The utility of the Australian primary health networks’ initial assessment and referral decision support tool (IAR-DST) for cross-sectional assessment of care needs in young adults attending a tertiary community mental health service

Abstract

Objective

The Australian Primary Health Networks’ Initial Assessment and Referral Decision Support Tool (IAR-DST) aims to help clinicians recommend an appropriate Level of Care (LOC) for adults with mental health difficulties. This study evaluated whether the IAR-DST has utility assessing ongoing care needs for young adults attending a tertiary community mental health service.

Method

Cross-sectional IAR-DST ratings for young adults (aged 18–24 years) attending a tertiary community mental health service in Adelaide in May 2019 were based on retrospective file review by senior clinicians. Health service use indices during patients’ current episode of care were collected using electronic record systems. Incidence Rate Ratios (IRRs) were generated to compare service intensity.

Results

104 young adults were included. Psychotic Spectrum Disorders and Borderline Personality Disorder were the most common diagnoses. 63% received IAR-DST ratings recommending for high-intensity care (i.e. LOC 4 or 5), whereas for 37% lower-intensity services were recommended. IRRs showed higher service use with increasing LOC.

Conclusion

The IAR-DST may be useful for reassessing service needs in young adults attending specialist mental health services, to support transitions within a tiered mental health system. More research is needed to evaluate the tool’s utility in different help-seeking populations.

Keywords

assessment community mental health stratified care triage young adult

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