Accurate identification and categorization of suicidal events can yield better suicide precautions, reducing operational burden, and improvi
Accurate identification and categorization of suicidal events can yield better suicide precautions, reducing operational burden, and improving care quality in high-acuity psychiatric settings. Pre-trained language models offer promise for identifying suicidality from unstructured clinical narratives. We evaluated the performance of four BERT-based models using two fine-tuning strategies (multiple single-label and single multi-label) for detecting coexisting suicidal events from 500 annotated psychiatric evaluation notes. The notes were labeled for suicidal ideation (SI), suicide attempts (SA), exposure to suicide (ES), and non-suicidal self-injury (NSSI). RoBERTa outperformed other models using multiple single-label classification strategy (acc=0.86, F1=0.78). MentalBERT (acc=0.83, F1=0.74) also exceeded BioClinicalBERT (acc=0.82, F1=0.72) which outperformed BERT (acc=0.80, F1=0.70). RoBERTa fine-tuned with single multi-label classification further improved the model performance (acc=0.88, F1=0.81). The findings highlight that the model optimization, pretraining with domain-relevant data, and the single multi-label classification strategy enhance the model performance of suicide phenotyping. Keywords: EHR-based Phenotyping; Natural Language Processing; Secondary Use of EHR Data; Suicide Classification; BERT-based Model; Psychiatry; Mental Health Comment: submitted to AMIA Informatics Summit 2025 as a conference paper
