China looks to AI to quantify suicide risk
Before dying by suicide in 2012, a student from Nanjing in eastern China made a final post on Weibo saying goodbye. It quickly became an online gathering place for the depressed, garnering millions of responses. Users called it a shudong ,or “tree hole,” for things they couldn’t say out loud. And nine years on, it still draws new comments every day.
Each of these comments is a data point for the Tree Hole Rescue Project, an organization that uses artificial intelligence to scan Weibo posts and identify users at risk of hurting themselves. The algorithm, designed by Zhisheng Huang, a Chinese computer scientist based in the Netherlands, flags posts to volunteers in a WeChat group who stand ready to message users, call their relatives or their employers — and, occasionally, alert the police.
Initiatives seeking to harness artificial intelligence for mental health problems have abounded in China in recent years, part of a broader embrace of digital technology that has, among its effects, given rise to TikTok and made cash payments nearly obsolete. Projects like Huang’s, which scour people’s social media accounts, have won awards and been praised by state-run news outlets, prevailing over thorny questions of privacy and efficacy that have slowed similar initiatives in the United States and Europe.
Huang, a Guangdong native who has been studying AI for 30 years, said he thinks his algorithm helps to reach the needy in a country where mental illness is widely stigmatized, and where, in 2019, more than 116,000 people died by suicide. But the gaps in China’s mental health resources are deep and systemic, experts say, and there’s little clinical evidence that AI-powered solutions are effective.
Started in 2018, the Tree Hole Rescue Project has grown from about two dozen volunteers — mostly AI enthusiasts — to 700 people across China. Every day, the algorithm flags about 100 comments on popular tree holes like the Nanjing student’s suicide note, which was briefly scrubbed by Weibo then reposted.
“Suicide risk: 7. Male. City: Fujian, Xiamen. Age: 29. ‘The decision of whether to jump off a building is difficult.’ “
“Suicide risk: 5. Female. City: Jiangsu, Yangzhou. Age: Unknown. ‘Actually, I still want to die, I just can’t think of how.’ “
The volunteers are typically able to reach only one-tenth of those considered at-risk — a total of about 14,000 people over three years, Huang said.
“It feels like a noble thing to do,” said Yuanyuan Yang, 37, a teacher from Henan province who says she spends as much time as she can volunteering. “It’s meaningful.”
In one of the project’s earliest cases, a man posted that he was closing his windows in preparation to die by suicide, Huang said. Volunteers tracked down a phone number for his selfrun company and reached his mother, who was in the adjoining room. She was enraged at the claims that her son was hurting himself, Huang said, until she went into his bedroom and realized they were right.
But individual anecdotes aren’t evidence that a tool is clinically useful, said Xiaoduo Fan, a psychiatry professor who leads the China Mental Health Program at the University of Massachusetts Medical School.
Mental health resources in China have grown since the Cultural Revolution, when mental illness was dismissed as bourgeois delusion. But according to the World Health Organization, there are still only about two psychiatrists per 100,000 residents in China, compared with 10 in the United States and 13 in Germany. In 2019, a Shanghai research center said there was a shortage of at least 400,000 mental health professionals.
“There’s like a few drops of rain for this large country,” Fan said. “The potential [of AI], in theory, is very promising. But there are so many problems in implementation.”
The problem, Fan said, is that in China, there isn’t adequate regulation or transparency to ensure that such tools are used ethically. Even with nonprofit entities such as the Tree Hole Rescue Project, he noted, it is not clear what relationship volunteers have with the people they attempt to help.