Efficiency of AIMS: A 4-Week Recovery Oriented Suicide Prevention Pathway

Abstract

The global rise in presentations to emergency departments (EDs) for suicidal crises has created significant challenges for healthcare systems. Traditional approaches often emphasise containment and risk aversion, leading to prolonged ED stays and resource-intensive inpatient admissions. A large Australian metropolitan mental health service introduced a Wellbeing Team (WBT), and trialled the recovery-oriented AIMS (assessment, intervention, monitoring, step up/down) pathway. Grounded in the PROTECT framework, its focus is on person-centred care, integrating positive risk-taking and collaborative safety planning to stabilise individuals and reduce reliance on public mental health services. This study analysed 552 people referred to the WBT over 32 months, primarily from EDs (47.1%) and acute care teams (47.5%). The population predominantly consisted of women (63.2%), with a mean age of 27.9 years. The most common diagnoses were adjustment disorders (30.4%), depressive episodes (22.3%) and emotionally unstable personality disorder (14.7%). The WBT provided tailored interventions, including motivational interviewing, safety planning, distress tolerance techniques and psychopharmacological optimisation, guided by tools like the DESPAIR safety formulation. Outcomes revealed significant system efficiencies, with only 3.8% of participants requiring ongoing public mental health support. Most participants were successfully transitioned to primary care. Six-month post-intervention data showed 76.3% of individuals with no prior public mental health involvement did not re-present, and 60.7% with prior involvement did not require further input from secondary mental health services. These findings demonstrate the efficiency of recovery-oriented care in reducing systemic pressures while fostering sustainable outcomes, underscoring the potential of short-term, intensive, structured interventions like AIMS to transform suicide prevention pathways.