In an era where mental health services are grappling with unprecedented demand and strained resources, the quest for innovative methods to streamline patient assessment processes has become more urgent than ever. A recent randomized controlled trial, published in BMC Psychiatry, sheds light on the promising potential of integrating online self-reported assessments into the traditional mental health triage workflow. This study explores how leveraging digital tools can not only improve efficiency but also maintain the quality of clinical evaluations delivered via telephone interviews.
The crux of the research lies in addressing a critical bottleneck—time-consuming initial assessments—by introducing an online platform where patients can self-report their clinical information prior to a clinician-delivered phone interview. Such a hybrid approach aims to reduce the duration of live clinical assessments without compromising the depth and accuracy necessary for diagnosing and planning patient care.
Conducted between February 2020 and June 2022, the trial enrolled patients referred to a public mental health service in Australia. Referrals, sent by general practitioners, were systematically randomized into two groups: one undergoing the traditional phone assessment by clinicians (control group) and another utilizing an online self-assessment tool before a follow-up clinical interview conducted via phone (intervention group). This design allowed researchers to directly compare the efficiency outcomes between these two methods.
The primary metric for evaluation was the time to complete the assessment, specifically measured by the duration of the phone interview. Out of 758 referrals considered eligible, 377 participants ultimately entered the study. The intervention group initially comprised 184 individuals; however, protocol adherence issues led to only 81 assessments being included in the final analysis. Clinician challenges adapting to the new workflow—such as bypassing the online data in favor of conventional interviewing—highlighted a real-world implementation hurdle.
The results are compelling. Participants in the intervention group, who first completed an online clinical self-report, demonstrated a statistically significant reduction in subsequent phone assessment time. On average, the control group spent approximately 25.19 minutes per assessment, while the intervention group required only about 20.76 minutes, amounting to a roughly 17.59% reduction in clinician time spent. Even when adjusting for variables like seasonal effects and clinician-related correlations through a mixed-effects linear model, the intervention maintained a significant time savings of over three minutes per assessment.
These findings suggest that online self-assessment tools can effectively streamline clinical interviews, allowing clinicians to focus their limited time on nuanced aspects of patient care rather than eliciting foundational information that patients can provide themselves. Importantly, this approach holds promise not only for enhancing efficiency but also for potentially improving accessibility by reducing wait times and bottlenecks in mental health services.
Despite the positive outcomes, the study highlights key obstacles in adopting technology-driven methodologies in clinical settings. Clinicians’ unfamiliarity or discomfort with utilizing patient-generated online data was a major factor limiting broader adherence to the intervention protocol. This points to the necessity of comprehensive training and workflow redesign to fully harness the benefits of such innovations.
Furthermore, future integration of these tools would benefit from seamless embedding into existing mental health care infrastructures. Automated data transfer, real-time clinician alerts, and adaptive interviewing techniques could enrich the assessment process, fostering a more dynamic circulation of information between patients and providers.
The study also opens avenues for considering patient engagement and empowerment. Encouraging patients to actively participate in their own assessments could improve the validity and reliability of clinical data collected, as well as increase patient satisfaction by involving them directly in the diagnostic journey.
There remain considerations regarding digital literacy, accessibility, and data privacy, which must be rigorously addressed to ensure equitable implementation across diverse populations. Tailoring online assessment platforms to be user-friendly for individuals with varying levels of comfort with technology is critical to prevent widening existing disparities in mental health care access.
Moreover, while the study demonstrates time savings, it invites further exploration into whether these efficiencies translate into improved clinical outcomes, cost-effectiveness, and patient adherence to care recommendations. Longitudinal research could uncover the broader impacts of integrating digital tools in mental health assessment beyond immediate time reductions.
In summary, this randomized controlled trial furnishes valuable evidence supporting the incorporation of patient online self-reporting as a complement to clinician-delivered phone assessments in mental health triage. As the mental health sector strives to meet escalating demands, such hybrid models represent a viable path toward optimizing resource allocation without sacrificing clinical rigor.
The implications resonate beyond mental health, signaling a transformative shift toward digital augmentation of healthcare services at large. Embracing these approaches with robust training, ethical frameworks, and technological integration will be pivotal in shaping the future landscape of accessible, efficient, and patient-centered care.
The trajectory of mental health service delivery is poised for evolution, with digital tools acting as catalysts to unlock efficiencies and enhance the clinician-patient partnership. This study underscores a foundational step in this direction, calling for continued innovation and systemic adaptation in meeting the global mental health challenge.
Subject of Research: Mental health assessment efficiency; online self-report tools; clinical triage process.
Article Title: Improving the time-efficiency of initial mental health assessment (triaging) using an online assessment tool followed by a clinical interview via phone: a randomised controlled trial
Article References:
Fernando, I., Gupta, R., Simpson, K. et al. Improving the time-efficiency of initial mental health assessment (triaging) using an online assessment tool followed by a clinical interview via phone: a randomised controlled trial.
BMC Psychiatry 25, 635 (2025). https://doi.org/10.1186/s12888-025-07023-8
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