Table 2.

Illustrative IRM scenario

Situation	Recovery-focussed outcome
Remediation phase
If a client advised of an escalation in their early warning signs and… it had become evident, after review by the CR team, that coping strategies and environmental supports were not sufficiently robust to prevent a relapse.	➮ A brief admission may be considered, particularly if safety was a concern. ➮ In consultation with the acute community team, client and family, an admission plan would be developed that reassured and affirmed the client’s role in working with clinicians (e.g., in regard to identification of warning signs). ➮ The plan would also be designed to reinstate hope by building a range of coping strategies and supports. ➮ Identification of triggers &/or vulnerabilities would be central to this process. Although the initial focus would be on MH remediation, the degree of involvement of the other IRM service components would be dependent on the vulnerabilities identified by the client in the clinical review.
Restoration/reconnection phases
If medications were a primary concern and further adjustments required.	➮ This could be managed safely in a recovery-oriented sub-acute inpatient unit, with follow-up review by the CR psychiatrist, working in conjunction with a GP.
If, on the other hand, adherence was a concern.	➮ Strategies could be developed by the CR clinician and, depending on the accommodation arrangements, supported by the accommodation provider. ➮ The frequency of clinical reviews would be increased to support the client and monitor effectiveness of the intervention strategies.
If additional coping strategies were required to manage stress in the residential or employment arena	➮ These could be developed and implemented, with the support of relevant CMOs/NGOs.
If issues emerged around substance misuse:	➮ The CR team would engage specialist MH services, as well as setting up risk management strategies.
If high levels of expressed emotion in the family were a factor.	➮ CR could develop a family intervention and education plan.
If the CMO/NGO indicated that there were sexual safety, antisocial or substance misuse issues in the living situation.	➮ Strategies could be developed to improve safety (before consideration of a disruptive change in location). Clinical experience would suggest that quite often a complex of vulnerabilities impacts on wellness.

Note: CR clinical rehabilitation, CMOs/NGOs community managed/non-government organisations