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The State Coroner is investigating the suspected death of a Pilbara schoolteacher who disappeared after walking out of the mental health unit at the local hospital.

A coronial inquest started today into the disappearance of Tracy Margaret Marshall, 35, who left Karratha's Nickol Bay Hospital on February 21, 2011 and has not been seen or heard from since.

The inquest, before State Coroner Alastair Hope, was told Ms Marshall became depressed and stressed because of work pressure, resulting in her quitting her job, but she started exhibiting odd behaviour, including hallucinations, in the week leading up to her disappearance.

Counsel assisting the coroner Emily Winborne said Ms Marshall attended the Pilbara Health and Drug Service four times in the week before she vanished. She was told there was no a psychiatrist available in Karratha for two weeks.

Her husband Iain Marshall claimed she had woken him up wanting him to perform an exorcism, claiming she had a cleft foot and saw the devil. When they went camping, Ms Marshall displayed more bizarre behaviour and the next day she told her husband about several recent suicide attempts.

She was taken back to hospital, where she was put under overnight observation but disappeared the next morning.

Const. Chelsea Magowan, from the missing persons unit, said Ms Marshall's car, which had overheated and broken down, was found abandoned on a road about 50km out of Karratha. She said immediate search efforts were hampered by the arrival of Cyclone Carlos, which brought gale force winds of up to 140kmh and caused significant damage.

She said an extensive search and inquiries had failed to shed any light on Ms Marshall's whereabouts.

Mr Marshall told the inquest his wife was "out of sorts" and not her normal energetic self for a while, but in the last week she was making odd comments like she "needed to find God and God needed to release her."

He said on her last presentation to the mental health unit he assumed she was put on suicide watch and would be there when he visited the next day. He was not aware that his wife was not made an involuntary mental health patient.

Mr Marshall said he felt he had been sidelined by mental health professionals and was not given the chance to have a say in his wife's treatment.

He said one nurse told his wife, who was "brutally honest" with medical staff, she did not believe she was having a psychotic episode and that vitamins would help her.

Mr Marshall said he had planned to fly his wife to Perth for psychiatric treatment on the day she disappeared as "things were just spinning out of control" and he did not want to wait for her to see a psychiatrist.

When asked if he believed there was any chance his wife could still be alive, Mr Marshall said: "My head says no, but my heart says yes."

The inquest continues.

Anyone needing help can call Lifeline on 13 11 14.