Whichever screening tool you use the score generated should lead to one of four outcomes:
- No action
- Low intensity intervention (Step 1 of the Stepped Care Model below.)
- Medium intensity intervention (Step 2 of the Stepped Care Model below.)
- High intensity intervention (Step 3 of the Stepped Care Model below.)
Stepped Care Intervention Model
Step one of the model is the least intensive intervention and is typically provided first. People can step up or down the model according to their changing needs and in response to treatment. the important thing is that healthcare professionals involved in working with individuals with cardiac disease are able to assess and recognise any signs of anxiety or low mood/depression.
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The person may require continued monitoring through repeated screening to ensure access to the right level of care.
Stepped Care Model
Step 1: Low intensity intervention:
- give advice or information i.e. self help resources
- monitor and rescreen
- NICE: 1.3 Step 1: Identification and assessment
Step 2: Medium intensity intervention:
discuss appropriate intervention with MDT could include:
- Cognitive Behavioural Therapy (CBT)
- counselling
- antidepressants
- NICE: 1.4 Steps 2 and 3: Treatment and referral for treatment
Step 3: High intensity intervention
referral to specialists such as:
- Psychologist
- Psychiatric Liaison
- Adult Mental Health
- Older Adult Mental Health
- NICE: 1.4 Steps 2 and 3: Treatment and referral for treatment
Page last reviewed: 31 Jul 2020
