Am I Suicidal?

A computer may know

Can a computer predict suicide attempts? Better yet, can it do so as successfully as a therapist? On the basis of preliminary tests at the University of Wisconsin Medical School, the answer is a tentative yes.

That conclusion was reached after hundreds of depressed patients had been interviewed by a computer programmed by Psychiatrist John Greist and David Gustafson, professor of preventive medicine. In 72 of the cases, the computer predictions were compared with those made by therapists in traditional face-to-face interviews. The computer correctly identified the three patients who attempted suicide within 48 hours after their interviews. The therapists failed to predict any of the three attempts. One patient was about to be released when the computer determined that he had a gun, bullets and a precise suicide plan. In long-range predictions, covering nine months after the interviews, the computer identified 90% of the actual suicide attempters, compared with 30% for the therapists.

Greist believes it is the methodical and impersonal nature of computer interrogation that may make it more accurate. "Doctors are often reluctant to ask direct questions," he says. "Patients talk readily to doctors about chest pains and nosebleeds. But when the problem is homosexuality, illicit drug use or thoughts of suicide, the communication problem is serious."

Patients sit at a keyboard and punch out answers to questions on the screen of a computer terminal. For the early part of the interview, the computer is programmed to cajole and compliment the user ("You're a pro at using the terminal"). But when it is time for the crucial questions, the computer is blunt ("What are your chances of being dead from suicide one month from now?" "By what method do you plan to commit suicide?").

Though more than 1,000 U.S. institutions have computers that could use his program, Greist admits it will be difficult to get the medical profession interested. One indication: even in Greist's tests, some of the therapists screening patients that the computer had interrogated refused to analyze the [interview] printouts. Their minds were already made up.

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