Response to the Consultation Draft for the National Initial Assessment and Referral for Mental Healthcare-Child and Adolescent

As a member of the Expert Advisory Group, the APS is broadly supportive of the tools as they stand and acknowledges the care and consideration provided by highly experienced practitioners into the development process. We commend the use of a stepped care model and the informed, systematic approach underlying the logic of the tools. Overall, the initial assessment domains capture the main considerations required in the determination of the appropriate level of mental health care. The APS suggests, however, that there are six main considerations which would serve to further refine the IAR tools for adolescents and children:

• Child - Domain 4: There needs to be further guidance provided as to the implementation of the domain criterion for children and adolescents with developmental disabilities.
• Child - Domain 4: This Domain seeks to distinguish between children’s development and mental health but significant issues arise within the current service systems when we attempt to categorise children’s mental wellbeing as either a developmental concern or a mental health concern. Separation of the two means that children with developmental concerns can be excluded from mental health services and vice versa.
• Child - Domain 4: It is important that the IAR recognises that a child may have undiagnosed or unrecognised co-occurring conditions which may be difficult to assess in a primary care setting.
• Adolescent – Domain 3: This Domain should also include sexual development and emphasise social-emotional skills as an important contributor and predictor of overall wellbeing.
• Adolescent – Domain 4: We suggest a revision of the term ‘developmental delay’ in adolescents, instead, we suggest a similar definition such as that used by the National Disability Insurance Scheme and be reserved for children under six years of age.
• Child and Adolescent – Domain 6: The IAR tool should be used in a trauma-informed manner and necessary psychosocial history is taken in a way to minimise re-traumatisation.

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