The first consultation begins by collecting history. Medication, prior episodes, substance use, family history, the reason for referral. The clinician asks, the patient retells, and the clinical conversation starts late.
Patients arrive after months or years of waiting. They have a lot to say and one hour to say it in. The parts that matter most come out at minute fifty, or not at all.
Static forms do not fix this. They are left half-finished, answered by ticking rather than telling, and re-asked in the room anyway.
It starts even earlier, at the enquiry. People hesitate for years before they reach out. When they finally do, they are asked what they want help with, and struggle to put it into words on the spot.
For private clinics, assessment capacity is the bottleneck. For public services, it is the waiting list. In both, clinician minutes spent gathering information are minutes not spent on clinical judgement.