Inside the Boardwalk: Using the IAR-DST in general practice

  24 April 2024  NWMPHN   

It can be challenging for GPs and other clinicians to determine the most appropriate level of care for patients with mental health concerns.

The Initial Assessment and Referral Decision Support Tool (IAR-DST) provides a standardised, evidence-based and objective approach to assist GPs and mental health clinicians understand the intensity of care needed for each patient.

The tool has been in use in the mental health sector since 2019, but it is also being increasingly adopted by GPs and other primary health care professionals.

One of the early adopters of the tool is Dr Sabina Amin, from the Boardwalk Health Medical Centre in Point Cook. She was introduced to IAR-DST through NWMPHN training, which she found very easy to complete.

“I use the IAR-DST for mental health management planning, and it is very helpful,” she said.

“The cases I used it on were complicated with multifactorial issues. I found it was an easy method to keep myself and the patient focused on a point, rather than moving from one point to another.”

The IAR-DST works to streamline initial assessment and intake, complementing each clinician’s own judgement. It bolsters the process of deciding the most appropriate referral.

It is designed to provide advice across 8 diagnostic domains:

  • symptom severity and distress
  • risk of harm
  • impact on functioning
  • impact of co-existing conditions
  • treatment and recovery history
  • social and environmental stressors
  • family and other supports
  • engagement and motivation.

Because of this, said Dr Amin, using the IAR-DST involves a learning curve.

“One needs to do it multiple times to be able to get faster at going through it,” she said.

“The description is very detailed, but the more I used it the easier it was to go through.”

Any initial unfamiliarity involved in using the tool, however, is easily balanced against its benefits for the clinician and the patient.

“Since mental health consultation can be challenging in getting the whole picture and framing a plan, the IAR-DST does justice to the clinician and patient equally.

“Getting to a management point considering all the domains is reassuring to myself and my patients.”

She said she would recommend the IAR-DST to any doctor considering adopting it.

“It makes the clinician feel more organised and in control, and leads to a lot of clarity into how to manage the patient,” she said.

More information on IAR-DST is available here.

If a GP is not sure of the best referral pathway, get in touch with our mental health referral and access team who can help with care options.