Initial Assessment and Referral Decision Support Tool
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 with mental health care recommendations. The tool has been in use by our Head to Health intake team and other clinicians in the mental health sector since 2019.
The Australian Government Department of Health and Aged Care is expanding its availability into primary care settings. North Western Melbourne Primary Health Network (NWMPHN) anticipates that use of the IAR-DST will become standard practice in many local settings in coming years.
On this page
How does the IAR-DST work?
The IAR-DST is a useful support to complement clinical judgement and assessment. It is used to assist clinicians to recommend the most appropriate level of care for a person seeking mental health support.
Using the IAR-DST to complement your clinical judgement will help align GPs and mental health clinicians in other parts of the mental health system to provide the best support and care for patients. This may help to avoid delays in connecting your patient to the right type of care.
The tool is designed to provide advice relating to initial assessment and intake, 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
The IAR-DST uses these criteria to assist with matching an individual to the most appropriate level of care that is most likely to help them get the treatment to recover. More information is available on page 2 of the IAR snapshot (.pdf) and in the image below.
Why use the IAR-DST?
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.
Paid CPD training for GPs
NWMPHN is providing training for GPs interested in learning about the IAR-DST.
Training is available face-to-face at your practice (minimum 3 participants), at the NWMPHN office in Parkville, or online (using Zoom or Teams). Sessions are 2 hours long and GPs will receive an incentive payment of $300 for their time. 4 RACGP CPD points are also available.
It covers the following topics:
- an introduction to IAR
- orientation to the domains
- levels of care and the decision support tool
- information on clinical judgement and supported decision-making
- a practical activity using case studies in referral, assessment and intake settings.