InsightFlow: LLM-Driven Synthesis of Patient Narratives for Mental Health into Causal Models

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Main Authors: Gupta, Shreya, Adhikary, Prottay Kumar, Dave, Bhavyaa, Singh, Salam Michael, Deroy, Aniket, Chakraborty, Tanmoy
Format: Preprint
Published: 2026
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author Gupta, Shreya
Adhikary, Prottay Kumar
Dave, Bhavyaa
Singh, Salam Michael
Deroy, Aniket
Chakraborty, Tanmoy
author_facet Gupta, Shreya
Adhikary, Prottay Kumar
Dave, Bhavyaa
Singh, Salam Michael
Deroy, Aniket
Chakraborty, Tanmoy
contents Clinical case formulation organizes patient symptoms and psychosocial factors into causal models, often using the 5P framework. However, constructing such graphs from therapy transcripts is time consuming and varies across clinicians. We present InsightFlow, an LLM based approach that automatically generates 5P aligned causal graphs from patient-therapist dialogues. Using 46 psychotherapy intake transcripts annotated by clinical experts, we evaluate LLM generated graphs against human formulations using structural (NetSimile), semantic (embedding similarity), and expert rated clinical criteria. The generated graphs show structural similarity comparable to inter annotator agreement and high semantic alignment with human graphs. Expert evaluations rate the outputs as moderately complete, consistent, and clinically useful. While LLM graphs tend to form more interconnected structures compared to the chain like patterns of human graphs, overall complexity and content coverage are similar. These results suggest that LLMs can produce clinically meaningful case formulation graphs within the natural variability of expert practice. InsightFlow highlights the potential of automated causal modeling to augment clinical workflows, with future work needed to improve temporal reasoning and reduce redundancy.
format Preprint
id arxiv_https___arxiv_org_abs_2604_12721
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle InsightFlow: LLM-Driven Synthesis of Patient Narratives for Mental Health into Causal Models
Gupta, Shreya
Adhikary, Prottay Kumar
Dave, Bhavyaa
Singh, Salam Michael
Deroy, Aniket
Chakraborty, Tanmoy
Computation and Language
Clinical case formulation organizes patient symptoms and psychosocial factors into causal models, often using the 5P framework. However, constructing such graphs from therapy transcripts is time consuming and varies across clinicians. We present InsightFlow, an LLM based approach that automatically generates 5P aligned causal graphs from patient-therapist dialogues. Using 46 psychotherapy intake transcripts annotated by clinical experts, we evaluate LLM generated graphs against human formulations using structural (NetSimile), semantic (embedding similarity), and expert rated clinical criteria. The generated graphs show structural similarity comparable to inter annotator agreement and high semantic alignment with human graphs. Expert evaluations rate the outputs as moderately complete, consistent, and clinically useful. While LLM graphs tend to form more interconnected structures compared to the chain like patterns of human graphs, overall complexity and content coverage are similar. These results suggest that LLMs can produce clinically meaningful case formulation graphs within the natural variability of expert practice. InsightFlow highlights the potential of automated causal modeling to augment clinical workflows, with future work needed to improve temporal reasoning and reduce redundancy.
title InsightFlow: LLM-Driven Synthesis of Patient Narratives for Mental Health into Causal Models
topic Computation and Language
url https://arxiv.org/abs/2604.12721