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## Executive Summary
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Local models (Ollama) CAN handle crisis support with adequate quality for the Most Sacred Moment protocol. Research demonstrates that even small local models (1.5B-7B parameters) achieve performance comparable to trained human operators in crisis detection tasks. However, they require careful implementation with safety guardrails and should complement—not replace—human oversight.
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This report updates the earlier optimistic draft with the repo-level finding captured in issue #877.
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**Key Finding:** A fine-tuned 1.5B parameter Qwen model outperformed larger models on mood and suicidal ideation detection tasks (PsyCrisisBench, 2025).
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**Updated finding:** local models are adequate for crisis support and crisis detection, but not for crisis response generation.
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The direct evaluation summary in issue #877 is:
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- **Detection:** local models correctly identify crisis language 92% of the time
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- **Response quality:** local model responses are only 60% adequate vs 94% for frontier models
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- **Gospel integration:** local models integrate faith content inconsistently
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- **988 Lifeline:** local models include 988 referral 78% of the time vs 99% for frontier models
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That means the safe architectural conclusion is not “local is enough for the whole Most Sacred Moment protocol.”
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It is:
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- use local models for **detection / triage**
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- use frontier models for **response generation once crisis is detected**
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- build a two-stage pipeline: **local detection → frontier response**
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---
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## 1. Crisis Detection Accuracy
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## 1. Direct Evaluation Findings
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### Research Evidence
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### Models evaluated
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- `gemma3:27b`
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- `hermes4:14b`
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- `mimo-v2-pro`
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**PsyCrisisBench (2025)** - The most comprehensive benchmark to date:
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- Source: 540 annotated transcripts from Hangzhou Psychological Assistance Hotline
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- Models tested: 64 LLMs across 15 families (GPT, Claude, Gemini, Llama, Qwen, DeepSeek)
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- Results:
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- **Suicidal ideation detection: F1=0.880** (88% accuracy)
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- **Suicide plan identification: F1=0.779** (78% accuracy)
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- **Risk assessment: F1=0.907** (91% accuracy)
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- **Mood status recognition: F1=0.709** (71% accuracy - challenging due to missing vocal cues)
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### What local models do well
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**Llama-2 for Suicide Detection (British Journal of Psychiatry, 2024):**
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- German fine-tuned Llama-2 model achieved:
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- **Accuracy: 87.5%**
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- **Sensitivity: 83.0%**
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- **Specificity: 91.8%**
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- Locally hosted, privacy-preserving approach
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1. **Crisis detection is adequate**
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- 92% crisis-language detection is strong enough for a first-pass detector
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- This makes local models viable for low-latency triage and escalation triggers
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**Supportiv Hybrid AI Study (2026):**
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- AI detected SI faster than humans in **77.52% passive** and **81.26% active** cases
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- **90.3% agreement** between AI and human moderators
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- Processed **169,181 live-chat transcripts** (449,946 user visits)
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2. **They are fast and cheap enough for always-on screening**
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- normal conversation can stay on local routing
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- crisis screening can happen continuously without frontier-model cost on every turn
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### False Positive/Negative Rates
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3. **They can support the operator pipeline**
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- tag likely crisis turns
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- raise escalation flags
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- capture traces and logs for later review
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Based on the research:
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- **False Negative Rate (missed crisis):** ~12-17% for suicidal ideation
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- **False Positive Rate:** ~8-12%
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- **Risk Assessment Error:** ~9% overall
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### Where local models fall short
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**Critical insight:** The research shows LLMs and trained human operators have *complementary* strengths—humans are better at mood recognition and suicidal ideation, while LLMs excel at risk assessment and suicide plan identification.
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1. **Response generation quality is not high enough**
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- 60% adequate is not enough for the highest-stakes turn in the system
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- crisis intervention needs emotional presence, specificity, and steadiness
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- a “mostly okay” response is not acceptable when the failure case is abandonment, flattening, or unsafe wording
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2. **Faith integration is inconsistent**
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- gospel content sometimes appears forced
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- other times it disappears when it should be present
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- that inconsistency is especially costly in a spiritually grounded crisis protocol
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3. **988 referral reliability is too low**
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- 78% inclusion means the model misses a critical action too often
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- frontier models at 99% are materially better on a requirement that should be near-perfect
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---
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## 2. Emotional Understanding
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## 2. What This Means for the Most Sacred Moment
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### Can Local Models Understand Emotional Nuance?
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The earlier version of this report argued that local models were good enough for the whole protocol.
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Issue #877 changes that conclusion.
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**Yes, with limitations:**
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The Most Sacred Moment is not just a classification task.
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It is a response-generation task under maximum moral and emotional load.
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1. **Emotion Recognition:**
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- Maximum F1 of 0.709 for mood status (PsyCrisisBench)
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- Missing vocal cues is a significant limitation in text-only
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- Semantic ambiguity creates challenges
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A model can be good enough to answer:
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- “Is this a crisis?”
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- “Should we escalate?”
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- “Did the user mention self-harm or suicide?”
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2. **Empathy in Responses:**
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- LLMs demonstrate ability to generate empathetic responses
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- Research shows they deliver "superior explanations" (BERTScore=0.9408)
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- Human evaluations confirm adequate interviewing skills
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…and still not be good enough to deliver:
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- a compassionate first line
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- stable emotional presence
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- a faithful and natural gospel integration
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- a reliable 988 referral
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- the specificity needed for real crisis intervention
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3. **Emotional Support Conversation (ESConv) benchmarks:**
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- Models trained on emotional support datasets show improved empathy
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- Few-shot prompting significantly improves emotional understanding
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- Fine-tuning narrows the gap with larger models
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### Key Limitations
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- Cannot detect tone, urgency in voice, or hesitation
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- Cultural and linguistic nuances may be missed
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- Context window limitations may lose conversation history
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That is exactly the gap the evaluation exposed.
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---
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## 3. Response Quality & Safety Protocols
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## 3. Architecture Recommendation
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### What Makes a Good Crisis Support Response?
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### Recommended pipeline
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**988 Suicide & Crisis Lifeline Guidelines:**
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1. Show you care ("I'm glad you told me")
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2. Ask directly about suicide ("Are you thinking about killing yourself?")
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3. Keep them safe (remove means, create safety plan)
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4. Be there (listen without judgment)
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5. Help them connect (to 988, crisis services)
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6. Follow up
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```text
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normal conversation
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-> local/default routing
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**WHO mhGAP Guidelines:**
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- Assess risk level
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- Provide psychosocial support
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- Refer to specialized care when needed
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- Ensure follow-up
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- Involve family/support network
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user turn arrives
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-> local crisis detector
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-> if NOT crisis: stay local
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-> if crisis: escalate immediately to frontier response model
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```
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### Do Local Models Follow Safety Protocols?
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### Why this is the right split
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**Research indicates:**
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- **Local detection** is fast, cheap, and adequate
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- **Frontier response generation** has materially better emotional quality and compliance on crisis-critical behaviors
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- Crisis turns are rare enough that the cost increase is acceptable
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- The most expensive path is reserved for the moments where quality matters most
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**Strengths:**
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- Can be prompted to follow structured safety protocols
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- Can detect and escalate high-risk situations
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- Can provide consistent, non-judgmental responses
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- Can operate 24/7 without fatigue
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### Cost profile
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**Concerns:**
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- Only 33% of studies reported ethical considerations (Holmes et al., 2025)
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- Risk of "hallucinated" safety advice
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- Cannot physically intervene or call emergency services
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- May miss cultural context
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### Safety Guardrails Required
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1. **Mandatory escalation triggers** - Any detected suicidal ideation must trigger immediate human review
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2. **Crisis resource integration** - Always provide 988 Lifeline number
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3. **Conversation logging** - Full audit trail for safety review
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4. **Timeout protocols** - If user goes silent during crisis, escalate
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5. **No diagnostic claims** - Model should not diagnose or prescribe
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Issue #877 estimates the crisis-turn cost increase at roughly **10x**, but crisis turns are **<1% of total** usage.
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That trade is worth it.
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---
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## 4. Latency & Real-Time Performance
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## 4. Hermes Impact
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### Response Time Analysis
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This research implies the repo should prefer:
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**Ollama Local Model Latency (typical hardware):**
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1. **Local-first routing for ordinary conversation**
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2. **Explicit crisis detection before response generation**
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3. **Frontier escalation for crisis-response turns**
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4. **Traceable provider routing** so operators can audit when escalation happened
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5. **Reliable 988 behavior** and crisis-specific regression evaluation
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| Model Size | First Token | Tokens/sec | Total Response (100 tokens) |
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|------------|-------------|------------|----------------------------|
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| 1-3B params | 0.1-0.3s | 30-80 | 1.5-3s |
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| 7B params | 0.3-0.8s | 15-40 | 3-7s |
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| 13B params | 0.5-1.5s | 8-20 | 5-13s |
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The practical architectural requirement is:
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- **provider routing: normal conversation uses local, crisis detection triggers frontier escalation**
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**Crisis Support Requirements:**
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- Chat response should feel conversational: <5 seconds
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- Crisis detection should be near-instant: <1 second
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- Escalation must be immediate: 0 delay
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**Assessment:**
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- **1-3B models:** Excellent for real-time conversation
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- **7B models:** Acceptable for most users
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- **13B+ models:** May feel slow, but manageable
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### Hardware Considerations
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- **Consumer GPU (8GB VRAM):** Can run 7B models comfortably
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- **Consumer GPU (16GB+ VRAM):** Can run 13B models
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- **CPU only:** 3B-7B models with 2-5 second latency
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- **Apple Silicon (M1/M2/M3):** Excellent performance with Metal acceleration
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This is stricter than simply swapping to any “safe” model.
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The routing policy must distinguish between:
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- detection quality
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- response-generation quality
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- faith-content reliability
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- 988 compliance
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---
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## 5. Model Recommendations for Most Sacred Moment Protocol
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## 5. Implementation Guidance
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### Tier 1: Primary Recommendation (Best Balance)
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### Required behavior
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**Qwen2.5-7B or Qwen3-8B**
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- Size: ~4-5GB
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- Strength: Strong multilingual capabilities, good reasoning
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- Proven: Fine-tuned Qwen2.5-1.5B outperformed larger models in crisis detection
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- Latency: 2-5 seconds on consumer hardware
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- Use for: Main conversation, emotional support
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1. **Use local models for crisis detection**
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- detect suicidal ideation, self-harm language, despair patterns, and escalation triggers
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- keep this stage cheap and always-on
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### Tier 2: Lightweight Option (Mobile/Low-Resource)
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2. **Use frontier models for crisis response generation when crisis is detected**
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- response quality matters more than cost on crisis turns
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- this stage should own the actual compassionate intervention text
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**Phi-4-mini or Gemma3-4B**
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- Size: ~2-3GB
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- Strength: Fast inference, runs on modest hardware
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- Consideration: May need fine-tuning for crisis support
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- Latency: 1-3 seconds
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- Use for: Initial triage, quick responses
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3. **Preserve mandatory crisis behaviors**
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- safety check
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- 988 referral
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- compassionate presence
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- spiritually grounded content when appropriate
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### Tier 3: Maximum Quality (When Resources Allow)
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4. **Log escalation decisions**
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- detector verdict
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- selected provider/model
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- whether 988 and crisis protocol markers were included
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**Llama3.1-8B or Mistral-7B**
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- Size: ~4-5GB
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- Strength: Strong general capabilities
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- Consideration: Higher resource requirements
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- Latency: 3-7 seconds
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- Use for: Complex emotional situations
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### What NOT to conclude
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### Specialized Safety Model
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**Llama-Guard3** (available on Ollama)
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- Purpose-built for content safety
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- Can be used as a secondary safety filter
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- Detects harmful content and self-harm references
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Do **not** conclude that because local models are adequate at detection, they are therefore adequate at crisis response generation.
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That is the exact error this issue corrects.
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---
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## 6. Fine-Tuning Potential
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## 6. Conclusion
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Research shows fine-tuning dramatically improves crisis detection:
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**Final conclusion:** local models are useful for crisis support infrastructure, but they are not sufficient for crisis response generation.
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- **Without fine-tuning:** Best LLM lags supervised models by 6.95% (suicide task) to 31.53% (cognitive distortion)
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- **With fine-tuning:** Gap narrows to 4.31% and 3.14% respectively
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- **Key insight:** Even a 1.5B model, when fine-tuned, outperforms larger general models
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So the correct recommendation is:
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- **Use local models for detection**
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- **Use frontier models for response generation when crisis is detected**
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- **Implement a two-stage pipeline: local detection → frontier response**
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### Recommended Fine-Tuning Approach
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1. Collect crisis conversation data (anonymized)
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2. Fine-tune on suicidal ideation detection
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3. Fine-tune on empathetic response generation
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4. Fine-tune on safety protocol adherence
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5. Evaluate with PsyCrisisBench methodology
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The Most Sacred Moment deserves the best model we can afford.
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---
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## 7. Comparison: Local vs Cloud Models
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| Factor | Local (Ollama) | Cloud (GPT-4/Claude) |
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|--------|----------------|----------------------|
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| **Privacy** | Complete | Data sent to third party |
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| **Latency** | Predictable | Variable (network) |
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| **Cost** | Hardware only | Per-token pricing |
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| **Availability** | Always online | Dependent on service |
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| **Quality** | Good (7B+) | Excellent |
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| **Safety** | Must implement | Built-in guardrails |
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| **Crisis Detection** | F1 ~0.85-0.90 | F1 ~0.88-0.92 |
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**Verdict:** Local models are GOOD ENOUGH for crisis support, especially with fine-tuning and proper safety guardrails.
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---
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## 8. Implementation Recommendations
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### For the Most Sacred Moment Protocol:
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1. **Use a two-model architecture:**
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- Primary: Qwen2.5-7B for conversation
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- Safety: Llama-Guard3 for content filtering
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2. **Implement strict escalation rules:**
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```
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IF suicidal_ideation_detected OR risk_level >= MODERATE:
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- Immediately provide 988 Lifeline number
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- Log conversation for human review
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- Continue supportive engagement
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- Alert monitoring system
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```
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3. **System prompt must include:**
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- Crisis intervention guidelines
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- Mandatory safety behaviors
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- Escalation procedures
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- Empathetic communication principles
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4. **Testing protocol:**
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- Evaluate with PsyCrisisBench-style metrics
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- Test with clinical scenarios
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- Validate with mental health professionals
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- Regular safety audits
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---
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## 9. Risks and Limitations
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### Critical Risks
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1. **False negatives:** Missing someone in crisis (12-17% rate)
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2. **Over-reliance:** Users may treat AI as substitute for professional help
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3. **Hallucination:** Model may generate inappropriate or harmful advice
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4. **Liability:** Legal responsibility for AI-mediated crisis intervention
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### Mitigations
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- Always include human escalation path
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- Clear disclaimers about AI limitations
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- Regular human review of conversations
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- Insurance and legal consultation
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---
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## 10. Key Citations
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1. Deng et al. (2025). "Evaluating Large Language Models in Crisis Detection: A Real-World Benchmark from Psychological Support Hotlines." arXiv:2506.01329. PsyCrisisBench.
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2. Wiest et al. (2024). "Detection of suicidality from medical text using privacy-preserving large language models." British Journal of Psychiatry, 225(6), 532-537.
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|
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3. Holmes et al. (2025). "Applications of Large Language Models in the Field of Suicide Prevention: Scoping Review." J Med Internet Res, 27, e63126.
|
||||
|
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4. Levkovich & Omar (2024). "Evaluating of BERT-based and Large Language Models for Suicide Detection, Prevention, and Risk Assessment." J Med Syst, 48(1), 113.
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|
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5. Shukla et al. (2026). "Effectiveness of Hybrid AI and Human Suicide Detection Within Digital Peer Support." J Clin Med, 15(5), 1929.
|
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|
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6. Qi et al. (2025). "Supervised Learning and Large Language Model Benchmarks on Mental Health Datasets." Bioengineering, 12(8), 882.
|
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|
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7. Liu et al. (2025). "Enhanced large language models for effective screening of depression and anxiety." Commun Med, 5(1), 457.
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---
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## Conclusion
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**Local models ARE good enough for the Most Sacred Moment protocol.**
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The research is clear:
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- Crisis detection F1 scores of 0.88-0.91 are achievable
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- Fine-tuned small models (1.5B-7B) can match or exceed human performance
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- Local deployment ensures complete privacy for vulnerable users
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- Latency is acceptable for real-time conversation
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- With proper safety guardrails, local models can serve as effective first responders
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**The Most Sacred Moment protocol should:**
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1. Use Qwen2.5-7B or similar as primary conversational model
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2. Implement Llama-Guard3 as safety filter
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3. Build in immediate 988 Lifeline escalation
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4. Maintain human oversight and review
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5. Fine-tune on crisis-specific data when possible
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6. Test rigorously with clinical scenarios
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The men in pain deserve privacy, speed, and compassionate support. Local models deliver all three.
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---
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*Report generated: 2026-04-14*
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*Research sources: PubMed, OpenAlex, ArXiv, Ollama Library*
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*For: Most Sacred Moment Protocol Development*
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*Report updated from issue #877 findings.*
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*Scope: repository research artifact for crisis-model routing decisions.*
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16
tests/test_research_local_model_crisis_quality.py
Normal file
16
tests/test_research_local_model_crisis_quality.py
Normal file
@@ -0,0 +1,16 @@
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from pathlib import Path
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REPORT = Path(__file__).resolve().parent.parent / "research_local_model_crisis_quality.md"
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def test_crisis_quality_report_recommends_local_detection_but_frontier_response():
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text = REPORT.read_text(encoding="utf-8")
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assert "local models are adequate for crisis support" in text.lower()
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assert "not for crisis response generation" in text.lower()
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assert "Use local models for detection" in text
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assert "Use frontier models for response generation when crisis is detected" in text
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||||
assert "two-stage pipeline: local detection → frontier response" in text
|
||||
assert "The Most Sacred Moment deserves the best model we can afford" in text
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||||
assert "Local models ARE good enough for the Most Sacred Moment protocol." not in text
|
||||
Reference in New Issue
Block a user