Table 1 Comparison of key features of the SAFE START and PIPA models of integrated psychosocial assessment
| Â | Model of integrated psychosocial assessment | |
|---|---|---|
SAFE START model (Care as usual) | PIPA model (Alternative model) | |
Psychosocial assessment measures | EPDS, SAFE START psychosocial questions | EPDS, ANRQ-R (psychosocial questions); clinician concerns |
Psychosocial risk levels | Three levels of psychosocial risk, defined as: Level 1: no specific vulnerabilities or risk Level 2: one or more risk factors of variable severity and significance including, but not limited to, low supports, multiple birth, financial stress, isolation, ‘mild-moderate’ depression or anxiety, history of mental health problem, young age. Level 3: one or more of four complex risk factors (domestic violence, involvement with child protection services, substance misuse, severe mental illness) | Six levels of psychosocial risk, defined as: No risk: ANRQ-R = 0; EPDS < 13 (Q10 = 0); no clinician concerns. No risk on ANRQ-R (ANRQ-R = 0) but clinician concerns and/or EPDS = 13 or 14. Low risk: ANRQ-R = 1–24 (excluding e,g., significant mental health historya) and EPDS < 15 (Q10 = 0). Medium risk: ANRQ-R = 1–24 (including e,g., significant mental health historya) and EPDS < 15 (Q10 = 0). Medium-high risk: ANRQ-R ≥25 (excluding any ‘complex’ risk factorsb) or combination of ‘social’ risk factorsc or EPDS ≥15 (Q10 = 0) or childhood trauma and neglect. High risk: ANRQ-R >25 and other ‘social’ risk factorsc or any ‘complex’ risk factor (s)b or EPDS Q10 ≥ 1. |
MCD meeting referral threshold | Levels 2 and 3 | High risk |