How we build
Standards and evidence
Synapse Cura is designed in line with established frameworks in mental health care. We say “in line with” on purpose: these are the standards we build to, not certificates we hold. Where something isn't done yet, we say so below.
Synapse Cura is for communication and coordination between a client and their care team. It does not diagnose, interpret results or recommend treatment — those stay with the client's clinicians.
Stepped care
People who sign up on their own get only low-intensity practices our review panel classes as safe for anyone, plus educational content. Practices that need guidance are described publicly, but their steps open only when a practitioner prescribes them. The questionnaire never recommends anything beyond the safe set.
Trauma-informed care
SAMHSA (2014), six key principles ↗
Safety, transparency, collaboration and choice shape the product. The client tells their story once and every clinician they invite reads it, instead of asking them to start again. The client sees every time a clinician opens their record. They choose what each person sees. If they don't feel safe with someone, that person's access pauses at once while a person reviews it.
Measurement-based care
PHQ-9 (Kroenke et al., 2001) · GAD-7 (Spitzer et al., 2006) · PCL-5 (Weathers et al., 2013) ↗
Clinicians can send standard questionnaires at a rhythm they choose. We use the exact published wording and published score bands, and show the trend beside the client's own check-ins. Bulgarian versions are held back until validated translations are licensed — a home-made translation isn't the same instrument.
Safety planning
Stanley & Brown, Safety Planning Intervention (2012) ↗
Every client has a safety plan in the six Stanley–Brown steps, written with their clinician or on their own, always one tap away under Help now, next to national crisis lines and their team's out-of-hours instructions.
Shared, coded clinical record
WHO ICD-11 · ICD-10 · DSM-5-TR ↗
Diagnoses are recorded with the ICD-11 code first, the ICD-10 code for systems that still use it, and the DSM-5-TR name. A change of diagnosis is a new entry, never an edit, so the history stays trustworthy. Clients see their diagnoses in plain language and can add their own context — openness reduces stigma.
Supported decision-making
UN Convention on the Rights of Persons with Disabilities, Article 12 ↗
The client decides by default. Where a condition calls for more support, the lead clinician can set a shared or supported care level with a reason the client reads. Clients can write advance choices for when they are unwell. Guardians are verified in person and only act where the law gives them a role.
Privacy by design
Access rules live in the database, not just the interface. Records are append-only and every clinician read is logged. Emails carry no personal or clinical details. Anonymous statistics are opt-in and never show a group smaller than ten people. Data-rights requests are made and answered inside the app.
Evidence labels on every practice
NICE Evidence Standards Framework for digital health technologies · APA App Evaluation Model ↗
Each practice states how strong the evidence is — strong, emerging or traditional — with references. Exercises practitioners write for the community library are reviewed by a panel before anyone else can use them, and no one reviews their own work. We use NICE's framework and the APA model as checklists for ourselves.
Patterns, not predictions
Clients and their clinicians can see patterns over time — for example whether hard months tend to come back in the same season. We describe what has happened; we don't predict what will. A predictive tool would need clinical validation and regulatory approval as a medical device first, and we won't ship one without both.
Not done yet
- Independent clinical sign-off of the safety classification of practices and of the care-level defaults by condition. Until then they are marked as drafts.
- Validated, licensed Bulgarian versions of the standard questionnaires.
- A data protection impact assessment, a processing agreement for clinics and an independent security audit.
- A formal evaluation of outcomes in a pilot, published whatever it shows.
Clinicians and researchers who want to help us get this right: get in touch. See also privacy & security.