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Initial Assessment and Referral – Decision Support Tool (IAR-DST)

When it comes to making well-informed decisions about mental health referrals, the IAR-DST provides a reliable, user-friendly evidence-based tool. The tool has a six-year planning history and has been refined by the collective input of clinicians, academics and an expert advisory group, including representatives from peak bodies, general practitioners, specialists and the Department of Health and Aged Care.

Its integration with Mental Health Treatment Plans (MHTPs) has been recommended in the recent review of ‘Better Access’ emphasizing the necessity of a consistent, standardised and evidence-based approach for mental health referrals nationwide.

Training is available to assist general practitioners (GPs) and other clinicians to use the IAR-DST, to complement their clinical judgement and identify the appropriate level of care for their patients.

GPs and GP Registrars who attend a training session will receive:

  • CPD points 2023-25 (30 minutes Reviewing Performance and 1.5 hrs Educational Activities through RACGP; 2 hours CPD for ACRRM).
RACGP qualification This is an RACGP-approved CPD activity under the RACGP CPD Program.
ACRRM accreditation This is an ACRRM accredited activity.

The Australian Government, through the Mental Health and Suicide Prevention Plan, is expanding and implementing the IAR tool in primary care. The IAR-DST is a decision-making framework guided by practitioner assessment and clinical judgement.

The IAR-DST is used to estimate or confirm the mental health response a person requires, and in doing so, aims to achieve the least burdensome intervention that is most likely to lead to the most significant clinical gain.

The IAR-DST and IAR Guidance are being implemented nationwide and sector-wide throughout Commonwealth-funded mental health services and beyond. With widespread use, we create an environment with a shared framework and consistent language to communicate about service needs.

IAR-DST training is available online in live sessions with experienced trainers and/or clinicians. Register here.

Learning outcomes include:

  • Knowledge about the IAR-DST development process including the principles underpinning the evidence-based approach to stepped care in primary care
  • Skills to use the IAR-DST in practice settings
  • Identify the Levels of Care and determine referral services available.

Widespread use of the IAR-DST improves awareness and transparency of how decisions about the appropriateness of referrals are made. This can reduce frustration and save time in managing rejected referrals, meaning more patients receive the right care at the right time.

The tool helps clinicians communicate initial assessment and referral information consistently, and to articulate treatment needs using language commonly understood across the sector. Its use may reduce the risks and liabilities associated with underestimating a person’s treatment needs.

The IAR-DST does not replace clinical judgement based on presentation.

How will the IAR DST help my practice?

The IAR-DST can help you:

  • Explore essential information during a mental health assessment and review critical information that is essential for decision making
  • Estimate or confirm the mental health treatment needs of the patient
  • Communicate the treatment need with others in the sector – reducing the frustration that might occur when referring to mental health services
  • Document the needs of the patient across eight assessment domains reducing medico-legal risks associated with difficulty documenting decision-making in mental healthcare.

More information on the IAR-DST support tool is available here.

The IAR-DST is a support tool and does not replace your clinical judgement.

How will this evidence-based approach help the people I work with?

The IAR-DST is an initiative of the Department. This initiative brings together information from a range of sources, including Australian and international evidence and advice from a range of leading experts.

The National IAR Guidance and IAR-DST were developed to provide primary healthcare with a nationally-consistent, evidence-based, and objective approach to initial assessment and referral of patients seeking mental health support. The IAR-DST simplifies how clinicians determine the care needs of a patient with mental health concerns.

The tool has been used by the Head to Health intake team and other clinicians in the mental health sector since 2019. The Department is now expanding its availability into primary care.

The eight initial assessment domains are used to match clients to one of five appropriate levels of care.

The IAR-DST utilises eight assessment domains that are used to match people to the most appropriate levels of care. The eight domains help to distil essential assessment information and identify key signals (i.e. red flags) that are critical for decision making.

NQPHN regional mental health planning and commissioning of services are founded upon a stepped-care approach that aims to match individuals presenting to the health system with the least intensive level of care that best suits their treatment needs.

By monitoring treatment experiences and outcomes, we can adjust treatment intensity up or down or provide a combination of services to reach the desired intensity as needed.

The stepped-care approach provides a consistent, standardised, and transparent process for referral, which is timely and necessary in today’s congested and strained mental health sector.

Click here to watch a video on how to use the Initial Assessment and Referral – Decision Support Tool (IAR-DST) in Inca.

Contact us

Please contact us for more information.

E: IARTraining@nqphn.com.au

P: (07) 4963 4400

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