Mental Health Pilot Study

Sir Charles Gairdner Hospital ED and Mental Health and Observation Area (MHOA) Pilot Study


The Sir Charles Gairdner Hospital ED and MHOA Systems-Level Study was a pilot study conducted by the Young Lives Matter Foundation in 2018. It was a preliminary systems-level investigation of patient trajectories, interactions and information flow within the Sir Charles Gairdner Hospital (SCGH) Emergency Department (ED) and Mental Health Observation Area (MHOA) for patients presenting with suicidal or parasuicidal behaviours.

Research Report Précis

Sir Charles Gairdner Hospital ED and MHOA Systems-Level Study

Dr Michael McCullough1, Dr Binu Jayawardena2, Professor Sean Hood2,3, and Professor Michael Small1.


1School of Physics, Mathematics and Computing, UWA

2Department of Health, Western Australia

3Division of Psychiatry, UWA Medical School


October 23, 2018


Young Lives Matter – UWA Foundation

The Young Lives Matter – UWA Foundation is a large-scale, cross-disciplinary research initiative established by The University of Western Australia (UWA), focused on combating issues of suicide that continue to challenge 15- to 24-year-olds.

UWA has assembled a team of world-leading experts in mental health and allied fields that has the capacity to leverage a diversity of expertise across relevant disciplines including clinical, medical, psychology, social science, mathematics and research institutes such as the Telethon Kids Institute.

Research Report Précis

Sir Charles Gairdner Hospital ED and Mental Health and Observation Area (MHOA) Pilot Study

The Sir Charles Gairdner Hospital (SCGH) Emergency Department and MHOA Systems-Level Study was a pilot study conducted by the Young Lives Matter – UWA Foundation in 2018. It was a preliminary systems-level investigation of patient trajectories, interactions and information flow within the Sir Charles Gairdner Hospital Emergency Department and Mental Health Observation Area (MHOA) for patients presenting with suicidal or parasuicidal behaviours.

Data for the study was collected by observers within the hospital who recorded the interactions of suicide-risk patients with clinical staff, emergency services and support services. Observers also recorded the usage of information systems by clinical staff as part of a patient’s trajectory. This data was used to construct two distinct models: a referral network and an interaction network.

The referral network models possible patient trajectories through the ED and MHOA by admission, referral and discharge. The interaction network models the structure and complexity of interactions, communications and information flow pertaining to the decision-making process for a patient’s trajectory.

The relative importance of all agents and information systems within the ED and MHOA was computed from the models and documented in the report.

The study revealed that the challenges in treating a suicidal patient within an emergency department not only arise from the diverse and complex psychiatric and psycho-social nature of mental illness, but from the complex system of observations, interactions and communications which combine to produce a decision about how a patient is to be treated.

Understanding the function and structure of this complex system in current clinical practice is critical for the development of clinical practice guidelines and clinical pathways to improve practice, improve patient outcomes and save lives.

One recommendation of the study proposed an expansion of the experimental protocol to collect a larger linkable dataset. This would enable more comprehensive modelling and analysis of current clinical practice for the treatment of patients affected by suicidal behaviours.

In a review of the study, the Head of the UWA Division of Emergency Medicine, working at SCGH Emergency Department, acknowledged the novel approach taken by the YLM Research Team and expressed the view that this could be extrapolated and successfully applied to other disciplines in emergency medicine.