National Initial Assessment (IAR) for mental health

A nationally consistent and evidence-based approach to mental health referral. 

IAR Snapshot

People seeking mental health support may present with a range of interrelated factors that can make it challenging to determine the most appropriate level of stepped care. The IAR provides a standardised, evidence-based and objective approach to assist with mental health care recommendations.

The IAR is a tool to assist general practitioners and clinicians to recommend the most appropriate level of care for a person seeking mental health support. The IAR is an initiative of the Australian Department of Health and brings together information from a range of sources including Australian and international evidence and advice from a range of leading experts. The IAR is designed to assist the various parties involved in the assessment and referral process, including:

  • General Practitioners (GP) and other clinicians seeking to determine the most appropriate care type and intensity for individuals.
  • Service providers and intake teams responsible for undertaking initial assessments which may involve making recommendations on the level of care required.

What is the IAR-DST? 

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

The IAR Guidance and 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 is being implemented nationwide and sector-wide throughout Commonwealth-funded mental health services and beyond. With widespread use, an environment using a shared framework is created promoting consistent language to communicate individual service needs.

How does the IAR-DST work?

The IAR-DST assessment is undertaken using eight initial assessment domains that are used to match clients to one of five appropriate levels of care.  The 8 domains help to distil essential assessment information and identify key signals i.e. red flags that are critical for decision making.


Initial Assessment and Referral (IAR) Snapshot

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

The IAR-DST can assist with:

  • 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 this treatment need with others in the sector – reducing the frustration that might occur when referring to mental health services.
  • Help you to document the needs of the patient across 8 assessment domains reducing medico-legal risks associated with difficulty documenting decision-making in mental healthcare.

The Levels of Care


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 Decision Support Tool (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.

The eight initial assessment domains

The IAR guidance identifies eight domains that should be considered when determining the next steps in the referral and treatment process for a person seeking mental health support. There are 4 primary assessment domains and 4 contextual domains. Specific criteria are outlined in the guidance for assessing severity across each domain.

This is an Australian Government initiative supported by the Central Queensland, Wide Bay and Sunshine Coast region PHN.



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

PH: 07 54568157


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