Evaluation finds extension of distress intervention during pandemic was a success in Scotland

A mental health program that supports people in distress was successfully extended during the pandemic, according to a new evaluation led by the University of Stirling.

Health experts from the Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP-RU) at Stirling and Glasgow Caledonian University conducted the evaluation into the Distress Brief Intervention (DBI), which was extended as part of Scotland's national COVID-19 response.

The evaluation found that the program—which was first developed in 2016 to support people in distress—adapted and integrated successfully with the NHS24 Mental Health Hub during the pandemic to deliver connected compassionate support to more people across Scotland.

Professor Edward Duncan, of the Faculty of Health Sciences and Sport and NMAHP-RU at Stirling, said, "Our evaluation found that is possible to extend ways in which DBI is delivered without impacting on the positive health outcomes we found in the wider evaluation of the core DBI program. The evaluation findings support the ongoing implementation of this successful interagency program to support people in distress."

National DBI program manager Kevin O'Neill, said, "I must thank the evaluation team for the report and emerging findings. The report validates all the tremendous work of the DBI community, who are inspired and committed to using the learning and recommendations, in support of the continuous improvement to provide the best connected, compassionate support possible.

"I pay the highest tribute to the DBI community who have demonstrated incredible commitment, innovation, flexibility, creativity, and adaptability in how they have responded to the pandemic, with all involved mobilizing their collective assets, not only maintaining the provision of connected compassionate support during these challenging times but answering the call to expand its reach at significant pace and scale.

"Special acknowledgement goes to all our frontline colleagues, which now includes NHS24 and the third sector DBI community, who by working together, day in and day out have provided connected compassionate support to over 30,000 people in distress, 10,000 of whom have been referred by NHS24."

The DBI was initially developed in 2016 to enable frontline workers in areas such as emergency departments, police, ambulance service, and primary care trained to ease a person's distress. If appropriate, they can then be referred to the DBI level two service, with the promise of support within 24 hours.

Level two support is provided by commissioned and trained third sector staff who contact the person within 24 hours of referral and provides around 14 days of problem-solving support, wellness, and distress management planning, supported connections, and signposting.

The evaluation's findings and recommendations will help inform further improvements and adjustments to the DBI program over the coming period.

The Associate Director or Nursing and Operations for NHS 24, Gail MacGregor said, "From the outset of the collaboration, it has been a pleasure to work alongside Kevin and our DBI colleagues. In addition to supporting our callers and providing quality input to their caller journey, it has also been a great experience for our staff in the sharing of services information and in providing the knowledge that their callers will have follow up care and knowing, from 2 way feedback, that their referrals are appropriate."

Professor Rory O'Connor from University of Glasgow's Institute of Health & Wellbeing who led the DBI training and intervention development, said, "At the height of COVID-19 pandemic, as part of the national response and as a matter of urgency, the DBI service was extended and integrated with the NHS24 Mental Health Hub to ensure that connected compassionate support was available to anyone across Scotland who needed it. In doing so, the frontline staff have been remarkable throughout and it is great to see this acknowledged in the evaluation. I also welcome the recommendations as the DBI roll-out continues and as we optimize the delivery of the DBI program moving forward."

Minister for Mental Wellbeing & Social Care Kevin Stewart said, "The Distress Brief Intervention program plays a hugely important role in providing timely, compassionate support to people in emotional distress. It is encouraging to see that this innovative program has been so strongly endorsed.

"Since the program was launched in 2017, the service has now supported over 30,000 people at a time of emotional distress—including over 10,000 who have been referred by NHS24 since spring 2020.

"I would like to thank NHS24 and all our partners involved in developing and providing this service, as part of our wider response to the pandemic."