An AI-based mental health guardrail and dataset for identifying psychiatric crises in text-based conversations

Large language models often mishandle psychiatric emergencies, offering harmful or inappropriate advice. This study evaluated the Verily Mental Health Guardrail (VMHG) on two clinician-labeled datasets: the Verily Mental Health Crisis Dataset v1.0, containing 1800 simulated messages and the NVIDIA Aegis AI Content Safety Dataset subsetted to 794 mental health-related messages. Performance was benchmarked against OpenAI Omni Moderation Latest and NVIDIA NeMo Guardrails. The VMHG demonstrated high sensitivity (0.990) and specificity (0.992) on the Verily dataset, with an F1-score of 0.939 and high category-level sensitivity (0.917-0.992) and specificity (≥0.978). On the NVIDIA dataset, it maintained strong sensitivity (0.982) and accuracy (0.921) with reduced specificity (0.859). Compared with NVIDIA and OpenAI guardrails, the VMHG achieved significantly higher sensitivity (all p < 0.001) and comparable specificity (NVIDIA p < 0.001, OpenAI p = 0.094). Overall, the VMHG demonstrated robust, generalizable, and clinically oriented safety performance that prioritizes sensitivity to minimize missed mental health crises.