Procedures for risk management and a review of crisis referrals from the MindSpot Clinic, a national service for the remote assessment and treatment of @entity148 and XXXX .

@entity1 @entity308 @entity458 @entity148 @entity1445 @entity7434
BACKGROUND: The MindSpot Clinic (MindSpot) provides remote screening assessments and therapist-guided treatment for @entity148 and @entity308 to adult Australians. Most @entity1 are self-referred. The purpose of this study was to report on the procedures followed to maintain the safety of @entity1 and to examine the circumstances of urgent referrals to local services made by this remote mental health service. METHOD: A description of the procedures used to manage risk, and an audit of case summaries of @entity1 who were urgently referred for crisis intervention. The reported measures were scores on self-report scales of @entity458 ( @entity7434 ) and @entity308 (PHQ-9), the number reporting suicidal thoughts and plans, and the number of acute referrals. RESULTS: A total of 9061 @entity1 completed assessments and consented for analysis of their data in the year from 1 July, 2013 to 30 June, 2014. Of these, 2599 enrolled in online treatment at MindSpot, and the remainder were supported to access local mental health services. Suicidal thoughts were reported by 2366 (26.1  %) and suicidal plans were reported by 213 (2.4  %). There were 51 acute referrals, of whom 19 (37.3  %) lived in regional or remote locations. The main reason for referral was the @entity1 ' self-report of imminent suicidal intent. The police were notified in three cases, and in another case an ambulance attended after the @entity1 reported taking an @entity1445 . For the remaining acute referrals, MindSpot therapists were able to identify a local mental health service or a general practitioner, confirm receipt of a written case summary, and confirm that the @entity1 had been contacted, or that the local service intended to contact the @entity1 . CONCLUSIONS: Around 0.6  % of the @entity1 seeking assessment or treatment by MindSpot were referred to local mental health services for urgent face to face care. The procedures for identifying and managing those @entity1 were satisfactory, and in every case, either emergency services or local mental health services were able to take over the @entity1 's care. This review suggests that the uncertainty associated with taking responsibility for the remote treatment of @entity1 who disclose active suicidal plans is not a major impediment to providing direct access online treatment for severe forms of @entity148 and @entity308 .
