Be reliable and consistent

Build reliability and consistency in your service delivery. This ensures the promise you make can be reliably delivered for people to use and retains a level of consistency in service continuity for users, particularly across multi-service provision.

Further description

Being clear is key to explaining what you can and will deliver for users. Over and above this, it’s important to ensure you can deliver on any promise or contract made with your users. 

This includes;

Providing different routes for people to use your service so they can get support in a way they need it and can always access it

If there are a number of ways for people to access your service a range of accessibility needs will be met, Additionally, in case of one route not working, there are others to make contact with you. 

Ensuring service continuity 

Change can happen in service provision; from unforeseen circumstances causing immediate inability to deliver services, to everyday occurrences that can be expected. This will cause a break in the ability to maintain a ‘normal’ service.

A key delivery member may become sick, or a building or server may be damaged meaning the service can not continue as normal. Ensuring ahead of time there are alternative provisions and modes of delivery to mitigate these service ‘breaks’ is important to support people who become reliant on your service. 

If changes are known to occur, like changing terms and conditions, functionality of an app or removing user data, letting people know in advance is important so they can plan for this change. 

Structured and consistent communication 

Being reliable, structured, consistent and predictable in your interactions and communication with users will help them develop trust in the services you offer. 

For example, users may interact at any hour they choose, but it has been advised to only conduct therapeutic interactions during normal business hours to distinguish therapeutic communications from everyday interactions with others in the user’s life.

Continuity of care

In mental health services, continuity of care is "a process involving the orderly, uninterrupted movement of patients among the diverse elements of the service delivery system”. Research highlights there are still a range of meanings for continuity of care and that this is particularly undefined by users themselves in what this may mean.

Users of mental health services can often move between different primary and specialised health and care services, depending on their current condition, which can lead to fragmentation of care. Studies show that continuity of care has psychological and social effects in terms of the user's quality of life, ability to function within the community and satisfaction with the care services. Continuity can mean ensuring services are stable without breaks for users, seeing the same member of staff, and coordinating between different health providers. 

A research study in Norway categorised poor continuity of care elements from users into; 

Relationships – from experiencing frequent setbacks and anxiety due to breaks in relationships, to feeling safe in an on-going personal relationship

Timeliness – from experiencing frustrating waiting times with worsening of problems, to getting help when needed

Mutuality – from having a one-sided struggle, to a situation in which both professionals and service users take initiatives

Choice – from not having the opportunity to make practical arrangements within the context of one’s everyday life, to having an array of support options to choose from

Knowledge – from feeling confused and insecure because one does not know what is happening, to feeling safe because one is informed about what is going to happen


Further reading

Technology Use and the mental health of children and young people. Royal College of Psychiatrists. (2020). 

Therapeutic boundaries in telepsychology: Unique issues and best practice recommendations. US National Library of Medicine National Institutes of Health. Katherine B. Druma, Heather L. Littletona. (2014).

Expanding Suicide Crisis Services to Text and Chat Responders' Perspectives of the Differences Between Communication Modalities. Hogrefe. Zachary Predmore et al. (2016).  

History and Measurement of Continuity of Care in Mental Health Services and Evidence of Its Role in Outcomes, Psychiatry Online. Carol E. Adair, M.Sc. et al. (2003).  

Obstacles to continuity of care in young mental health service users’ pathways - an explorative study. International Journal of Integrated Care. Marian Ådnanes, Sissel Steihaug. (2013).

Reconstructing continuity of care in mental health services: A multilevel conceptual framework. Sage Journals. Cornelis Mulder et al. Sanne De Vries, Sjoerd Sytema. (2009).

Continuity of care as experienced by mental health service users - a qualitative study. BMC (part of Springer Nature), Eva Biringer et al. (2017).