Ensure everyone can access aftercare by expanding referral options and setting clear criteria for prioritisation.
Referral pathways
Identify services for inbound and outbound referrals through service mapping in the local area.
Extend inbound referrals beyond NSW Health local health districts (LHDs), specialty health networks (SHNs) and emergency departments.
Accept self-referrals from people in a suicidal crisis or following a suicide attempt, and their family members, carers, friends and kin.
Also consider accepting referrals from the following services.
LHDs and SHNs
- Hospital and community services
- Drug and alcohol services
- Mental health services, including Towards Zero Suicides Initiatives, such as Safe Havens, Suicide Prevention Outreach Teams (SPOTs)
- Aboriginal mental health clinical leaders and district coordinators
- Aboriginal health units
Private and community health providers
- Mental health community managed organisations (CMOs)
- Private mental health providers
- General practitioners (GPs)
- Aboriginal community controlled health organisations (ACCHOs)
- Services or facilities that support older people, e.g. aged care assessment services, community and residential aged care facilities and services
Social and cultural services
- Social services, e.g. family violence, financial counselling, housing and employment
- Cultural services, e.g. settlement services, Aboriginal community controlled organisations (ACCOs) and other Aboriginal support services
- Other support services for priority populations
- Educational facilities, e.g. schools, TAFEs and universities.
Referral processes
All inbound referring services must understand your referral criteria and processes. Share this information through service agreements, local governance groups and other forms of ongoing communication.
When accepting referrals from non-clinical services, ensure the appropriate clinical support is available based on the consumer’s needs, e.g. a GP, the acute care team or a community-based mental health team.
Referral criteria
Consider the following when establishing referral criteria for your aftercare service.
Suicide attempt and crisis
Evidence shows that early intervention is effective in suicide prevention, and aftercare is more effective when offered to the person following their first suicide attempt.1
People who have experienced a recent suicide attempt or are experiencing a suicidal crisis are eligible for referral to aftercare services; however:
- prioritise referrals for people who have experienced a recent attempt
- accept referrals for people experiencing suicidal crisis, where capacity allows and considering the individual’s needs.
Age
Accept referrals for people aged 16 and older and consider accepting referrals for people as young as 14, if they have been assessed to have capacity for consent.
Some specialised services, such as ACON or i.am youth aftercare pilot, have different age criteria.
Flexibility for priority populations
People at an increased risk of suicide may benefit from earlier intervention and lower thresholds to enter an aftercare program.
Consider accepting referrals for people experiencing suicidal ideation who:
- may be at higher risk of suicide
- have limited access to alternate suicide prevention services, due to rurality, accessibility or other barriers.
While expanding referral criteria may affect service demand and referral pathways, supporting priority populations is crucial to achieve universal access to aftercare and proactive suicide prevention.
All providers working with people aged under 18 years must obtain a Working with Children Check and consider mandatory reporting requirements.
Service capacity
Establish processes to prioritise and accept or decline referrals.
Prioritising referrals
Establish a procedure for prioritising referrals based on local priority populations, accessibility and need. This can be determined through local governance groups. Consider flexibility for priority populations, as above.
The procedure must involve phone contact with the consumer – preferably by a peer worker – to understand their circumstances and suicidal risk.
Alternate care for declined referrals
If your service is at capacity, or the referral does not meet the eligibility criteria, follow these steps within two business days from receiving the referral:
- Communicate outcome back to referring provider or person.
- Direct consumers at high suicide risk to alternative services, such as Safe Haven, the local emergency department or emergency services.
- Suggest an alternative pathway of care, identified through local service mapping. These may include Safe Haven or Lifeline's Eclipse Group support and helpline support in your local area.
Alternate care for minors
If a referral is declined based on age, the below services may provide alternative care options.
- Child and Adolescent Mental Health Services (CAMHS)
CAMHS provide community-based and inpatient mental health support to children, adolescents and their families. Their multidisciplinary team offer assessment, education and treatment services for mental health difficulties, such as anxiety disorders, depression and emotional trauma.
Source: NSW Health - Medicare Mental Health: Support for children (previously Head to Health Kids Hub)
Provides easy access to Medicare Mental Health initiatives, including support for children.
Source: Australian Government Department of Health and Aged Care - New Horizons 'i.am' Youth Aftercare
The ‘i.am’ Youth Aftercare support services is a pilot program delivered by New Horizons. It is available in select communities providing support to children and young people aged under 25 following significant suicidal ideation, self-harm or a suicide attempt.
Source: NSW Health - NSW Health Child and Family Counselling Services offered in your local area
- Safeguards, NSW Health
Safeguards teams offer a community-based service for children and adolescents (0–17 years) experiencing acute mental distress. They provide crisis assessment and brief intervention over 6 to 8 weeks before connecting the young person to local ongoing supports. Contact the local health district for more information about the service in your area.
Source: NSW Health - Star4Kids
The Star4Kids programs provides free short-term psychological services to children aged 3 to 12 years with, or at risk of, developing mental illness. Search for a program in your local area.
References
- Suicide Aftercare Services: An Evidence Check Rapid Review Brokered by The Sax Institute for The Commonwealth Department of Health and Aged Care. Sydney (AU): Sax Institute; 2023 [cited 25 Sept 2024].