AI gives potential suicides pause for thought

By Zhao Yimeng and Liu Kun | China Daily
Updated: March 30, 2020
LIANG LUWEN/FOR CHINA DAILY

A new computer program is helping those weighed down by the mental stress caused by the virus. Zhao Yimeng reports from Beijing, with Liu Kun in Wuhan.

"After 10 hours' hard work, I finally adapted Intelligent Agent 001 (a computer program) to collect helpful information about COVID-19 patients. From now on, we will release a daily report on the epidemic," Huang Zhisheng posted on social media on Feb 6.

As an expert in artificial intelligence, Huang, senior researcher at Vrije University of Amsterdam, the Netherlands, has established a group of volunteers, including psychological counselors and medical AI experts, to support critically ill patients who post messages online asking for help.

Intelligent Agent uses algorithms to identify such messages on social media platforms and produce a report that details the subject's name, city, age, specific location, contact number and symptoms.

For example, on Feb 6, Cheng Jiaxin in Wuhan, Hubei province, the city hardest hit by the coronavirus outbreak, posted a plea for assistance.

His father, Cheng Ziguo, had been confirmed as a coronavirus patient, but was unable to obtain treatment because of a shortage of hospital beds. Concerned that his disabled mother might also become infected, Cheng Jiaxin posted his message on Weibo.

The same day, Huang's computer program collected nearly 50 similar messages. By Feb 28, it had released about 410 pieces of information that were shared with the volunteer group or sent to a special column in People's Daily that arranges treatment for infected people.

Other volunteers in the group provide online psychological assistance for medical workers, infected patients or people experiencing anxiety or other negative emotions caused by the epidemic.

By Feb 28, Zhang Zhihan, a counselor in the Xinjiang Uygur autonomous region, had received about 100 calls. Many came from front line medical professionals who were working under huge pressure.

"In one, an ICU doctor in Wuhan expressed the agony he felt. The contradiction between a doctor's responsibilities and his failure to save patients' lives amid the shortage of medical supplies had led to negative feelings," she said.

Some medical workers have questioned the value of their work or expressed doubts about continuing to work as colleagues were becoming infected. Meanwhile, some patients' relatives didn't understand the medics' work, so they complained and humiliated them, she added.

Eventually, the doctor returned to the battle buoyed with new energy and confidence after receiving professional advice from Zhang.

Huang Zhisheng, an expert in artificial intelligence and senior researcher at Vrije University of Amsterdam, the Netherlands. [Photo provided to China Daily]

Inspiration

Huang said, "Saving lives is our top priority." That is the motivation behind his volunteer group, called the Tree Hole Rescue Team.

The name was inspired by a Chinese fairy tale in which a person divulged a secret to a hole in a tree and then sealed the hole to ensure his words remained secret forever.

Now, the phrase "tree hole" has another meaning-strangers can express their deepest thoughts anonymously on online platforms, such as websites, bulletin boards or social media.

The Sina Weibo accounts of deceased people, especially those who died recently from the coronavirus, have also become "tree holes" in which posters express negative feelings and even issue death threats. Others use their own accounts to voice suicidal thoughts, openly or via veiled references.

The Tree Hole group is an extension of research Huang started in 2010 on the application of AI technology to mental health.

"I worked with Beijing Anding Hospital to study depression and AI. Many people with depression are unwilling to tell anyone, especially their families or bosses, because they are afraid of the stigma," he said.

Taking advantage of internet anonymity, people with suicidal thoughts often search online for ways to cure depression, meaning they often miss the optimum treatment time. As the condition worsens, their thoughts can turn to suicide, Huang said.

He founded his team in 2018, looking to use AI technology to help people with suicidal feelings by establishing an expert team to search for such thoughts in social media posts.

Intelligent Agent began operating on July 25 that year. The next day, it produced its first report, listing the time and content that suggested suicidal thoughts and providing a link to the person's social media account.

Huang grades the risk level from zero to 10. Zero signifies "No expressions to indicate a painful existence", while 10 indicates "Suicidal actions may be in progress".

"The program has been updated to its sixth generation, and the accuracy of the information obtained has risen from 75 percent to 82," he said.

"Initially, it provided a report once a day, but now the frequency can be once every six hours, with 50 to 60 pieces of information."

Huang said the program has become more subtle, and can now report on level 5 indications, in which a person may make veiled references to suicide. Initially, it could only work on level 7 and higher, which required more overt information. Now, it is also able to establish the gender of the person at risk.

The rescue team has 600 members. Three hundred are qualified mental health professionals, including 100 from the fields of psychiatry and psychology, while the rest are interns learning to deal with lower-risk cases.

"The difference between us and rescue hotlines is that we actively search for suicidal people, while they wait for people to approach them for help," Huang said.

He added that he has refused an offer from a company that wanted to buy his AI technology for use in profit-generating applications.

"Everyone involved in the rescue work is unpaid. It is just a group of people volunteering to help others unconditionally, which reflects a positive aspect of society," he said.

On Jan 14, the Beijing Abundance Foundation, an NGO that focuses on the mental health of people ages 6 to 16, stepped in to help with the rescue group's management and to support its lifesaving mission.

Hotel hunt

Around 7 pm on Aug 31, Huang posted a message on the team's group chat to inform members that a young woman was planning to commit suicide in a hotel in Chengdu, capital of Sichuan province.

Li Hong, a psychological counselor in Beijing who is director of the rescue team's Chengdu office, immediately organized volunteers in the city to obtain more information about the woman, who had used a pseudonym.

"The 19-year-old was at a high level of risk as she had already taken drugs and lost consciousness. She had come to Chengdu from Shenzhen (Guangdong province) as a migrant worker and was staying at a chain hotel," Li said.

The chain had seven establishments in Chengdu, so the volunteers had to identify the correct hotel by calling each one. Eventually, the reaction of a hotel staff member helped them pinpoint the location.

"One of the hotel receptionists became nervous when a volunteer mentioned the girl's real name," Li said.

She phoned the hotel herself and asked the employees to cooperate because one of their guests had taken drugs and fallen into a coma. The receptionist admitted that the woman was staying there and gave Li the number of the local police station before calling the hospital.

"I checked with the police three or four times to ensure they had taken action, because they initially said it wasn't their job to help depressed people. They valued the help when they discovered the woman had lost consciousness," Li said.

Wang Xueming, a retired teacher who is a Chengdu team member, was close to the hotel, so he rushed to help. He accompanied the woman to the hospital and helped with the admission procedures.

At the same time, Li repeatedly tried to contact the woman's parents. "We failed to get through to her father's phone, so a friend of hers visited their house at 11 pm that night. Her father arrived in Chengdu the next day," she said.

Wang frequently visited the woman in the hospital, and took her to Mount Qingcheng, a scenic spot in Sichuan, after she was discharged.

So far, all the group's rescue missions have been successful, though a couple of people subsequently committed suicide, despite appearing to be living untroubled lives, Huang said.

"Saving a single life is worthwhile," he said, adding that volunteers usually accompany survivors for a period ranging from three months to a year, based on their mental condition.

Depression, disorders

The World Health Organization estimates that 54 million people in China have depression and about 41 million have anxiety disorders. About 700 people take their own life every day, while more than 6,000 attempt suicide.

Li called for families and society in general to pay more attention to the problems of people with depression, as childhood environment and schooling can play an important role in triggering the condition.

"I found similarities between many of the people we helped. Most felt they had an incomplete personality and lacked confidence and a sense of security. They came from tough backgrounds and endured parents who fought or uneducated grandparents," she said.

This sort of background often leads to people endeavoring to prove themselves to their family, and depression builds slowly before the floodgates open when they are adults, she added. She appealed for more volunteers in different fields and locations to join the group, the only NGO in China dedicated to preventing suicide.

Yin Feng, a psychological counselor in Singapore, joined the Tree Hole Rescue Team in August 2018, after it was recommended by an old classmate who works in AI.

"I've been working to help families with mental illnesses in Singapore to recover and rebuild their relationships. I hope that one day, my experience here will help Huang and me to devise a family recovery therapy that is suitable for Chinese people and all of society," the 43-year-old said.

In her 18 months with the group, Yin has helped about 100 troubled people, mostly students or young people in the initial stages of their working lives.

In June, she noticed a level 7 message that Intelligent Agent had obtained. The message, posted by a young man in the Chinese mainland, said: "I want to leave the world. I have no desire to stay here. I'm in poor physical condition and my psychological endurance is weak. I have lost the courage to face the future."

Yin started communicating with the young man to learn more.

"He often expressed a pessimistic attitude toward life and told me he had failed to make his first choice in the college entrance exam due to his poor physical condition. He had been unhappy for his whole college life," she said.

During their messaging sessions, she suggested he see a doctor. The young man was later diagnosed with moderate depression.

"Once, he told me by WeChat that he was giving up on life. I immediately reported his name, university and major to Huang and other team members. One of them, who happened to be a former staff member at the young man's university, called his teacher," Yin said.

Eventually, intervention by the university and the young man's family prevented a potential suicide and he was sent home for professional treatment.

"It was one of the most successful missions I have participated in, which was also due to the university's great awareness of mental illness," Yin said, adding that team members refer to those they help as "Tree Hole babies".

When the "babies" complain about the prejudice, even discrimination, they face, Yin tells them to treasure themselves and live good lives.

"We may not change others' perceptions right now, but we are entitled to speak for ourselves and receive professional treatment. Only when we are hopeful can we enlighten more people. We will keep each other company," she said.