Characterising Referral Pathways and Delays to Community Mental Health Services

Process mining revealed delays in subsequent transitions, with a median time (IQR) of 4 (0.9–39.7) days from triage-to-triage loops (21,831) and 3 (0.1–31.3) days from triage to ED presentation (9705). Sequence mining identified 15 rules; notably, one rule indicated that 59% of the 5228 pathways with three consecutive triage events were followed by an ED attendance. The pathways demonstrated high variability, with access to active care often following unpredictable service patterns.

Conclusions: This study identified delays, inefficiencies and areas where integration can be improved. It also highlighted the importance of examining the consumers’ pathways to and through care, which often begin well before they successfully engage with active care (treatment contacts following formal activation) in community mental health services. The heterogeneity of pathways implies that, for a substantial share of referrals, access to stable care is governed more by stochastic factors than by deliberate signposting or intentional recruitment.