Connecting people with the right mental health care at the right time
Supporting health professionals to use the Initial Assessment and Referral Decision Support Tool (IAR-DST).
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People experiencing mental health concerns may present with a range of interrelated factors that can make it challenging for general practitioners and clinicians to determine the most appropriate type and level of care.
While evidence-based Stepped Care approaches exist, many clinicians find implementation difficult without a shared decision-making model to support referral decision making, and a common language to describe the continuum of mental health services based on intensity. This places people at an increased risk of receiving mental health interventions that are too intensive, or not intensive enough, to meet their unique treatment needs.
In 2019, the Initial Assessment and Referral Decision Support Tool (IAR-DST) was introduced by the Australian Department of Health and was primarily used within the mental health sector. The tool provides a holistic and consistent framework to help match a person's mental health needs with the right care type and intensity, at the right time.
HOW THE IAR-DST WORKS
The tool identifies eight holistic initial assessment domains that need to be considered when determining the next steps in the referral and treatment process for a person seeking mental health support.
- Symptom Severity and Distress
- Risk of Harm
- Functioning
- Impact of Co-Existing Conditions
- Treatment and Recovery History
- Social and Environmental Stressors
- Family and Other Support
- Engagement and Motivation
The information gathered through the initial assessment domains is used to recommend the intensity (level of care) of mental health support a person may need to match their treatment needs and goals. This process is based on a clinically informed algorithm and is calculated automatically using the digital
Decision Support Tool (DST).
Recognising that general practitioners are usually the first port of call for people seeing mental health support, the Australian Department of Health expanded this tool’s availability into primary care settings in 2022. As a result, Primary Health Networks across Australia were tasked with delivering localised training to general practitioners and referring professionals to ensure effective integration and use of the tool.
To make the training relevant to SEMPHN’s catchment, our team consulted with general practitioners and local mental health services to identify supports and barriers to implementing the IAR-DST in different settings. Adopting a co-design approach, we invited those previously consulted back to test the training before launching at the beginning of 2023.
To-date SEMPHN has delivered 46 training sessions on the IAR-DST. This equates to 353 GPs (13% of GPs in our catchment) and 124 clinicians and peer workers who are now equipped to use the tool and can share a common language when assessing and referring patients presenting with mental health concerns.
Most importantly, clinicians who complete the training report feeling more confident in their referral decisions. Additionally, consumers recognise the benefits of having streamlined referral processes to support their mental health journey.
All training sessions have an embedded feedback loop to allow our team to continuously enhance and adjust training to meet the changing needs of professionals. General practitioners have recently reported that they would like to understand which services in south east Melbourne align with the five Levels of Care within the tool. In response to this, we have initiated a project to map and match services within our catchment. Following this, we expect clinicians will be able to search for local services by the Levels of Care.
By promoting a consistent and holistic approach to referral decision making, we’re not only supporting local clinicians in their role but also improving the help seeking journey for people experiencing mental health challenges.
To find out more about the IAR Decision Support Tool (IAR-DST) and upcoming training dates, visit our website.
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