Adapt to changing needs

It’s important that services can design flexibly to respond to changing situations and the needs of people they are supporting. This is to ensure that people are always safe, and are receiving the right support for them in relation to their current wellbeing. 

The needs of an individual can change due to a variety of external circumstances and scenarios.

Needs can change over a long period of time, both positively and negatively due to ongoing support and engagement with a product or service. The intervention that is offered when first assessing an individual’s need might change over time. It’s important that you can accommodate both the understanding of what needs adapting and make the appropriate changes in the right time frame. 

External factors can contribute negatively on an individual’s wellbeing and put them at risk. Where the risk wasn’t present before, it may change. 

This might be a sudden adverse event that affects someone’s well being, for example, an undesired harmful effect resulting from a medication or other intervention. 

This might be a safeguarding issue where an individual is at an increased risk of harm, for example, a form of physical abuse. 

This might be an event that has happened, in the home or elsewhere that negatively impacts the individual’s wellbeing, for example, a relationship breaking up or being bullied at school, leading to negative thought patterns and/or suicidal tendencies. 

Needs can also change instantaneously during the use of a product or service to protect information from other individuals or feeling unsafe to be engaging in a mental health service. For example, an abusive partner may return to an individual’s home and the individual might not want them to know they are talking to someone else or the content of their conversation. 

There can be short and long term effects on people due to changing circumstances. 

Adjustment disorder (stress response syndrome) is a short-term condition that happens when you have great difficulty managing with, or adjusting to, a particular source of stress, such as a major life change, loss, or event. It is sometimes known as situational depression. It can change the way individual’s feel and think about the world and their place in it. A person might have emotional and/or behavioral symptoms as a reaction to a stressful event. These symptoms generally begin within 3 months of the event and rarely last for longer than 6 months after the event or situation has ended.

In adjustment disorder/stress response syndrome, the reaction to the stressor is greater than what is typical or expected for the situation or event. The symptoms may cause problems with a person's ability to function; for example, the person may have trouble with sleep, work, or studying. It can have a wide variety of symptoms that are changes from someone's usual self, which may include anxiety, worrying, tearfulness and more. AD doesn't involve as many of the physical and emotional symptoms of clinical depression and is not the same as is not the same as posttraumatic stress disorder (PTSD) although some symptoms may overlap. 

It must be recognised that with stress comes a difference in decision making. Acute stress can impair valuation of reward information critical to decision making, and drive a shift from goal-directed to habit-based decision making. 

Further to individuals, societal conditions may change. For example, a global pandemic might mean that services accessed physically need to find new ways to deliver to meet needs. The Covid19 pandemic reduced the availability of many family, social, and psychiatric supports. 

Additionally, new technologies and behaviours of a population or group may drive new ways for needs to be met. For example, youth at-risk of suicide didn’t use Crisis hotlines, which meant that Crisis extended their communication services to texts and chat. 

Mental health services need to constantly adapt in order to remain relevant and helpful.

Digital therapy is an enabler, not a barrier, to mental health support. Ieso Digital Health. Andy Blackwell. (2020).

Adjustment disorder. Ministry of Defence. (2008).

What is adjustment disorder? WebMD. (2020).

Stress and Decision Making: Effects on Valuation, Learning, and Risk-taking. US National Library of Medicine National Institutes of Health. Anthony J. Porcelli and Mauricio R. Delgado. (2018).

Awareness, Attitudes, and Use of Crisis Hotlines among Youth At‐Risk for Suicide. Wiley Online Library. Meghan Crosby Budinger et al. (2014). 

Expanding Suicide Crisis Services to Text and Chat. Hogrefe. Zachary Predmore et al. (2017). 

How mental health care should change as a consequence of the COVID-19 pandemic. The Lancet. Carmen Moreno et al. (2020).