The Care Outcomes and Mental health Pathways for Acute Suicidality and Self-Harm (COMPASS) project — The Association Specialists
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  3. The Care Outcomes and Mental health Pathways for Acute Suicidality and Self-Harm (COMPASS) project

The Care Outcomes and Mental health Pathways for Acute Suicidality and Self-Harm (COMPASS) project (23842)

Craig Cumming 1 , Anna Waterreus 1 , Colleen O'Leary 2 , Amanda Neil 3 , Wendy Feng 1 , Giulietta Valuri 1 , David Preen 1
  1. University of Western Australia, Crawley, WA, Australia
  2. Office of the Chief Psychiatrist Western Australia, Perth, WA, Australia
  3. University of Tasmania, Hobart, Tasmania, Australia

Background

Each year in Australia, more than 3,000 people die by suicide and >65,000 attempt suicide. Despite substantial investment in mental health care, critical gaps persist in post-emergency department (ED) referral pathways. For nearly half of people seeking mental health care, the ED is their first point of contact, yet over 50% leave without admission and evidence of subsequent service use remains limited. The Western Australian (WA) Office of the Chief Psychiatrist and University of WA have partnered to investigate health service pathways and outcomes for people presenting to an ED in WA seeking care for mental illness or suicidal and self-harm behaviours.

Methods

COMPASS is a large longitudinal retrospective cohort study including all people with an ED presentation, hospital admission, or outpatient service for mental illness and/or suicidal behaviour/self-harm in WA from 2010–2024. Linked administrative health data were analysed to quantify service contacts across the total cohort and by age group.

Results

The dataset includes 945,723 individuals with 3,697,176 mental health-related and 373,495 suicidal behaviour/self-harm-related hospital/ED contacts. Overall, 898,232 (95%) participants had at least one mental health-related service contact and 123,163 (13%) had at least one suicidal behaviour/self-harm contact across the study period. The 70–79 year age group accounted for the highest proportion of mental health-related contacts (18%; n=650,498), while the 20–29 year group had the highest proportion of suicidal behaviour/self-harm contacts (26%; n=97,737) across the study period.

Conclusion

COMPASS will identify referral and service delivery gaps to inform state and national mental health policy, referral procedures, service planning, and standards of care, with a particular focus on high-risk sub-populations. COMPASS will generate whole-population evidence on post-ED mental health referral patterns and model the clinical and economic implications when inpatient and community mental health services may be warranted but not accessed.