Veith Weilnhammer

Veith Weilnhammer, Lennart Luettgau, Christopher Summerfield et al.

AI chatbots are increasingly used for health advice, but their performance in psychiatric triage remains undercharacterized. Psychiatric triage is particularly challenging because urgency must often be inferred from thoughts, behavior, and context rather than from objective findings. We evaluated the performance of 15 frontier AI chatbots on psychiatric triage from realistic single-message disclosures using 112 clinical vignettes, each paired with 1 of 4 original benchmark triage labels: A, routine; B, assessment within 1 week; C, assessment within 24 to 48 hours; and D, emergency care now. Vignettes covered 9 psychiatric presentation clusters and 9 focal risk dimensions, organized into 28 presentation-by-risk groups. Each group contributed 4 distinct vignettes, with 1 vignette at each triage level. Each vignette was rendered as a realistic human-authored conversational query, and the AI chatbots were tasked with assigning a triage label from that disclosure. Emergency under-triage occurred in 23 of 410 level D trials (5.6%), and all under-triaged emergencies were reassigned to level C urgency. Across target models, average accuracy ranged from 42.0% to 71.8%. Accuracy was highest for level D vignettes (94.3%) and lowest for level B vignettes (19.7%). Mean signed ordinal error was positive (+0.47 triage levels), indicating net over-triage. Dispersion was highest around the middle triage levels. All results were confirmed relative to clinician consensus labels from 50 medical doctors. When presented with user messages containing sufficient clinical information, frontier AI chatbots thus recognized psychiatric emergencies as requiring urgent medical assessment with near-zero error rates, yet showed marked over-triage for low and intermediate risk presentations.

Veith Weilnhammer, Jefferson Ortega, David Whitney

Scalable assessments of mental illness remain a critical roadblock toward accessible and equitable care. Here, we show that everyday human-computer interactions encode mental health with state-of-the-art biomarker precision. We introduce MAILA, a MAchine-learning framework for Inferring Latent mental states from digital Activity. We trained MAILA on 20,000 cursor and touchscreen recordings labelled with 1.3 million mental-health self-reports collected from 9,000 participants. The dataset includes 2,000 individuals assessed longitudinally, 1,500 diagnosed with depression, and 500 with obsessive-compulsive disorder. MAILA tracks dynamic mental states along three orthogonal dimensions, identifies individuals living with mental illness, and achieves near-ceiling accuracy when predicting group-level mental health. By extracting non-verbal signatures of psychological function that have so far remained untapped, MAILA represents a key step toward scalable digital phenotyping and foundation models for mental health.