# HARBOR: Holistic Adaptive Risk assessment model for BehaviORal healthcare

arXiv: https://arxiv.org/abs/2512.18829 · HTML: https://mlsanity.com/paper/2512.18829/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 12 of its 29 references that are in the map.
- First posted on arXiv 21 Dec 2025.

## Builds on (most cited first, 12 of 12)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Scaling Laws for Neural Language Models](https://mlsanity.com/paper/2001.08361/) (2020)
- [On Calibration of Modern Neural Networks](https://mlsanity.com/paper/1706.04599/) (2017)
- [Finetuned Language Models Are Zero-Shot Learners](https://mlsanity.com/paper/2109.01652/) (2021)
- [Gemini 1.5: Unlocking multimodal understanding across millions of tokens of context](https://mlsanity.com/paper/2403.05530/) (2024)
- [Training Compute-Optimal Large Language Models](https://mlsanity.com/paper/2203.15556/) (2022)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [Language Model Probabilities are Not Calibrated in Numeric Contexts](https://mlsanity.com/paper/2410.16007/) (2024)

## Abstract (arXiv)

Behavioral healthcare risk assessment remains a challenging problem due to the highly multimodal nature of patient data and the temporal dynamics of mood and affective disorders. While large language models (LLMs) have demonstrated strong reasoning capabilities, their effectiveness in structured clinical risk scoring remains unclear. In this work, we introduce HARBOR, a behavioral health aware language model designed to predict a discrete mood and risk score, termed the Harbor Risk Score (HRS), on an integer scale from -3 (severe depression) to +3 (mania). We also release PEARL, a longitudinal behavioral healthcare dataset spanning four years of monthly observations from three patients, containing physiological, behavioral, and self reported mental health signals. We benchmark traditional machine learning models, proprietary LLMs, and HARBOR across multiple evaluation settings and ablations. Our results show that HARBOR outperforms classical baselines and off the shelf LLMs, achieving 69 percent accuracy compared to 54 percent for logistic regression and 29 percent for the strongest proprietary LLM baseline.