> ## Documentation Index > Fetch the complete documentation index at: https://docs.medera.info/llms.txt > Use this file to discover all available pages before exploring further. # Speech-to-Behavioral-Text > Three endpoints. One BH-tuned engine. The first speech engine purpose-built for behavioral health. Medera Speech-to-Behavioral-Text is the first speech engine purpose-built for behavioral and mental health. It is exposed through **three endpoints** backed by **one calibrated BH-tuned engine** — same vocabulary, same DSM-5-TR alignment, same C-SSRS calibration, same instrument-score extraction across every endpoint. General medical STT was trained on radiology dictations and OR cross-talk. Medera Co-Therapy was trained on the conversation that happens inside a 50-minute behavioral-health session — outpatient psychiatry, CBT, DBT, and psychiatric emergency assessments. ## Three endpoints. One BH-tuned engine. medera/stt-engine.svgthree endpoints · one BH-tuned engine /transcribeWSS · real-time statelessdictation/sessionsWSS · real-time statefultranscription/transcriptsREST · async batchtranscription Ingress + RoutingDiarize + TranscribeFormat + Correction STRUCTURED TRANSCRIPT ## What makes it BH-tuned | Property | Generic medical STT | Medera Co-Therapy | | :------------------- | :--------------------------------- | :-------------------------------------------------------------------------------- | | **Training audio** | Radiology dictation, OR cross-talk | Outpatient psychiatry, CBT, DBT, psychiatric emergency | | **Vocabulary bias** | Anatomy, procedure names | DSM-5-TR, psychopharmacology, BH program names | | **Calibration** | Procedural accuracy | C-SSRS safety, instrument scoring, validated screeners | | **Speaker model** | Single-speaker dictation | 2-speaker diarization (clinician + patient) | | **Crisis handling** | None | C-SSRS-aligned, non-bypassable human handoff | | **Median WER** | — | 5.2 % on outpatient psych / CBT / DBT (vs. 18–25 % typical for psychotherapy ASR) | | **Keyword accuracy** | — | \~91 % on the practice's custom vocabulary | ## Endpoints **WSS · real-time stateless dictation.** Between-visit charting, refills, paging colleagues. Built for the 5-minute window between encounters. **WSS · real-time stateful transcription.** Live therapy session capture, 2-speaker diarization, in-line crisis markers, structured instrument scoring. **REST · async batch.** Process recorded encounters after the fact. Same engine, same calibration, same structured output. Pick the endpoint by workflow, not by accuracy. The engine, vocabulary, calibration, and structured emission are identical across all three. *** ## Endpoint capability matrix | | /transcribe | /sessions | /transcripts | | :-------------------------------------- | :----------------: | :-----------------------------------: | :----------------------------: | | **Connection** | WSS | WSS | REST | | **Processing** | Real-time | Real-time | Async | | **Architecture** | Stateless | Stateful | Stateful | | **Speech model** | BH-tuned dictation | BH-tuned conversational | Either | | **2-speaker diarization** | — | ✓ | ✓ | | **Multichannel input** | — | ✓ | — | | **Spoken commands** | ✓ | — | — | | **Automatic punctuation** | ✓ | ✓ | ✓ | | **Spoken punctuation** | ✓ | — | — | | **Interim results** | ✓ | ✓ | — | | **Custom vocabulary (at request time)** | ✓ | ✓ | ✓ | | **Instrument-score extraction** | — | ✓ | ✓ | | **C-SSRS in-line crisis marker** | — | ✓ | ✓ | | **DSM-5-TR / ICD-10 emission** | — | ✓ | ✓ | | **Output** | Text + commands | Structured transcript + scores + risk | Structured transcript + scores | *** ## Languages English variants are GA across **US, UK, Canada, Australia**. **Arabic (ar-SA)** ships for MENA deployments. Spanish, French, and German behavioral-health vocabularies are in private beta. The vocal-acoustic engine — F0, jitter, shimmer, prosodic flatness, depression / anxiety / distress indices — is language-agnostic and ships unchanged across every locale. medera/stt-locales.svglocale matrixLocale availability matrixen-USGAen-GBGAen-AUGAen-CAGAes-MXprivate betaes-ESprivate betafr-FRprivate betafr-CAprivate betaar-SAGA · MENAde-DEprivate betapt-BRroadmapit-ITroadmapsv-SEroadmapda-DKroadmapno-NOroadmap+ 6 moreroadmapGAprivate betaroadmap ## Behavioral-health-specific calibration | Channel | What it does | | | :-------------------------------- | :---------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | **DSM-5-TR vocabulary bias** | Recognition biased toward DSM-5-TR diagnostic language, common behavioral-health symptoms, and psychopharmacology | | | **Validated screener extraction** | PHQ-9, GAD-7, AUDIT-C, C-SSRS responses captured as structured items with item-level scores | | | **C-SSRS safety check** | Crisis language flagged in-line; non-bypassable human handoff trigger | | | **Custom vocabulary at request** | Practice formulary, IOP / PHP program names, clinician roster — passed per request, no retraining | | | **2-speaker diarization** | Clinician vs. patient consistently labelled | Custom vocabulary lifts keyword recall by **10–15 percentage points** while holding overall WER flat — comparable to what Medera STT Nova-3 Medical and AssemblyAI publish for keyterm prompting. | ## Accuracy (internal eval set) | Metric | Medera Co-Therapy | Typical psychotherapy ASR | | | :------------------------------ | :-------------------------------------------------------- | :----------------------------------------------------- | -------------------------------------------------------------------------------------------------------- | | Median WER | **5.2 %** | 18 – 25 % (Miner et al., *npj Digital Medicine*, 2020) | | | Keyword accuracy (custom vocab) | **\~ 91 %** | — | | | Eval audio | Outpatient psychiatry · CBT · DBT · psychiatric emergency | Mixed conversational | We don't benchmark on radiology dictation; we benchmark on the audio the engine actually has to work on. | *** ## Regions | Region | Storage | Compute | Sub-processors | | | :---------------------- | :---------------------------------------- | :----------- | :--------------------- | ---------------------------------------------------------------------------------------------- | | **US (default)** | US region | US | US-only | | | **EU** | EU-West (Ireland), EU-Central (Frankfurt) | EU | EU-only | | | **MENA (Arabic ar-SA)** | Customer VPC option | Customer VPC | Per customer agreement | | | **Customer VPC** | Customer-managed AWS / GCP | Customer | Per customer agreement | Region is selected at tenant creation and is immutable. Audio never crosses region boundaries. | *** ## What's next Stateless dictation WebSocket. Stateful diarized session WebSocket. REST upload + processing. Full per-surface matrix. Contact us if you need help selecting the right endpoint or have questions about configuring requests. [medera.info/contact](https://medera.info/contact)