Mental Health Disorders Project Group Change Process

Mental Health Disorders Project Group

Content Change & Quality Assurance Process

Purpose

This document defines a proportionate, quality-driven process for proposing, reviewing, and implementing changes within the Mental Health Disorders Project, ensuring clinical validity, semantic clarity, and stable evolution of SNOMED CT mental health content.

Core Principles

All proposed changes must:

• Represent a single, precise clinical meaning.

• Align with accepted psychiatric and psychological knowledge, supported by authoritative references (e.g. DSM, ICD-11, peer-reviewed literature).

• Proposed changes should be informed by widely accepted international diagnostic frameworks and contemporary clinical practice, while avoiding direct reliance on or reproduction of proprietary classification systems.

• Ensure that changes fit cleanly into SNOMED CT’s “is-a” structure and conceptual model.

• Be proportionate to risk and impact, avoiding unnecessary churn or destabilisation of widely used concepts.

• Be transparent and traceable, with documented rationale and decisions.

End-to-End Change Process

1. Identify & Scope the Change (Inception)

Inputs

• Member Forum identified content.

• CRS submissions.

• CRG or Project Group proposals.

• Identified modelling inconsistencies or gaps

Quality checks

• Is the clinical need clear and justified?

• Is the change internationally applicable?

• Does it affect diagnostic meaning, hierarchy, or analytics?

Outcome

• Agreement that the change is in scope, valuable, and appropriate to progress.

2. Define the Proposed Solution (Elaboration)

Activities

• Define intended meaning.

• Propose modelling approach (hierarchy, attributes, descriptions).

• Identify affected existing content.

Quality checks

• Semantic clarity and absence of ambiguity.

• Correct hierarchy structure.

• Alignment with existing mental health modelling patterns.

• Assessment of downstream impact.

Outcome

• Documented proposal suitable for authoring and review.

3. Author & Classify the Change (Construction)

Activities

• Author content in the SNOMED International Authoring Platform.

• Run classification to generate inferred relationships.

Quality checks

• Compliance with Editorial Guide and concept model rules.

• Expected inferred parents and subtypes.

• No unintended loss or gain of meaning.

Outcome

• Technically valid, classifiable content.

4. Secondary Review & Consensus

Activities

• Independent review by a second terminologist.

• Iteration to resolve questions or inconsistencies.

Quality checks

• Semantic clarity and single meaning confirmed.

• Correct hierarchy and modelling pattern applied.

• Modelling consistency across related concepts.

• Editorial Guide and concept model compliance verification.

• Classification results reviewed for unintended inferences.

Outcome

• Approved change or escalation for resolution.

5. Project Group Review (clinical sense check)

Activities

• Present the authored and classified content to the Project Group.

• Summarise the intent of the change, including scope, modelling approach and any known impact.

• Highlight areas where interpretation, boundaries or terminology usage may be sensitive or complex.

• Capture feedback, questions and recommendations from Project Group members.

Quality checks

• The authored content is understandable and interpretable in real-world mental health contexts.

• The meaning aligns with contemporary international mental health understanding, without reproducing diagnostic criteria or proprietary classification content.

• No unintended clinical interpretations, ambiguity, or overlap with existing concepts are identified.

• The change remains within the agreed project scope and does not introduce unnecessary churn or instability.

• Any identified issues are clearly documented with proposed resolutions.

Outcome

• Project Group agreement to proceed as authored, or

• Agreed actions for refinement prior to release, or

• Decision to defer or reconsider the change based on identified concerns.

Project-Level Validation & Release

Activities

• Promotion to project branch and re-classification.

• Resolution of interactions between related changes.

• Completion of release validation checks.

Quality checks

• No unresolved validation errors.

• Appropriate handling of inactivations and associations.

• Clear documentation of rationale and impact.

Outcome

• Safe promotion to International release.