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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 Care Plans (MHCPs) 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.

NQPHN offers continuous training and support to assist general practitioners (GPs) and other clinicians in using the IAR-DST, enabling you to complement your clinical judgment and assessment with this valuable support tool. We extend an invitation to GPs and service providers in the mental health sector to participate in the IAR-DST training sessions to understand how this tool can elevate your practice and enhance patient outcomes.

GPs and GP Registrars who attend a training session may be eligible for:

  • $300 reimbursement* 

  • CPD points 2023 (30 minutes Reviewing Performance and 1.5 hrs Educational Activities through RACGP; 2 hours CPD for ACRRM)** 

To register for the next training session click here.

This is an RACGP-approved CPD activity under the RACGP CPD Program This is an RACGP-approved CPD activity under the RACGP CPD Program

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 is being implemented nation-wide 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.

*Payment is available to GPs and GP Registrars. The one-off payment is not available to other medical staff, clinicians or GPs working with Adult Mental Health Centres or Aboriginal Medical Services already funded by the Australian Government, unless the training is outside of normal employed hours. 

IAR-DST training is available both online and face-to-face to suit your team's needs. 

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 regional services available. 

Virtual sessions

Dates to be confirmed.

Register your interest for a virtual session here.


For face-to-face training, we offer the flexibility of delivering the training in a two-hour session or multiple sessions that suit your team's availability. 

We also offer collaborative workshops and networking events within the NQPHN region to provide an opportunity to complete the training face-to-face.  

Register your interest for a face-to-face session here.


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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. 

Stepped 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.  

Stepped care

 5 levels of care

Services by level of care within the NQPHN region

The information gathered through the initial assessment domains is used to recommend a service type and intensity (level of care) and inform a referral decision. This process is based on a clinically informed algorithm and is calculated automatically using the digital IAR-DST.

The levels are differentiated by the amount and scope of resources that are likely to be required. A child may use some or all interventions described at that level and move between levels of care as required.

Evidence based digital interventions and other forms of self-help.  

Typically, no risk of harm, experiencing mild symptoms, and/or no or low levels of distress. Symptoms have typically been present for a short period. The individual is generally functioning well and should have high levels of motivation and engagement. 

Examples of self-management services available across the NQPHN region include:

Services that can be accessed quickly and easily and include group work, phone, and online interventions, and involve few or short sessions 

Typically, minimal or no risk factors, mild symptoms/low levels of distress, and where present, this is likely to be in response to a stressful environment. Symptoms have typically been present for a short period of time (less than six months but this may vary). The individual is generally functioning well but may have problems with motivation or engagement. Moderate or better recovery from previous treatment. 

Examples of low intensity services available across the NQPHN region include:

Moderate intensity, structured, and reasonably frequent interventions (e.g. psychological interventions). 

Typically, likely to be experiencing mild to moderate symptoms (that would meet the criteria for a diagnosis).   

Symptoms have typically been present for six months or more (but this may vary). The initial assessment would usually indicate problems present in risk of harm, functioning, or impact of co-existing conditions, but not at very severe levels. 

Examples of moderate intensity services available across the NQPHN region include:

Periods of intensive intervention, typically: multidisciplinary support, psychological interventions, psychiatric interventions, and care coordination. 

Typically, has significant symptoms or significant problems with functioning.   

An older adult with a severe presentation is likely to be experiencing moderate or higher problems associated with risk of harm, functioning, and impact of co-existing conditions.   

Examples of high intensity services available across the NQPHN region include:

Specialist assessment and intensive interventions (typically, state/ territory mental health services) with involvement from a range of mental health professionals. 

Typically, has significant symptoms (e.g. severe symptoms or extreme behavioural problems) or problems in functioning independently across multiple or most everyday roles, or is experiencing significant risk of suicide, self-harm, self-neglect, vulnerability, or significant risk of harm to others. 

Examples of specialist and acute mental health services available across the NQPHN region include:

Contact us

Please contact us for more information or to register your interest in future training. 


P: (07) 4963 4400

30 November 2023