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Main Authors: Nelson, Benjamin W., Wong, Celeste, Silvestrini, Matthew T., Shin, Sooyoon, Robinson, Alanna, Lee, Jessica, Yang, Eric, Torous, John, Trister, Andrew
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2510.12083
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author Nelson, Benjamin W.
Wong, Celeste
Silvestrini, Matthew T.
Shin, Sooyoon
Robinson, Alanna
Lee, Jessica
Yang, Eric
Torous, John
Trister, Andrew
author_facet Nelson, Benjamin W.
Wong, Celeste
Silvestrini, Matthew T.
Shin, Sooyoon
Robinson, Alanna
Lee, Jessica
Yang, Eric
Torous, John
Trister, Andrew
contents Large language models often mishandle psychiatric emergencies, offering harmful or inappropriate advice and enabling destructive behaviors. This study evaluated the Verily behavioral health safety filter (VBHSF) on two datasets: the Verily Mental Health Crisis Dataset containing 1,800 simulated messages and the NVIDIA Aegis AI Content Safety Dataset subsetted to 794 mental health-related messages. The two datasets were clinician-labelled and we evaluated performance using the clinician labels. Additionally, we carried out comparative performance analyses against two open source, content moderation guardrails: OpenAI Omni Moderation Latest and NVIDIA NeMo Guardrails. The VBHSF demonstrated, well-balanced performance on the Verily Mental Health Crisis Dataset v1.0, achieving high sensitivity (0.990) and specificity (0.992) in detecting any mental health crises. It achieved an F1-score of 0.939, sensitivity ranged from 0.917-0.992, and specificity was >= 0.978 in identifying specific crisis categories. When evaluated against the NVIDIA Aegis AI Content Safety Dataset 2.0, VBHSF performance remained highly sensitive (0.982) and accuracy (0.921) with reduced specificity (0.859). When compared with the NVIDIA NeMo and OpenAI Omni Moderation Latest guardrails, the VBHSF demonstrated superior performance metrics across both datasets, achieving significantly higher sensitivity in all cases (all p < 0.001) and higher specificity relative to NVIDIA NeMo (p < 0.001), but not to OpenAI Omni Moderation Latest (p = 0.094). NVIDIA NeMo and OpenAI Omni Moderation Latest exhibited inconsistent performance across specific crisis types, with sensitivity for some categories falling below 0.10. Overall, the VBHSF demonstrated robust, generalizable performance that prioritizes sensitivity to minimize missed crises, a crucial feature for healthcare applications.
format Preprint
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institution arXiv
publishDate 2025
record_format arxiv
spellingShingle An AI-Based Behavioral Health Safety Filter and Dataset for Identifying Mental Health Crises in Text-Based Conversations
Nelson, Benjamin W.
Wong, Celeste
Silvestrini, Matthew T.
Shin, Sooyoon
Robinson, Alanna
Lee, Jessica
Yang, Eric
Torous, John
Trister, Andrew
Computation and Language
Artificial Intelligence
Large language models often mishandle psychiatric emergencies, offering harmful or inappropriate advice and enabling destructive behaviors. This study evaluated the Verily behavioral health safety filter (VBHSF) on two datasets: the Verily Mental Health Crisis Dataset containing 1,800 simulated messages and the NVIDIA Aegis AI Content Safety Dataset subsetted to 794 mental health-related messages. The two datasets were clinician-labelled and we evaluated performance using the clinician labels. Additionally, we carried out comparative performance analyses against two open source, content moderation guardrails: OpenAI Omni Moderation Latest and NVIDIA NeMo Guardrails. The VBHSF demonstrated, well-balanced performance on the Verily Mental Health Crisis Dataset v1.0, achieving high sensitivity (0.990) and specificity (0.992) in detecting any mental health crises. It achieved an F1-score of 0.939, sensitivity ranged from 0.917-0.992, and specificity was >= 0.978 in identifying specific crisis categories. When evaluated against the NVIDIA Aegis AI Content Safety Dataset 2.0, VBHSF performance remained highly sensitive (0.982) and accuracy (0.921) with reduced specificity (0.859). When compared with the NVIDIA NeMo and OpenAI Omni Moderation Latest guardrails, the VBHSF demonstrated superior performance metrics across both datasets, achieving significantly higher sensitivity in all cases (all p < 0.001) and higher specificity relative to NVIDIA NeMo (p < 0.001), but not to OpenAI Omni Moderation Latest (p = 0.094). NVIDIA NeMo and OpenAI Omni Moderation Latest exhibited inconsistent performance across specific crisis types, with sensitivity for some categories falling below 0.10. Overall, the VBHSF demonstrated robust, generalizable performance that prioritizes sensitivity to minimize missed crises, a crucial feature for healthcare applications.
title An AI-Based Behavioral Health Safety Filter and Dataset for Identifying Mental Health Crises in Text-Based Conversations
topic Computation and Language
Artificial Intelligence
url https://arxiv.org/abs/2510.12083