Int J Mental Health Nurs - 2025 - Kar Ray - Efficiency of AIMS A 4‐Week Recovery Oriented Suicide Prevention Pathway
The article evaluates the Wellbeing Team (WBT) and its 4‑week AIMS (assessment, intervention, monitoring, step up/down) recovery‑oriented suicide prevention pathway, implemented in a large Australian metropolitan public hospital. Grounded in the PROTECT framework, the pathway integrates person‑centred care, positive risk‑taking, collaborative safety planning, and lived‑experience peer workers. Using routine electronic records, 552 referrals to the WBT from January 2020 to September 2022 were analysed. Participants were young (mean age 27.9), predominantly female (63.2%), with common diagnoses of adjustment disorder, depressive episode, and emotionally unstable personality disorder. Referrals came mainly from emergency departments (47.1%) and acute care teams (47.5%). The WBT delivered a suite of interventions: motivational interviewing, solution‑focused therapy, distress‑tolerance techniques, psychopharmacology, mindfulness, SAFE workshops, and structured tools such as the Care Compass and DESPAIR safety formulation. Outcomes showed that only 3.8% required ongoing public mental health care, 85.5% were stepped down to general practitioners, and 49.4% to NGOs. Psychiatric admissions were rare (3.4%). Six‑month follow‑up indicated low re‑presentation rates (76.3% of those with no prior public mental health contact did not re‑present; 60.7% of those with prior contact did not re‑present). The authors conclude that the AIMS pathway improves individual wellbeing while delivering system‑level efficiencies, reducing ED length of stay, ACT caseloads, and reliance on public mental health services. Limitations include short follow‑up, lack of a control group, missing external care data, and limited qualitative feedback. The paper suggests that short‑term, intensive, recovery‑oriented interventions can transform suicide prevention pathways and alleviate systemic pressures.
Topics
PROTECT Framework as the Philosophical Bedrock
Describes the PROactive deTECTion (PROTECT) framework that underpins the shift from deficit‑focused risk containment to recovery‑oriented positive risk‑taking and person‑centred safety planning.
Wellbeing Team (WBT) and the AIMS Pathway Design
Details the establishment of the Wellbeing Team in 2020 and the structure of the 4‑week AIMS pathway (assessment, intervention, monitoring, step up/down) as a structured, intensive, short‑term intervention for suicidal crisis.
Participant Demographics and Referral Landscape
Presents the characteristics of the 552 participants (mean age 27.9, 63.2% female) and the primary referral sources (ED 47.1%, acute care team 47.5%).
Assessment Phase: Dual Perspective Collaboration
Explains the collaborative bio‑psycho‑social assessment integrating clinicians and lived‑experience peer workers, including tools like the 1‑2‑7 safety planning conversation and baseline SWEMWBS measurement.
Therapeutic Modalities Delivered Within AIMS
Lists evidence‑based interventions used: motivational interviewing, solution‑focused therapy, distress‑tolerance, mindfulness/ACT, psychopharmacology optimisation, SAFE scenario‑planning workshops, and the SAFER review cycle.
Outcome Metrics: Discharge Destinations and Re‑Presentation Rates
Summarises key quantitative outcomes: 85.5% stepped down to GPs, 49.4% to NGOs, only 3.8% continued public mental health care, 3.4% required psychiatric admission, and low 6‑month re‑presentation (76.3% no‑prior‑contact, 60.7% prior‑contact groups).