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Beyond the checklist: An exploration of informatics needs in emergency mental health triage
Ruoxu Shu1, Dulaji Hidellaarachchi2, Jonny Low1
1Faculty of Information Technology, Monash University, Melbourne, Australia.
Background:
Emergency mental health triage faces significant challenges due to protocols primarily designed for physical trauma. These protocols tend to focus heavily on physiological metrics, frequently overlooking the complex behavioural cues that are essential for effective psychiatric assessment. While Clinical Decision Support Systems (CDSS), which are digital tools designed to assist clinical decision-making through real-time data integration, offer potential solutions to reduce cognitive load, their adoption is often limited by poor usability and a lack of alignment with the practical realities of clinical practice.
Objective:
This study explores the informatics needs and workflow barriers of frontline clinicians to inform the design of user-centred digital mental health triage systems.
Methods:
A qualitative exploratory study was conducted using an interpretivist approach. Semi-structured interviews were held with 14 clinicians involved in emergency mental health triage across emergency department (ED) and related crisis care settings, spanning both standardised protocol-driven and resource-constrained distributed triage environments. Data were analysed using reflexive thematic analysis.
Results:
Three core themes were identified: (1) systemic constraints from fragmented information systems and resource shortages force clinicians to make high-stakes decisions with incomplete data; (2) clinicians employ experiential heuristics and pattern recognition to navigate psychiatric complexity beyond standardised protocols; (3) future digital tools should prioritise deep interoperability, support non-linear workflows, and incorporate culturally sensitive privacy protections.
Conclusion:
This study reveals that triage challenges are deeply rooted in fragmented information infrastructure and workflow misalignment. Effective digital support systems require interoperability, workflow integration, and user-centred design to transition from administrative burden to real cognitive support for ED clinicians.
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