# Speech-based Psychological Crisis Assessment using LLMs

arXiv: https://arxiv.org/abs/2605.10027 · HTML: https://mlsanity.com/paper/2605.10027/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 15 of its 29 references that are in the map.
- First posted on arXiv 11 May 2026.

## Builds on (most cited first, 15 of 15)

- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Qwen2.5 Technical Report](https://mlsanity.com/paper/2412.15115/) (2024)
- [gpt-oss-120b & gpt-oss-20b Model Card](https://mlsanity.com/paper/2508.10925/) (2025)
- [Qwen2.5-Omni Technical Report](https://mlsanity.com/paper/2503.20215/) (2025)
- [emotion2vec: Self-Supervised Pre-Training for Speech Emotion Representation](https://mlsanity.com/paper/2312.15185/) (2023)
- [Paraformer: Fast and Accurate Parallel Transformer for Non-autoregressive End-to-End Speech Recognition](https://mlsanity.com/paper/2206.08317/) (2022)
- [Step-Audio-R1 Technical Report](https://mlsanity.com/paper/2511.15848/) (2025)
- [Benchmarking Contextual and Paralinguistic Reasoning in Speech-LLMs: A Case Study with In-the-Wild Data](https://mlsanity.com/paper/2509.16589/) (2025)
- [Large language models improve Alzheimer's disease diagnosis using multi-modality data](https://mlsanity.com/paper/2305.19280/) (2023)
- [Enhancing Depression Detection with Chain-of-Thought Prompting: From Emotion to Reasoning Using Large Language Models](https://mlsanity.com/paper/2502.05879/) (2025)
- [Deep Learning and Large Language Models for Audio and Text Analysis in Predicting Suicidal Acts in Chinese Psychological Support Hotlines](https://mlsanity.com/paper/2409.06164/) (2024)
- [Cognitive-Mental-LLM: Evaluating Reasoning in Large Language Models for Mental Health Prediction via Online Text](https://mlsanity.com/paper/2503.10095/) (2025)
- [Incorporating Contextual Paralinguistic Understanding in Large Speech-Language Models](https://mlsanity.com/paper/2508.07273/) (2025)
- [Evaluating Large Language Models in Crisis Detection: A Real-World Benchmark from Psychological Support Hotlines](https://mlsanity.com/paper/2506.01329/) (2025)
- [An Exploratory Deep Learning Approach for Predicting Subsequent Suicidal Acts in Chinese Psychological Support Hotlines](https://mlsanity.com/paper/2408.16463/) (2024)

## Abstract (arXiv)

Psychological support hotlines provide critical support for individuals experiencing mental health emergencies, yet current assessments largely rely on human operators whose judgments may vary with professional experience and are constrained by limited staffing resources. This paper proposes a large language model (LLM)-based framework for automated crisis level classification, a key indicator that supports many downstream tasks and improves the overall quality of hotline services. To better capture emotional signals in spoken conversations, we introduce a paralinguistic injection method that inserts identified non-verbal emotional cues into speech transcripts, enabling LLM-based reasoning to incorporate critical acoustic nuances. In addition, we propose a reasoning-enhanced training strategy that trains the model to generate diagnostic reasoning chains as an auxiliary task, which serves as a regulariser to improve classification performance. Combined with data augmentation, our final system achieves a macro F1-score of 0.802 and an accuracy of 0.805 on the three-class classification task under 5-fold cross-validation.