Mental crisis prediction

Koa Health (Series B), in collaboration with Birmingham and Solihull NHS Foundation Trust. 1.2M patients covered. The project was part of the NHS Testbeds programme.

Mental health crises are costly and traumatic — for patients and the health system. An unplanned hospital admission for a mental health crisis costs multiples of planned care. Clinicians had no early warning signal: by the time deterioration was visible, it was often too late for low-cost intervention. The business need was to demonstrate clinical and commercial value to NHS partners to secure ongoing contracts and investment.

I directed the product team and the product manager responsible for this project, setting direction and overseeing delivery. My direct personal involvement was in the explainable AI layer — specifically how model outputs were surfaced to clinicians in a way they could understand and act on. Data science modelling was led by the technical team; information governance, data sharing agreements, and NHS relationship management were handled by the product and research team.

The team began by researching how clinicians currently worked: their existing workflows, what a successful outcome looked like to them, and how they valued a tool like this. This informed both where the product could add the most meaningful improvement and how the alert logic should be designed to fit into clinical practice.

The model used de-identified NHS Electronic Health Records (178 features, 1 million patients over 6 years, 20,000 mental health patients) as the primary training signal. The four-week prediction horizon was a deliberate clinical decision — long enough to enable a proactive response, short enough to be actionable. The alert logic was designed so that outputs were filtered to patients not already on an active crisis plan, avoiding alert fatigue.

• Model achieved 75% accuracy (80% recall) predicting mental health crisis four weeks in advance
• Clinicians could schedule reviews, adjust medication, or increase support before patients reached crisis point
• The project contributed to the evidence base that helped Koa Health secure investment and NHS partnerships, including a subsequent contract with Janssen
• Findings were published in Nature Medicine