Download the NSQDMH Standards
Model of care
The model of care outlines the way a digital mental health service is to be delivered. Service users and their support people access digital mental health services through a range of channels and media, and the model of care for their chosen service may not always be obvious.
Service providers should understand and describe the purpose and intent of the service, how it is to operate, what it is intended to achieve and how it is informed by evidence and best practice. This can help to assist service users, and where relevant, their support people, to make informed choices about digital mental health services.
As the NSQDMH Standards apply to a wide range of digital mental health services, the actions in the Model of Care Standard may apply differently in each different type of service. Monitoring the delivery of care to ensure the service does what it promises to do, that it communicates clearly to the service user and engages with their support people (to the extent that the service user chooses) is equally necessary, but requires appropriate accountabilities to be put in place.
Minimising risk in any care delivery setting is important. For digital mental health services, in-person interactions and environmental cues are often not available to signpost potential risks. Screening of risk is therefore important, particularly in relation to the risk of harm, including self-harm and suicide. Where risk is detected, an effective response should be available, whether that is provided directly by the service or via referral to another agency.
Serious adverse events may be preceded by changes in a person’s behaviour or mood that can indicate a deterioration in their mental state. Early identification of deterioration may improve outcomes but can be more difficult in a digital setting. However, digital services should not mean a higher level of risk. A systematic approach to recognising deterioration early and responding to it appropriately is therefore required, noting that the response may include calling for emergency assistance internally or via external emergency response systems.
Communicating for safety
Communication is a key safety and quality issue, and no less so in services delivered by a digital means. Correct identification is an important component of communication in health care settings. When a service user is not physically present and when they may even be accessing the service anonymously, it remains critical to ensure that they are correctly identified and receive continuity in their care, and that no other individual is able to inappropriately access their care details.
There are key times when effective communication and documentation are critical to the safety of service users and their support people. This includes when critical information about a service user’s care emerges or changes, and when their care is transferred. Systems and processes should be in place to ensure effective communication at these times.