Implementation

Since inception the Distress Brief Intervention (DBI) programme is building the vision of connected compassionate support, through a large and far reaching national and regional distress collaboration between NHS24, health and social care, emergency services, and third sector, providing early intervention, and improving outcomes and experience for people experiencing distress and those providing support. The focus on compassion defined as “a sensitivity to distress together with the commitment, courage and wisdom to do something about it”, underpins a shared commitment to collective action.

A supported infrastructure has been developed and is continuously adapted in support of the growth and expansion of the DBI programme as summarised below:

Governance

The Scottish Government has established a national DBI Programme Board, to oversee all aspects of programme delivery supported via robust governance systems and structures.

Programme Management

A DBI Central Team has been established by the host organisation to provide programme management, co-ordination and support underpinned by improvement science and collaboration.

Public Health Scotland

Routine data, collection, analysis and reporting is supported via the DBI Principal & Senior Information Analysts on secondment from Public Health Scotland, in-line with information governance requirements.

Intervention, support & training

The University of Glasgow’s Institute of Health & Well-being have developed and continuously adapted, improved and updated all aspects of the DBI intervention and training. In addition, the University of Glasgow lead the DBI Children and Young People programme, and have developed a ‘Recognising and Responding to Distress’ open access module and have digitised the DBI toolkit.

Evaluation

The DBI collaborative evaluation team of the Nursing Midwifery and Allied Health Professions Research Unit at the University of Stirling, ScotCen, The Mental Health Foundation and Glasgow Caledonian University led the DBI independent evaluation of the original four test sites[1]. In addition, The Nursing Midwifery and Allied Health Professions Research Unit at the University of Stirling led the evaluation of the DBI COVID 19 response (NHS24 Pathway)[2]. Both evaluations validated the work of the DBI community. The recommendations are being progressed in support of continuous improvement. There are further independent evaluations underway for the Under 18s elements of the programme as well as the DIMES project exploring the Impact of a Distress Brief Intervention on Suicidal Ideation, Suicide Attempts and Self-harm in the immediate, short and longer term[3]

[1] https://www.dbi.scot/news/independent-evaluation-recommends-further-roll-out-of-dbi-across-scotland/

[2] https://www.dbi.scot/news/independent-evaluation-reports-dbis-successful-adaption/

[3] https://www.dbi.scot/news/scotcen-to-lead-new-study-of-innovative-distress-intervention/

NHS24, Police Scotland & Scottish Ambulance Services

There are national DBI leads who support co-ordination and implementation across their respective organisations.

DBI Level 2 Providers

There are currently eleven third sector DBI Level 2 providers leading and delivering level 2 DBI support across Scotland. The current DBI Level 2 providers are LifeLink, Change Mental Health, Penumbra, Scottish Action for Mental Health, Orkney Blide Trust, Mind Your Head Shetland, Glasgow Association for Mental Health, Recovery Across Mental Health, Falkirk and District Association for Mental Health, the Neuk (Anchor House) and The Beacon (Hillcrest Futures).

Regional Development & Delivery

Since the establishment of DBI in the four original DBI test sites of Aberdeen, Inverness, Lanarkshire and Scottish Borders, the establishment of local DBI Implementation Groups or Boards have been essential. These groups ensure that key stakeholders are involved and that local DBI provision is embedded and connected with, and respectful of, related and complimentary programmes.

We made excellent progress in supporting all H&SCP’s towards reaching the Scottish Government’s expectation of embedding DBI by 2024. By the 25th November 2024, all 31 H&SCP’s across Scotland had live DBI local pathways and are embedding and incrementally building DBI.

Five original DBI Pilot H&SCP’s live in 2017

  • North Lanarkshire
  • South Lanarkshire
  • Scottish Borders
  • Aberdeen City
  • Inverness (Highland partially)

A further 26 Associate H&SCP’s Now live as at November 2024

  • Moray
  • North Ayrshire
  • South Ayrshire
  • East Ayrshire
  • Inverclyde
  • Midlothian
  • Dumfries & Galloway
  • Orkney
  • West Dunbartonshire
  • Angus
  • Perth & Kinross
  • Dundee City
  • Edinburgh City
  • Aberdeenshire
  • Argyll & Bute
  • Glasgow
  • East Dunbartonshire
  • East Lothian
  • Fife
  • Shetland
  • East Renfrewshire
  • Renfrewshire
  • West Lothian
  • Western Isles
  • Highland H&SCP (beyond Inverness)
  • Clackmannanshire & Stirling
  • Falkirk

International Interest

In addition, there has been a great deal of interest from across the globe including, Australia, Wales, North & South Ireland and England, supported by University of Glasgow. This has provided excellent opportunities for collaboration and shared learning, with significant interest in taking the DBI model to their populations. Although not the responsibility of the Scottish Government’s DBI programme, we have been delighted to learn and work with colleagues outside Scotland, which has seen the first non-Scottish DBI services go live in Tees, Esk and Weer NHS Trust in September 2022, with a local mental health third sector provider, Everyturn Mental Health commissioned to deliver the service.