diff --git a/voice_analysis.py b/voice_analysis.py
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+"""
+voice_analysis.py — Voice message distress analysis via paralinguistic features.
+
+Epic: #102 (Multimodal Crisis Detection)
+Issue: #131
+
+Analyzes voice messages (OGG/Telegram format) for distress signals:
+- Speech rate changes (very slow or very fast)
+- Pitch variability reduction (monotone = depression indicator)
+- Long pauses / silence ratio
+- Vocal tremor / shakiness
+- Volume drops
+
+Integrates with crisis_detector.py text-based detection for multimodal coverage.
+"""
+
+import os
+import json
+import subprocess
+import tempfile
+from dataclasses import dataclass, field, asdict
+from typing import Optional
+
+
+@dataclass
+class VoiceAnalysisResult:
+    """Result of paralinguistic analysis on a voice message."""
+    transcript: str = ""
+    speech_rate: float = 0.0          # words per minute
+    pitch_mean: float = 0.0           # Hz, average fundamental frequency
+    pitch_variability: float = 0.0    # std dev of pitch (low = monotone)
+    silence_ratio: float = 0.0        # 0-1, fraction of audio that is silence
+    tremor_score: float = 0.0         # 0-1, vocal shakiness estimate
+    volume_drop_score: float = 0.0    # 0-1, sudden volume decreases
+    distress_score: float = 0.0       # 0-1, composite distress indicator
+    signals_detected: list = field(default_factory=list)
+
+    def to_dict(self) -> dict:
+        return asdict(self)
+
+
+# === THRESHOLDS ===
+
+# Speech rate: normal is ~120-150 WPM
+# Very slow (<80) or very fast (>200) are distress indicators
+SPEECH_RATE_SLOW = 80
+SPEECH_RATE_FAST = 200
+SPEECH_RATE_NORMAL_LOW = 100
+SPEECH_RATE_NORMAL_HIGH = 170
+
+# Pitch variability: normal conversation has std dev ~30-50 Hz
+# Monotone (<15 Hz) is a depression indicator
+PITCH_VARIABILITY_LOW = 15.0  # Hz — monotone threshold
+PITCH_VARIABILITY_NORMAL = 30.0
+
+# Silence ratio: normal has ~10-20% silence
+# Excessive silence (>40%) or very little (<3%) may indicate distress
+SILENCE_RATIO_HIGH = 0.4
+SILENCE_RATIO_LOW = 0.03
+
+# Composite thresholds
+DISTRESS_LOW = 0.3
+DISTRESS_MEDIUM = 0.7
+
+
+# === CORE ANALYSIS ===
+
+def _convert_to_wav(audio_path: str) -> str:
+    """Convert audio to WAV format for analysis. Returns path to temp WAV file."""
+    wav_path = tempfile.mktemp(suffix='.wav')
+    try:
+        subprocess.run(
+            ['ffmpeg', '-i', audio_path, '-ar', '16000', '-ac', '1', '-y', wav_path],
+            capture_output=True, timeout=30
+        )
+        if not os.path.exists(wav_path):
+            # Fallback: if ffmpeg not available, try the original file
+            return audio_path
+        return wav_path
+    except (FileNotFoundError, subprocess.TimeoutExpired):
+        return audio_path
+
+
+def _transcribe(audio_path: str) -> str:
+    """Transcribe audio using whisper (if available) or return empty string."""
+    try:
+        import whisper
+        model = whisper.load_model("base")
+        result = model.transcribe(audio_path)
+        return result.get("text", "").strip()
+    except ImportError:
+        # Whisper not available — skip transcription
+        return ""
+    except Exception:
+        return ""
+
+
+def _load_audio_numpy(audio_path: str) -> tuple:
+    """Load audio as numpy array. Returns (samples, sample_rate) or (None, None)."""
+    try:
+        import librosa
+        samples, sr = librosa.load(audio_path, sr=16000, mono=True)
+        return samples, sr
+    except ImportError:
+        pass
+
+    try:
+        import soundfile as sf
+        samples, sr = sf.read(audio_path)
+        if len(samples.shape) > 1:
+            samples = samples.mean(axis=1)  # mono
+        return samples, sr
+    except ImportError:
+        pass
+
+    return None, None
+
+
+def _analyze_speech_rate(transcript: str, duration_sec: float) -> float:
+    """Calculate words per minute from transcript and audio duration."""
+    if not transcript or duration_sec <= 0:
+        return 0.0
+    words = len(transcript.split())
+    minutes = duration_sec / 60.0
+    return words / minutes if minutes > 0 else 0.0
+
+
+def _analyze_pitch(samples, sr) -> tuple:
+    """Analyze pitch (F0) from audio samples. Returns (mean_hz, variability_hz)."""
+    try:
+        import librosa
+        f0, voiced_flag, _ = librosa.pyin(
+            samples, fmin=librosa.note_to_hz('C2'),
+            fmax=librosa.note_to_hz('C7'), sr=sr
+        )
+        import numpy as np
+        f0_clean = f0[~np.isnan(f0)]
+        if len(f0_clean) == 0:
+            return 0.0, 0.0
+        return float(np.mean(f0_clean)), float(np.std(f0_clean))
+    except (ImportError, Exception):
+        return 0.0, 0.0
+
+
+def _analyze_silence(samples, sr, threshold_db: float = -40.0) -> float:
+    """Calculate ratio of silence in audio (0-1)."""
+    try:
+        import librosa
+        import numpy as np
+        rms = librosa.feature.rms(y=samples)[0]
+        rms_db = librosa.amplitude_to_db(rms, ref=np.max)
+        silence_frames = np.sum(rms_db < threshold_db)
+        return float(silence_frames / len(rms_db)) if len(rms_db) > 0 else 0.0
+    except (ImportError, Exception):
+        return 0.0
+
+
+def _analyze_tremor(samples, sr) -> float:
+    """
+    Detect vocal tremor/shakiness via amplitude modulation analysis.
+
+    Tremor manifests as periodic amplitude fluctuations (3-12 Hz range).
+    Returns 0-1 score where 1 = strong tremor detected.
+    """
+    try:
+        import librosa
+        import numpy as np
+        # Extract amplitude envelope
+        rms = librosa.feature.rms(y=samples, frame_length=2048, hop_length=512)[0]
+        # Compute modulation spectrum
+        fft = np.abs(np.fft.rfft(rms))
+        freqs = np.fft.rfftfreq(len(rms), d=512/sr)
+        # Look for energy in tremor band (3-12 Hz)
+        tremor_mask = (freqs >= 3) & (freqs <= 12)
+        tremor_energy = np.sum(fft[tremor_mask])
+        total_energy = np.sum(fft[1:])  # skip DC
+        if total_energy == 0:
+            return 0.0
+        ratio = tremor_energy / total_energy
+        return float(min(1.0, ratio * 5))  # normalize — typical tremor is 0.1-0.3 of total
+    except (ImportError, Exception):
+        return 0.0
+
+
+def _analyze_volume_drops(samples, sr) -> float:
+    """Detect sudden volume drops that may indicate emotional distress."""
+    try:
+        import librosa
+        import numpy as np
+        rms = librosa.feature.rms(y=samples, frame_length=2048, hop_length=512)[0]
+        if len(rms) < 2:
+            return 0.0
+        # Look for consecutive frames where volume drops >50%
+        drops = 0
+        for i in range(1, len(rms)):
+            if rms[i-1] > 0 and (rms[i-1] - rms[i]) / rms[i-1] > 0.5:
+                drops += 1
+        return float(min(1.0, drops / (len(rms) * 0.1)))
+    except (ImportError, Exception):
+        return 0.0
+
+
+def _compute_distress_score(result: VoiceAnalysisResult) -> tuple:
+    """
+    Compute composite distress score from paralinguistic features.
+
+    Returns (score, signals_detected).
+    """
+    signals = []
+    score = 0.0
+    weights = 0
+
+    # Speech rate (0.2 weight)
+    if result.speech_rate > 0:
+        if result.speech_rate < SPEECH_RATE_SLOW:
+            signals.append(f"very_slow_speech ({result.speech_rate:.0f} WPM)")
+            score += 0.8 * 0.2
+        elif result.speech_rate > SPEECH_RATE_FAST:
+            signals.append(f"very_fast_speech ({result.speech_rate:.0f} WPM)")
+            score += 0.6 * 0.2
+        elif result.speech_rate < SPEECH_RATE_NORMAL_LOW:
+            score += 0.3 * 0.2
+        weights += 0.2
+
+    # Pitch variability (0.25 weight — monotone is strong depression indicator)
+    if result.pitch_variability > 0:
+        if result.pitch_variability < PITCH_VARIABILITY_LOW:
+            signals.append(f"monotone_voice (variability={result.pitch_variability:.1f} Hz)")
+            score += 0.9 * 0.25
+        elif result.pitch_variability < PITCH_VARIABILITY_NORMAL:
+            signals.append(f"reduced_pitch_variability ({result.pitch_variability:.1f} Hz)")
+            score += 0.5 * 0.25
+        weights += 0.25
+
+    # Silence ratio (0.2 weight)
+    if result.silence_ratio > 0:
+        if result.silence_ratio > SILENCE_RATIO_HIGH:
+            signals.append(f"excessive_silence ({result.silence_ratio:.0%})")
+            score += 0.7 * 0.2
+        elif result.silence_ratio < SILENCE_RATIO_LOW:
+            signals.append(f"minimal_pauses ({result.silence_ratio:.0%})")
+            score += 0.3 * 0.2
+        weights += 0.2
+
+    # Tremor (0.2 weight)
+    if result.tremor_score > 0:
+        if result.tremor_score > 0.5:
+            signals.append(f"vocal_tremor (score={result.tremor_score:.2f})")
+            score += result.tremor_score * 0.2
+        weights += 0.2
+
+    # Volume drops (0.15 weight)
+    if result.volume_drop_score > 0:
+        if result.volume_drop_score > 0.4:
+            signals.append(f"volume_drops (score={result.volume_drop_score:.2f})")
+            score += result.volume_drop_score * 0.15
+        weights += 0.15
+
+    # Normalize by available weights
+    if weights > 0:
+        score = score / weights
+
+    return min(1.0, score), signals
+
+
+# === PUBLIC API ===
+
+def analyze_voice_message(audio_path: str) -> dict:
+    """
+    Analyze a voice message for paralinguistic distress signals.
+
+    Args:
+        audio_path: Path to audio file (OGG, WAV, MP3, etc.)
+
+    Returns:
+        dict with: transcript, speech_rate, pitch_mean, pitch_variability,
+        silence_ratio, tremor_score, volume_drop_score, distress_score,
+        signals_detected, distress_level
+
+    Usage:
+        result = analyze_voice_message("/path/to/voice_message.ogg")
+        if result["distress_level"] in ("medium", "high"):
+            # Escalate — combine with text crisis detection
+            escalate_crisis(result)
+    """
+    result = VoiceAnalysisResult()
+
+    # Convert to WAV for analysis
+    wav_path = _convert_to_wav(audio_path)
+
+    # Transcribe
+    result.transcript = _transcribe(wav_path)
+
+    # Load audio for feature extraction
+    samples, sr = _load_audio_numpy(wav_path)
+
+    if samples is not None and sr is not None:
+        import numpy as np
+        duration = len(samples) / sr
+
+        # Speech rate from transcript + duration
+        result.speech_rate = _analyze_speech_rate(result.transcript, duration)
+
+        # Pitch analysis
+        result.pitch_mean, result.pitch_variability = _analyze_pitch(samples, sr)
+
+        # Silence ratio
+        result.silence_ratio = _analyze_silence(samples, sr)
+
+        # Tremor detection
+        result.tremor_score = _analyze_tremor(samples, sr)
+
+        # Volume drops
+        result.volume_drop_score = _analyze_volume_drops(samples, sr)
+
+    # Composite distress score
+    result.distress_score, result.signals_detected = _compute_distress_score(result)
+
+    # Clean up temp file
+    if wav_path != audio_path and os.path.exists(wav_path):
+        os.unlink(wav_path)
+
+    # Classify distress level
+    if result.distress_score >= DISTRESS_MEDIUM:
+        distress_level = "high"
+    elif result.distress_score >= DISTRESS_LOW:
+        distress_level = "medium"
+    elif result.distress_score > 0:
+        distress_level = "low"
+    else:
+        distress_level = "none"
+
+    output = result.to_dict()
+    output["distress_level"] = distress_level
+    return output
+
+
+def get_audio_duration(audio_path: str) -> float:
+    """Get audio duration in seconds."""
+    try:
+        import librosa
+        duration = librosa.get_duration(path=audio_path)
+        return float(duration)
+    except (ImportError, Exception):
+        try:
+            import soundfile as sf
+            info = sf.info(audio_path)
+            return float(info.duration)
+        except (ImportError, Exception):
+            return 0.0