The new Digital Mental Health Standards

Accreditation to the National Safety and Quality Digital Mental Health Standards (NSQDMHS) became available for all organisations on November 1 2022. Digital mental health services provide valuable support to clients, as they can be easier to access for most clients, and they can also offer clients the opportunity to discuss issues anonymously.

Launched in November of 2020, the Standards are not mandatory, however they do provide an opportunity for providers to give greater confidence to users of their services.

Who are the NSQDMHS for?

The Digital Mental Health Standards are available to a variety of mental health support providers. These include providers of:

  • Peer to peer support;
  • Services that provide information about accessing mental health services;
  • Digital counselling; and
  • Treatment services (assessment, triage and referral).

Digital mental health services may be provided via telephone, video conference, online (including web chat), SMS, and mobile applications.

What is in the standards?

There are three standards, and a total of 59 actions within the Digital Mental Health Standards. The three standards are:

  • Clinical and Technical Governance Standard;
  • Partnering with Consumers Standard; and
  • Model of Care Standard.

The standards map directly to the National Safety and Quality Healthcare Standards (NSQHS), however they contain fewer requirements than the NSQHS.

For more information about the content within the National Safety and Quality Digital Mental Health Standards, see our previous blog post on the topic.

Should we consider accreditation to the NSQDMHS?

Accreditation to the Digital Mental Health Standards provides clients with the assurance that their service provider is meeting the expected standards for safety and quality. The standards will also help to refine a provider’s processes, and provide better outcomes for users.

Feedback from organisations who participated in the pilot program for the Digital Mental Health Standards was that the standards helped them to document the processes they already had in place, and helped them to identify if they had any issues or areas for improvement in their processes. Organisations highlighted the data collection and management requirements within the Standards, saying that these assisted in mapping patient care journeys and change management processes.

What is the accreditation process?

Accreditation is provided by independent accrediting agencies who have been approved by the AHSSQA Scheme. The Australian Commission on Safety and Quality in Health Care (the Commission) has a list of accreditors on their website.

The process for accreditation to the National Safety and Quality Digital Mental Health Standards is as follows:

Application and engagement

  • Application – apply to an approved accrediting agency
  • Preparation – implement the NSQDMH Standards and clarify arrangements for an assessment
  • Application for not applicable actions – not all of the actions within the NSQDMH Standards are applicable to all providers, here you will specify which actions are irrelevant

Assessment and remediation

  • Interim assessment – the approved accreditor conducts an interim assessment which includes:
    • Desktop review – a review of evidence submitted by the provider to demonstrate compliance with the NSQDMH Standards
    • Verification – an assessment to verify the safety and quality systems described by the provider
  • Remediation period – a period of 60 business days is allowed in order to address any areas where the service provider does not comply with the requirements of the Standards
  • Final assessment – this assessment is for the actions that were either ‘not met’ or ‘met with recommendations’ during the interim assessment

Outcome, reporting and monitoring

  • Outcome – the provider receives an outcome based on the final assessment
  • Final report – the accrediting agency delivers a final assessment report
  • Submission of data – the Commission is notified of assessment outcomes by the accrediting agency
  • Registration the Commission adds the provider to their register of accredited digital mental health service providers
  • Ongoing monitoring – the service provider continues their monitoring and continuous improvement responsibilities

Further reading and how we can help

Since April 2021 we have had a module available to help providers self-assess against the NSQDMH Standards and ensure that their documented processes are in line with the requirements of the Standards. The module is intended to help to conduct a gap analysis before beginning accreditation, and with ongoing monitoring.

The Commission has developed a resource pack for the Digital Mental Health Standards, which can be found on their website.   

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Want to check out our Digital Mental Health resources? Talk to our team.

New key standards for the digital mental health space

The National Safety and Quality Digital Mental Health (NSQDMH) Standards were released in November 2020, and are the first of their kind. Developed by the Australian Commission on Safety and Quality in Health Care in consultation with consumers, service providers, academics, regulators and technical experts, the NSQDMH Standards aim to improve the quality of digital mental health service provision, and protect service users and their support people from harm.

What is a digital mental health service?

In the current context of the COVID-19 pandemic, coupled with the rapid evolution of digital technologies, telehealth services are being used more widely than ever before. As the take-up of these digital services increases, it makes sense to improve the regulation of the digital health service provision space.

So what does a digital mental health service look like?

The NSQDMH Standards define digital mental health as a mental health, suicide prevention or alcohol and other drug (AOD) service that uses technology to facilitate engagement and deliver care. Traditionally mental health, suicide prevention and AOD were considered distinct sectors, however the NSQDMH Standards refer to these digital services collectively.

Digital mental health services include:

  • Services that provide information
  • Digital counselling services
  • Treatment services (including assessment, triage and referral services)
  • Peer-to-peer support services

Digital mental health services may be delivered by:

  • Telephone (including mobile phone)
  • Videoconferences
  • Online services (such as web chats)
  • SMS
  • Mobile health applications (apps)

What are the National Safety and Quality Digital Mental Health Standards?

The three NSQDMH Standards are:

  • Clinical and Technical Governance Standard
  • Partnering with Consumers Standard
  • Model of Care Standard

The three standards include 59 actions related to clinical and technical aspects of digital mental health services. They describe the level of care and the safeguards that a digital mental health service should provide.

The NSQDMH Standards create a nationally consistent quality assurance mechanism for digital mental health service providers. Providers can assess areas of compliance as well as areas for improvement, with respect to their safety and quality assurance systems.

The standards are modelled on the National Safety and Quality Health Service Standards (NSQHS). Providers who already meet NSQHS are only required to implement actions specific to the NSQDMH Standards, which are relevant to their service.

Implementation of the NSQDMH Standards is currently voluntary. Self-assessing against the standards is an excellent way for service providers to demonstrate best practice in this space.

To assist providers to learn more about these standards and measure themselves against them, we are pleased to offer a self-assessment for the NSQDMH Standards on SPP. Our self-assessment consists of quizzes for each action across the three standards, as well Evidence Guides and linked resources to accompany each quiz.

You can find the self-assessment for the National Safety and Quality Digital Mental Health Standards in SPP under the Standards tab > Australian National Standards.

Want to learn more?

Self- assess against the National Safety and Quality Digital Mental Health Standards on SPP.

Working in partnership with family, friends and carers

Historically, staff training and delivery of care for people with a mental illness have been based around the individual. The emphasis on confidentiality has sometimes acted as a constraint when caring for an individual. Carers often report that they are not recognised and are not given sufficient information to fulfil their role. The failure to engage with carers has excluded the very people who are often responsible for putting care plans into action.

In 2013, the National Report Card on Mental Health and Suicide Prevention recommended that a practical guide be developed and implemented for the inclusion of families and support people in services and that this must include consideration of the services and supports that they need to be sustained in their role. Similarly, in 2014 the National Review of Mental Health Programmes and Services – Contributing lives, Thriving Communities highlighted Australia’s complex mental health care system and the importance of ensuring that “people with lived experience, families and support people encounter a system that involves them in decisions, is easily navigable and provides continuity of care.”

In 2016, the Practical Guide for Working with Carers of People with a Mental Illness (the Guide) was released. A number of mental health care experts worked together to develop the Guide including: Helping Minds, Mind Australia, Private Mental Health Consumer Carer Network (Australia), Mental Health Australia and Mental Health Carers Australia.

In developing the Guide, national consultation with relevant stakeholders found that:

  • Current practices were not meeting national, state and territory policies of carer engagement;
  • Staff did not feel that they were trained to undertake the practice of Family Therapy;
  • Carers often felt that they were not recognised sufficiently or given key information or support in their role;
  • Where carers persist in the quest for information, they are often labelled as ‘angry’, ‘over-involved’ or ‘difficult’; and
  • There is a no consistency in treatment across clinicians and across service sectors.

There was also strong support for adoption of the “Triangle of Care” model that was developed by the UK Carers Trust.  The Triangle of Care recognises that there are three partners in the care relationship, being the consumer who is living the experience of illness, the carers of the consumer, and the service provider.

Family members are in a unique position where they know the person, and in many cases knew them before they became unwell. The Triangle of Care model combines the knowledge and skills of staff with the knowledge and lived experience of the consumer, their family and other carers in a partnership approach to service delivery across all settings.

About the Guide

The Guide seeks to assist providers to better engage, support and work with carers in all areas where mental health is provided.

There are six partnership standards contained in the Guide:

  1. Carers and the essential role they play are identified at first contact, or as soon as possible thereafter.
  2. Staff are carer aware and trained in carer engagement strategies
  3. Policy and practice protocols regarding confidentiality and sharing of information are in place.
  4. Defined staff positions are allocated for carers in all service settings.
  5. A carer introduction to the service and staff is available, with a relevant range of information across the care settings
  6. A range of carer support services is available.

Within each of the six standards there are practical examples of tasks that individuals and organisations may undertake to demonstrate that they are able to work in a partnership manner. These practical examples aim to assist providers to work with carers in a mutually beneficial way.

How can your organisation implement the standards?

A self-assessment for the Practical Guide for Working with Carers of People with a Mental Illness has recently been added into SPP. By self-assessing against these standards, your organisation can highlight priority areas and create action plans to make improvements to the engagement of carers.

Implementation of the standards will demonstrate your organisation’s commitment to working in partnership and to meeting the requirements of the accreditation processes.

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You can access the Practical Guide for Working with Carers of People with a Mental Illness and much more in the SPP platform

Working from home during COVID-19

Working from home can present many challenges. Spending long hours on a laptop at the kitchen table can be both physically and mentally stressful. Employees must take reasonable care for their own health and safety, and must co-operate with employers to ensure the workplace is safe by following any guidelines and carrying out necessary checks. For many organisations the pandemic presents new challenges, however there is an abundance of resources that organisations can use to assist them to maintain a productive workplace, and to assist employees struggling with their mental health.

A few tips to help you work from home safely and effectively:

  • Have a comfortable workstation;
  • Take regular breaks: for some people this may mean putting triggers in place to remind us to have a break- including setting an alarm;
  • Set boundaries between work and home. Setting up a designated space can be a good way to signal when you aren’t working. Moving the workstation to the end of the table, putting it away or covering it can be a good way to establish work hours;
  • Stay connected with your workmates, whether through regular meetings or more casual virtual chats; and
  • Schedule physical or creative activities into each day- get outside if the weather allows, or do indoor activities such as Yoga or Pilates.

Comcare has developed a useful working from home checklist which can assist organisations to ensure that short-term working from home arrangements fulfil the minimum requirements to keep them safe and healthy.  

Mental Health and Working from Home

Comcare has also developed some practical resources to assist you and your workplace to maintain good mental health throughout this time. They are updating their website as the situation evolves, with newly developed fact sheets. Some of their current fact sheets include:

Employers have an important role to play in ensuring their employees maintain their mental health. Employers should:

  • Check in regularly;
  • Create team chats that allow for continued communication;
  • Provide employees with appropriate flexibility when they work;
  • Encourage employees to stay physically active as well as regularly go outside;
  • Ensure employees are effectively disengaging from their work at the end of the day; and
  • Be available, accessible and ready to listen.

Dr Jill Newby, Associate Professor of Psychology at UNSW, who is based at the Black Dog Institute, has noted some common feelings that people may be experiencing during this time when working from home, including:

  • struggling to ‘switch off’ after work hours;
  • feeling isolated or disconnected both socially and professionally;
  • feeling a lack of motivation; or
  • feeling uncertain about their progress.

She offers some practical tips for individuals to stay motivated and productive when working from home.

It is vital that workers are supported to reach out and seek professional help if they are struggling during this time. Beyond Blue has many useful resources to help individuals stay positive and stay connected. It also provides support services which allow people to talk with a counsellor or to connect with others through online forums.

BNG has also developed some resources which may be useful when working from home. Our working from home policy outlines the responsibilities of both employees and employers when working from home, and outlines the confidentiality requirements when taking home or accessing client files from home. Our working from home agreement ensures that employers are aware of their obligations when working from home, and that the employee has undertaken the appropriate health and safety checks on their workspace.  

These resources are now available in SPP:

  • Policy: Working from home
  • Template: Working from home agreement

You can access these resources by searching for “working” in the Reading Room. 

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