Distress Brief Interventions (DBIs) are an innovative way of supporting people in distress. The DBI approach emerged from the Scottish Government’s work on the Suicide Prevention and Mental Health strategies. The need to improve the response to people presenting in distress has been strongly advocated by people who have experience of distress - and by front line service providers - and is supported through a review of available literature.
This led to the Scottish Government establishing a pilot DBI programme (November 16 - March 21), which is hosted by Health and Social Care North Lanarkshire (H&SCNL) and South Lanarkshire Health & Social Care Partnership (SLH&SCP).
The DBI approach is initially being piloted over four years in four sites across Scotland: 1. Penumbra in Aberdeen, 2. Support in Mind in Inverness, 3. NHS Borders Joint Mental Health Service 4. North & South Lanarkshire as above.
The new Mental Health Strategy for Scotland 2017 - 2027 reaffirms the commitment to DBI through the inclusion of action 11, "complete an evaluation of the Distress Brief Intervention Programme by 2021 and work to implement the findings from that evaluation".
2. What is Distress Brief Intervention (DBI)?
The overarching aim of the DBI Programme is to provide a framework for improved inter-agency co-ordination, collaboration and co-operation across a wide range of care, settings, interventions and community supports, towards the shared goal of providing a compassionate and effective response to people in distress, making it more likely that they will engage with and stay connected to services or support that may benefit them over time.
A Distress Brief Intervention is a time - limited and supportive problem solving contact with an individual in distress. It is a two-level approach. DBI level 1 is provided by front line staff and involves a compassionate response, signposting and offer of referral to a DBI level 2 service. DBI level 2 is provided by commissioned and trained third sector staff who would see the person within 24-hours of referral and provide compassionate community problem solving support, wellness and distress management planning, supported connections and signposting for a period of up to 14 days.
3. Who is the DBI for?
Distress is being defined as ‘An emotional pain for which the person sought, or was referred for, help and which does not require (further) emergency service response’. The initial test period will focus on people aged 18 and over.
4. Who will provide the DBI and where?
For the purposes of the pilot, the DBI approach will be tested primarily in relation to people presenting in distress to A&E, Police Scotland, Scottish Ambulance Service and primary care, including out of hours, although each partnership site can include other services if the conditions facilitate this.
Provision of DBI level 1 will be by front line staff, in the above settings. Provision of level 2 will be by third sector services, providing a welcome additional option to which level 1 staff can sign-post people.
5. How is the programme being co-ordinated?
5.1 Governance: A DBI central team have been established by the host organisation. The Scottish Government have established a national DBI Programme Board. Each of the four partnership sites has established DBI Implementation Boards. This structure will ensure that key stakeholders are involved and that local delivery is embedded and connected with, and respectful of, related and complementary programmes.
5.2 Evaluation: To evaluate the effectiveness of the approach the Scottish Government will be commissioning an independent evaluation, informed by an evaluability assessment completed by NHS Health Scotland.
5.3 Intervention, support & training: The University of Glasgow’s Institute of Health & Well-being are leading a systematic programme of developing the DBI and supportive training in preparation for the implementation phase commencing June 2017. It is important to note that the intervention does not currently exist.
6. When will the programme be implemented?
The DBI package and training programme will be in place for a very controlled implementation in Lanarkshire beginning in June 2017, with incremental up scaling across all four partnership sites from October 2017 in preparation for full delivery from April 2018 - September 2020 - with a final transformation phase from October 2020 to March 2021.
7. For further information or to be added to the e-bulletin distribution list.
DBI Central Team Netherton House, Wishaw General Hospital, 94 - 104 Netherton Street, Wishaw, ML2 0DZ
t: 01698 366988 f: 01698 366916 e: DBIcentral@lanarkshire.scot.nhs.uk