People seeking mental health support may present with a range of factors that can make it challenging for health professionals to determine the most appropriate level of care required.
The Initial Assessment and Referral – Decision Support Tool (IAR-DST) is a free tool developed by the Australian Government Department of Health, Disability and Ageing to provide GPs and mental health clinicians across Australia with an estimate of the intensity of the mental health response that a person may need when first seeking mental health support. The IAR-DST complements clinical judgement and provides clinicians with a standardised, evidence-based approach to providing mental health assessments and care recommendations. GPs, GP registrars, practice nurses, mental health nurses, allied health professionals and anyone else working in the mental health space can complete IAR-DST training.
Self-paced eLearning training
The e-Learning module is a self-paced format designed for health professionals who are suitably qualified and experienced in mental health assessment and/or treatment. It provides flexibility to complete training at a time and place that suits individual needs.
In response to several different referral and assessment tools being previously used, with little or no consistency, and varying levels of validity, the IAR-DST was developed by a multidisciplinary expert advisory group of clinicians, researchers and consumers, informed by Australian and international evidence and best practice.
In the 2021-22 Budget, the Australian Government allocated $34.2 million to make the IAR-DST tool available in all primary care settings.
In 2022, PHNs began offering training to GPs and clinicians in their respective regions. Since then, Murray PHN has delivered more than 125 training sessions, both in-person and online, with more than 370 local GPs and almost 500 other health professionals trained.
The IAR-DST is designed to be used alongside a comprehensive mental health assessment and aims to:
simplify how clinicians determine the care needs of a patient with mental health concerns
prevent patients being overburdened with services they may not need or can cope with, or under-serviced with recommendations that may not meet their needs improve transparency on decisions made relating to referrals
create consistency and a common language among health professionals, enabling them to articulate treatment needs that will be understood across the sector.
The tool collects data across four primary domains and four contextual domains (eight domains total) and will provide a recommend Level of Care (LoC) after all domains have been rated.
Further detail on the eight domains and five levels of care can be found in the IAR documentation in the resources listed below.
National, widespread use of the IAR-DST aims to improve awareness and consistency of how decisions about the appropriateness of referrals are made across the primary mental healthcare system, articulates treatment needs using language understood across the sector, and reduces the likelihood of rejected referrals to help patients receive the right care, at the right place, and at the right time.
Guided by practitioner assessment and clinical judgement, the tool provides a consistent way for GPs and clinicians to make decisions when matching a patient’s mental health needs with the right level of service intensity at the right time.
Each level of care is based on the least intensive and least intrusive evidence-based intervention that will likely lead to the most significant possible gain.
The IAR-DST helps to communicate about a person’s treatment needs and what level of service intensity a person requires (Level 1: self-management through to Level 5: specialist and acute).
When using the IAR-DST, a person seeking mental health assistance has their experiences understood in the context of holistic assessment domains. The eight domains help to distil essential assessment information and identify key signals. The eight domains are:
Implementing the IAR decision support tool across the primary healthcare sector will:
ensure the person is matched to care most suited to their current need
enable use of common language and a consistent intake process
promote nationally consistent definitions and understanding of service types, based on the intensity of care
minimise the likelihood of consumers having to repeat information
enable efficient and appropriate referrals across the mental health sector
support step-down referrals from public health services
highlight the range of effective mental health services that are available across the state.
Murray PHN acknowledges its catchment crosses over many unceded First Nations Countries, following the Dhelkunya Yaluk (Healing River).
We pay our respects and give thanks to the Ancestors, Elders and Young people for their nurturing, protection and caregiving of these sacred lands and waterways, acknowledging their continuing cultural, spiritual and educational practices.
We are grateful for the sharing of Country and the renewal that Country gives us. We acknowledge and express our sorrow that this sharing has come at a personal, spiritual and cultural cost to the wellbeing of First Nations peoples. We commit to addressing the injustices of colonisation across our catchment, and to listening to the wisdom of First Nations communities who hold the knowledge to enable healing. We extend that respect to all Aboriginal and Torres Strait Islander peoples.
Leadership