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Background Even before the onset of the COVID-19 pandemic, children and adolescents were experiencing a mental health crisis, partly due to a lack of quality mental health services. The rate of suicide for Black youth has increased by 80%. By 2025, the health care system will be short of 225,000 therapists, further exacerbating the current crisis. Therefore, it is of utmost importance for providers, schools, youth mental health, and pediatric medical providers to integrate innovation in digital mental health to identify problems proactively and rapidly for effective collaboration with other health care providers. Such approaches can help identify robust, reproducible, and generalizable predictors and digital biomarkers of treatment response in psychiatry. Among the multitude of digital innovations to identify a biomarker for psychiatric diseases currently, as part of the macrolevel digital health transformation, speech stands out as an attractive candidate with features such as affordability, noninvasive, and nonintrusive. Objective The protocol aims to develop speech-emotion recognition algorithms leveraging artificial intelligence/machine learning, which can establish a link between trauma, stress, and voice types, including disrupting speech-based characteristics, and detect clinically relevant emotional distress and functional impairments in children and adolescents. Methods Informed by theoretical foundations (the Theory of Psychological Trauma Biomarkers and Archetypal Voice Categories), we developed our methodology to focus on 5 emotions: anger, happiness, fear, neutral, and sadness. Participants will be recruited from 2 local mental health centers that serve urban youths. Speech samples, along with responses to the Symptom and Functioning Severity Scale, Patient Health Questionnaire 9, and Adverse Childhood Experiences scales, will be collected using an Android mobile app. Our model development pipeline is informed by Gaussian mixture model (GMM), recurrent neural network, and long short-term memory. Results We tested our model with a public data set. The GMM with 128 clusters showed an evenly distributed accuracy across all 5 emotions. Using utterance-level features, GMM achieved an accuracy of 79.15% overall, while frame selection increased accuracy to 85.35%. This demonstrates that GMM is a robust model for emotion classification of all 5 emotions and that emotion frame selection enhances accuracy, which is significant for scientific evaluation. Recruitment and data collection for the study were initiated in August 2021 and are currently underway. The study results are likely to be available and published in 2024. Conclusions This study contributes to the literature as it addresses the need for speech-focused digital health tools to detect clinically relevant emotional distress and functional impairments in children and adolescents. The preliminary results show that our algorithm has the potential to improve outcomes. The findings will contribute to the broader digital health transformation. International Registered Report Identifier (IRRID) DERR1-10.2196/46970
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A call for open data to develop mental health digital biomarkers
Digital biomarkers of mental health, created using data extracted from everyday technologies including smartphones, wearable devices, social media and computer interactions, have the opportunity to revolutionise mental health diagnosis and treatment by providing near-continuous unobtrusive and remote measures of behaviours associated with mental health symptoms. Machine learning models process data traces from these technologies to identify digital biomarkers. In this editorial, we caution clinicians against using digital biomarkers in practice until models are assessed for equitable predictions (‘model equity’) across demographically diverse patients at scale, behaviours over time, and data types extracted from different devices and platforms. We posit that it will be difficult for any individual clinic or large-scale study to assess and ensure model equity and alternatively call for the creation of a repository of open de-identified data for digital biomarker development.
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- Award ID(s):
- 1750326
- PAR ID:
- 10325326
- Date Published:
- Journal Name:
- BJPsych Open
- Volume:
- 8
- Issue:
- 2
- ISSN:
- 2056-4724
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.1192/bjo.2022.28
