Using Social Media to Gauge Suicide Risk
Dr. Molly Adrian is chasing an elusive goal: finding a way to know when adolescents and young adults who contemplate suicide might actually try to harm themselves.
“Suicide risk rises and falls but it’s really hard to tell when it’s rising, even when you’re regularly seeing a patient,” says Adrian, a Seattle Children’s psychiatrist and a researcher in the Center for Child Health, Behavior and Development.
Now she is pursuing an innovative solution – a computerized system that would scan adolescents’ social media posts for signs of crisis and alert a medical specialist or family member when someone needs immediate help.
“Many adolescents are guarded in person but post their suicide crises online,” Adrian says. “If we can use that to know when those crises happen, we might be able to help kids before it’s too late.”
Predicting Suicide Based on Key Words and Phrases
Adrian’s idea is based on the Durkheim Project, a nonprofit research effort that developed a new way to identify suicide risk among military veterans.
The Durkheim team used sophisticated technology to analyze psychiatrists’ notes about veteran patients and identify clusters of words, phrases and behaviors – such as “agitation” and “frightening” – that correlated to patients who committed suicide. Then the team developed a prediction model that tabulates a patient’s suicide risk. In a study in PLOS ONE, the researchers found this text-mining approach could have predicted about 65% of suicide attempts among the population it studied.
This prediction accuracy has improved to 70% since that study and will continue to improve as more data is collected and analyzed.
Now the Durkheim Project is testing a system that uploads content from the text messages and Facebook, Twitter and LinkedIn posts of veterans who volunteer to be part of its study. This content feeds into a database and is automatically searched for words and phrases that hint a veteran is at risk. Each study participant’s risk level is tracked in real-time and reflected via a numerical score and color-coded system.
When the risk score gets to a dangerous level, the system sends an email or text message to a mental health provider or family member. Someday, it might also send calming tips to the person at risk, such as advice to “hold several pieces of ice in your hand until they completely melt.”
Working to Prevent Teen Suicide
Now the Durkheim Project is partnering with experts like Adrian to adapt its work to other populations. Adrian recently applied for a National Institutes of Health K award – a grant that helps young researchers establish their careers – to conduct a study that would start with “retraining” the Durkheim Project’s technology to tailor it to adolescents. One key is to identify whether the words or phrases that reflect suicide risk in this population are different from the veteran population.
From there, Adrian’s team would launch a small study to determine whether adolescents and young adults would actually opt in to the system, and to assess how usable the system is. Specifically, youth will be asked how easy the system was to navigate and how helpful it was in conjunction with therapy. Clinicians will be asked about usability and about how the technology fits with their clinical workflow. The system would also use providers’ notes to help tabulate the automated risk scores.
“Ideally, the risk score would help us know when suicide risk is going up so we can address it in therapy before it gets too high,” Adrian says.
Finally, Adrian would lead a small, randomized controlled trial to evaluate how well the system identifies participants’ risk and whether it can truly help improve care and prevent suicide.
The Potential to Help Teens Everywhere
The system could be expanded so teens anywhere could opt in, along with their friends and family members. This could provide an early-warning system that helps everyone from medical providers to family members support adolescents when they need it most.
“We have a long way to go to see if it works, but it has the potential to make a huge difference,” Adrian says.