Mental health and suicide prevention

We use an integrated mental health and suicide prevention approach ('stepped care') to guide mental health activity. All regional mental health planning and commissioning of services is founded upon this approach.

A stepped care approach to mental health service provision involves the following elements:

1. stratification of the population into different 'needs groups', ranging from whole of population needs for mental health promotion and prevention, through to those with severe, persistent and complex conditions
2. setting interventions for each group – this is necessary because not all needs require formal intervention
3. defining a comprehensive 'menu' of evidence-based services required to respond to the spectrum of need
4. matching service types to the treatment targets for each needs group and commissioning / delivering services accordingly.

An individual is matched to the intervention level that most suits their need. They do not have to start at the lowest, least intensive level of intervention in order to access a different ‘step’. Rather, they have their service level aligned to their requirements at the time of entering the mental health system.

You can read about the 10 stepped care principles we have adopted, or watch this short explainer video. You can also read about our stepped care approach in more detail via our Integrated primary mental health and suicide prevention (stepped care) document.

The Australian Government, through the Mental Health and Suicide Prevention Plan, is implementing the Initial Assessment and Referral (IAR) tool in primary care.

The IAR Decision Support Tool (IAR-DST) uses the stepped care approach to assist general practitioners when matching your patient’s mental health needs with the right level of service intensity, at the right time. Widespread uptake of the tool will promote the use of common language and standardise the initial assessment for people presenting with mental health conditions.

Effective suicide prevention requires coordinated effort across sectors, organisations and communities. This approach is highlighted in our Regional Mental Health and Suicide Prevention Plan.

We have identified opportunities for system improvements, and the need to design and implement new suicide prevention initiatives tailored to local needs. Strategies range from whole-of-community health promotion, through to the design and commissioning of services that improve access to supports for individuals at risk of suicide.

Some of the strategies we are actively working on include:

• commissioning new services and working with existing services to improve access to evidence-based treatment for suicidality
• supporting GPs and primary care to better identify and support people experiencing suicidality
• working with the Local Health Districts to improve crisis and follow up care for individuals following a suicidal crisis
• learning from people with a lived experience and working with communities to raise awareness and tackle stigma
• training key gate keepers within our community
• supporting safe media reporting
• understanding our community and data so that activities and resources are directed where they are most needed.

We are also a lead agency in the Illawarra Shoalhaven Suicide Prevention Collaborative and received further funding to scale this approach across our region.

Our recovery-focused Mental Health Lived Experience (Peer) Work Framework ensures people with experience of mental illness continue to shape and deliver mental health services.

The framework was designed and developed by a joint working group that included COORDINARE, Southern NSW Local Health District, Illawarra Shoalhaven Local Health District, community-based organisations, and people with lived experience of mental illness who also work in mental health services.

Digital mental health is the delivery of services targeting common mental health problems through phone, online and mobile phone interactive websites, apps, sensor-based monitoring devices, and computers.

These services are a great option for people searching for mental health support for themselves or others, and can be used alone or in combination with face-to-face therapy. They are accessible at any time, low-cost or free, and easy to use in a variety of settings.

Find some useful digital mental health resources, including modules and webinars available for health professionals below.

• This Way Up provides online courses for depression, anxiety, panic disorder, social phobia, and more. You can recommend patients visit the site and enrol in a self-guided program, or you can register to prescribe these courses.
• Head to Health brings together apps, online programs and forums, phone supports, and treatment options as well as a range of resources.
• The Black Dog Institute's e-Mental Health in Practice is a hub of mental health resources and forums for all health professionals.