision process about person's suicidal risk. To tackle this problem, in this work we have presented a detailed methodology of building the dataset for detecting texts that describe presuicidal and anti-suicidal signals. This methodology describes the process of instruction and class table creation, the process of annotation, verification and post-annotation correction. Guiding by this methodology, we collect and annotate a large-scale Russian dataset with more than 50 thousand texts from social media. We provide a count statistic of the dataset as well as common problems in annotation. We also conduct basic experiments of building the classification models to show the on go performance on different levels of annotation. Furthermore, we make the dataset, code and all materials publicly available.

Suicide ideation detection models are typically evaluated using aggregate performance metrics, yet little is known about how they internally represent psychologically meaningful risk factors. In high-stakes mental health applications, understanding these internal representations is essential for safety, transparency, and responsible deployment. In this work, we move beyond accuracy and analyze how suicide detection models trained on original and topic-augmented datasets encode psychological risk factors in their internal representation space. Using visualization and geometric analysis, we examine the coherence and separability of topic-related features. Our results show that topic-aware augmentation increases the clarity and distinctness of underrepresented psychosocial risk factors such as immigration, family issues, and financial crisis. These findings suggest that augmentation not only improves model performance but also leads to more structured and interpretable internal representations.

Transfer learning is a natural strategy when a target population has limited data but multiple related auxiliary sources are available. A central difficulty is source heterogeneity: auxiliary sources may not be equally useful, and their usefulness may vary in a structured, cluster-like fashion. Existing transfer-learning methods often reduce source selection to a binary informative/non-informative decision, overlooking subgroups of sources with differential transferability. Motivated by a suicide-risk study using data from the Connecticut Hospital Information Management Exchange (CHIME), comprising 636,758 patients across 27 hospitals, we propose Trans-GLMC, a cluster-structured transfer-learning procedure for generalized linear models. The CHIME setting illustrates the core challenge: hospital-specific risk models are unstable because suicide attempts are rare at any single facility, whereas indiscriminate pooling across hospitals can obscure facility-level differences in patient mix and risk profiles. Trans-GLMC first constructs a coefficient-based distance among the target and candidate sources to recover latent source clusters. It then combines global fusion, within-cluster refinement, and target debiasing to produce an estimator that adapts to the detected structure. We establish a non-asymptotic error bound that improves over its unclustered counterpart whenever a meaningful target cluster exists and matches the unclustered rate up to constants otherwise. In simulations and in the CHIME study, Trans-GLMC improves facility-specific prediction, identifies interpretable communities of hospitals with mutual transferability, and recovers clinically coherent suicide-risk factors.

Suicide is a critical global public health challenge, causing approximately 720,000 deaths each year and calling for timely, effective prevention strategies. Existing computational studies primarily focus on post-based social media platforms such as Twitter and Weibo, leaving instant messaging environments such as Telegram underexplored. Yet group chats pose distinct challenges: messages are short, fragmented, multi-party, and often rely on implicit or culturally specific expressions, making isolated post-level analysis insufficient. We introduce SuiChat-CN, a Chinese group-chat benchmark for contextual suicide risk assessment. We collect public Telegram group-chat data, construct coherent conversational segments through signal-word extraction and bidirectional context expansion, and annotate user risk levels with an expert-validated, LLM-assisted paradigm. SuiChat-CN contains 13,312 contextual segments from 1,406 users, covering 258,228 raw chat messages. Extensive experiments with PLMs and more than 40 LLMs demonstrate that contextual information is essential for reliable risk assessment, while fine-tuning and partial-context evaluation further reveal the challenges of early detection in multi-party conversations. Due to ethical and sensitivity concerns, the dataset is not publicly released but will be shared with accredited mental health and suicide-prevention research institutions upon reasonable request.

Recent advances in artificial intelligence (AI) and social media data have led to growing optimism about the ability to detect suicide risk at scale. However, the empirical foundations of this work remain unclear. This article provides a synthesis of current research on AI-based suicide detection in social media, drawing on a recent umbrella review of 22 systematic reviews covering studies up to 2022, alongside an ongoing literature review extending the analysis to more recent work. Across these sources, we identified 195 relevant studies, which are documented in a detailed supplementary dataset outlining their key characteristics and findings (see Supplementary Information). Analysis of these studies reveals consistent patterns, including rapid growth, concentration on a small number of platforms, reliance on textual and English-language data, and repeated use of similar datasets. Most importantly, the majority of studies rely on indirect labeling strategies that do not involve direct, individual-level validation of suicide risk. Instead, ground truth is typically inferred from observable features of online content, such as linguistic markers or community membership. As a result, the predictive task often shifts from identifying individuals at risk to classifying posts that contain suicidal or distress-related language, limiting the ability of current approaches to detect individuals who do not express such content explicitly online. These findings suggest that current advances in model performance should be interpreted with caution. Progress in this field is likely to depend less on improving model performance and more on ensuring that model predictions meaningfully correspond to suicide risk as it is experienced in real life.

Understanding and monitoring human behavior in metro stations play an important role in supporting suicide prevention efforts, where early identification of high-risk situations can enable timely intervention. This requires assessing suicide risk from a surveillance video by jointly reasoning about the behavior of each passenger, his/her spatial context, and temporal dynamics. However, this assessment using videos captured by surveillance cameras is challenging, as it demands accurate perception of human motion, understanding of platform geometry, and aggregation of heterogeneous behavioral cues over time. In this work, we formalize the task of Suicide Risk Assessment (SRA) in metro stations and introduce the first interpretable framework that addresses this challenge. Unlike approaches that focus on isolated subtasks or attempt to infer intent directly, our formulation assesses suicide risk from accumulated evidence by incorporating person tracking, activity recognition, semantic segmentation of the platform, and trajectory-driven risk heatmap modeling. By formalizing SRA as a distinct task and benchmarking a complete operational pipeline achieving 83.2% ROC-AUC on real surveillance data, this work highlights the complexity of suicide risk assessment and opens new directions for research on interpretable AI systems for social good.

Ecological Momentary Assessment (EMA) studies provide real-time data on suicidal thoughts and behaviors, but forecasting suicide attempts remains challenging: attempts are rare, and the pathways patients take to them are heterogeneous. Here, we investigate a cohort of patients from an EMA study with recorded suicide-related events. We show that a single model fit to all patients forecasts poorly, while idiographic (per-patient) models show improvement but overfit for those with little data. Based on this result, one may hypothesize that patients should be partitioned into subgroups---this way, similar patients' data can be pooled together to improve forecasts. However, we show that grouping patients at random already improves forecasts, with performance increasing monotonically with the number of groups. Moreover, we show that grouping patients by demographics yields worse forecasts than random groupings. From these results, we hypothesize that patient similarity is continuous, rather than discrete, and must be inferred from the data. This motivated us to use Latent Variable Multiple Output Gaussian Processes (LVMOGPs), adapted to our data. Preliminary results show that, even without careful kernel design, LVMOGPs already match the strongest baseline models on most metrics, and their latent spaces yield a similarity between patients that we can inspect directly. Because the cohort is conditioned on the outcome and the splits are not temporal, we read these results as evidence that idiographic structure exists and can be recovered, not as deployable forecasting performance---an area for future work.

Ecological Momentary Assessment (EMA) studies enable the collection of high-frequency self-reports of suicidal thoughts and behaviors (STBs) via smartphones. Latent stochastic differential equations (SDEs) are a promising model class for EMA data, as it is irregularly sampled, noisy, and partially observed. But SDE-based models suffer from two key limitations. (a) These models often violate domain constraints, undermining scientific validity and clinical trust of the model. (b) Training is numerically unstable without ad hoc fixes (e.g. oversimplified dynamics) that are ill-suited for high-stakes applications. Here, we develop a novel class of expressive SDEs whose solutions are provably confined to a prescribed compact polyhedral state space, matching the domains of EMA data. In this work, (1) we show why chain-rule based constructions of SDEs on compact domains fail, theoretically and empirically; (2) we derive constraints on drift and diffusion for general and stationary SDEs so their solutions remain in the desired state space; and (3), we introduce a parameterization that maps arbitrary (neural or expert-given) dynamics into constraint-satisfying SDEs. On several real EMA datasets, including a large suicide-risk study, our parameterization improves forecasts and optimization dynamics over standard latent neural SDE baselines. These contributions pave the way for principled, trustworthy continuous-time models of suicide risk and other clinical time series and extend applications of SDE-based methods (e.g. diffusion models) to domains with hard state constraints.

Real-world crisis intervention is inherently conversational, yet existing research largely focuses on static texts. When applied to multi-turn dialogues, current models exhibit significant performance degradation, struggling to track risk signals that emerge as context evolves. To address this gap, we introduce CRADLE-Dialogue, a clinician-annotated benchmark for turn-level crisis detection in conversational settings. The dataset features 600 dialogues with multi-label annotations across clinically grounded risks, including suicide ideation, self-harm, and child abuse, distinguishing past from ongoing risk. We further propose an Alert-Confirm evaluation protocol that distinguishes early warning signals (Alert) from turns where a specific crisis becomes explicitly identifiable (Confirm), reflecting the clinical need to intervene before risk becomes explicit. Experiments show that identifying when risk emerges is much harder than recognizing that it exists: models achieve only mid-40% to high-60% Micro F1. Additionally, we release a synthetic training corpus and a 32B-parameter model that substantially outperforms existing open-source models and achieves competitive or superior results against proprietary models across turn-level, dialogue-level, and confirm-only evaluation settings.