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Triage generally is a process of sifting and prioritising both in terms of urgency and relevance. In mental health triage can be undertaken face to face or via telephone: ‘red flags’ include suicidal ideas, intent or actions, violence and aggression set in the context of psychosis and specific items such as command hallucinations, delusional misidentification and grandiose delusions.

Older adults who present with purposeless wandering especially at night will often be ‘red flagged’ too.

In the early noughties (2000s) mental health services in Bridgend, South Wales in the United Kingdom and in Melbourne in Australia simultaneously developed triage scales suitable for processing large numbers of urgent and routine referrals into both adult and old age mental health services.

Mental health nursing academics Natisha Sands and Steve Elsom developed a variety of teaching and training materials in Australia (some of which are now available on website while Dr Robert Colgate produced training materials suitable for NHS staff in the United Kingdom.

A substantial series of case scenarios suitable for rating using the triage scale have already been developed – one set of twenty is available as an iBook (search author Robert Colgate). the scenarios cover a range from urgent to routine allocations suitable for a classroom setting.

In addition to written material there is an obvious need for audio training resources – especially telephone calls. I want to collaborate with members of the Q community to extend the range of training materials to include practical advice for front line mental health staff. We already have an list of ‘frequently asked questions’ (FAQs) including situations where the triage decision is challenged or when the pressure of work is overwhelming …

There is already considerable local interest in developing case scenarios specific to perinatal psychiatry and for child and adolescent mental health services (CAMHS).

I want to produce a stand alone training resource, ideally audiovisual, to address the list of FAQs in a supportive and non confrontational style. All genuine offers of assistance gratefully received!

Line drawing by Andy Frazer (Dragons of Wales).

How you can contribute

  • Are there any existing educational resources that consistently work well for explaining these 'red flags'?
  • Are any of the Q community interested in developing the resource?
  • Are there colleagues working in the areas of perinatal psychiatry and CAMHS who would be willing to write case scenarios based on the existing iBook template?


  1. Hi Robert, Really pleased to see your initiative. I am a GP and work quite a few sessions for Clinical Advise Service of NHS111 and there is quite a bit of challenging mental health triage on every shift I work. I also have a few scenarios to contribute.

    Please let me know if I can be of any help. email-

  2. Guest

    Hi Bob more than happy to meet up over a working lunch to chat through the ideas etc. Just let me know when available and I will add you to my scheduler if you wish so I can co ordinate couple of short meetings.

  3. Anna - thanks for this! I do have some outline material for CAMHS scenarios. Happy to share. Kind regards Bob

  4. Hi Robert,

    great to to see a mental health initiative being proposed. I work in CAMHS, just across the bridge in Gloucestershire and would be happy to help think through some ideas with you and others.

    I also wonder if there are creative ways to make the training more interactive, as it's already hard to keep up with the large amounts of stat and man training we have to do? Could you do some creative videos/ art work or ask young people to get involved, or reach out to the student community to help you produce this? I have often worked with tutors from local universities and art colleges to set a real life challenge as part of their curriculum and the response has always been amazing

    Good luck and thanks for posting this idea

    best wishes


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