Mining Free-Text Medical Notes for Suicide Risk Assessment

Machine Learning in Mental Health

“…Noisy/ ambiguous signals Ambiguous words/lexical variations Chancellor [ 28 ]; Nobles et al [ 134 ]; Saha and De Choudhury [ 165 ]; Yazdavar et al [ 211 ] Ambiguity in signals (e.g . , for audio: robust speaker detection; distinguish personal speaking style from symptoms) Chang et al [ 31 ]; Mallol-Ragolta et al [ 112 ]; Rabbi et al [ 153 ]; Salekin et al [ 168 ]; Spathis et al [ 176 , 177 ]; Zhou et al [ 222 ] Managing irrelevant, redundant information Ojeme and Mbogho [ 136 ] Dataset limitations Restrictions due to data subjects/scale/study context Too small or restricted study sample/need for larger (more diverse) datasets Adamou et al [ 2 ]; Diederich et al [ 45 ]; Feng et al [ 61 ], Kavuluru et al [ 89 ]; Morshed et al [ 128 ], Nobles et al [ 134 ]; Ojeme and Mbogho [ 136 ]; Parades et al [ 140 ]; Park et al [ 141 ], Pestian et al [ 145 ]; Quisel et al [ 152 ]; Ray et al [ 155 ]; Salekin et al [ 168 ]; Spathis et al [ 177 ], Yazdavar et al [ 211 ]; Zhou et al [ 222 ] Unknown confounding variables + limitations of study context Fatima et al [ 57 ]; Saha and De Choudhury [ 165 ]; Salekin et al [ 168 ] Reference dataset not explicitly designed for mental health-related analysis Alam et al [ 6 ] Biased, missing, incomplete data General acknowledgement of biases inherent to model design and datasset used for training Ernala et al [ 53 ]; Hirsch et al [ 78 ]; Park et al [ 141 ] Difficulties due to missing data values/sparse data Alam et al [ 6 ]; Spathis et al…”

“…Predominantly this included efforts to predict future suicide risks from either sensor data [ 6 ], health records [ 2 , 192 ], or text [ 145 , 134 ]. Examples include: the analysis of written suicide notes [ 145 ]; of suicidality periods from the SMS messages of individuals with a history of suicidal behaviors [ 134 ]; and of suicide risk at time of a person's referral to mental health services [ 192 ], and subsequent periods [ 2 ]. Outside of suicide prediction, individual papers sought to help predict: episodes of mania or depression in people who experience bipolar conditions [ 50 ]; risks of re-hospitalization of outpatients with severe mental health difficulties [ 144 ]; and experiences of patient stress [ 139 ].…”

“…For example, Aguilar-Ruiz et al [ 4 ] developed a knowledge model from questionnaire data about psychiatric hospital patients' experiences of their relationship with their doctors to help improve doctor communication. The remaining papers either sought to help identify what may 2 Reddit ( w w w.reddit.com ) is a website that offers a collection of forums, where users can share content or comment on other peoples' posts. The service consists of more than one million communities, called 'subreddits', and has more than 330 million monthly active users.…”

“…However, for structured data and text analysis outside of social media, there was a stronger emphasis on the need to advance existing health care practices by developing more "accurate," "reliable," and "evidence-based" clinical assessment tools . For example, where text was analyzed to better understand or predict (acute) suicide risk, the need for novel, data-driven tools was argued by foregrounding the insufficiency of existing clinical approaches ; suggesting that "traditional methodologies deployed in assessing suicide have not lived up to promise" (p.1) [ 2 ]. As a consequence, clinicians "are often left to manage suicidal patients by clinical judgment alone" (p.96) [ 145 ], and "are not able to reliably predict when someone is at greatest risk" (p.1) [ 134 ].…”

“…Zhou et al [ 222 ] for example only mentioned having been provided with video and audio chat content of patients with symptoms of depression by a psychiatrist; while other papers [ 136 , 144 , 192 ] only stated the type of hospital, health department or services from which data was received. Often, patient information was solicited from a hospital [ 2 ] or other mental health service, institute or psychiatry department [ 45 , 61 , 63 ] that at least one or more of the paper authors were affiliated with. This further suggests that this kind of data access and analysis may be primarily led and conducted by health organizations or requires close collaboration with these institutions and care providers.…”