New project gives people place to turn to

Distress Brief Intervention model aims to plug gap in mental health services and stop crises developing

Monday 29th April 2019

How do you help people experiencing a crisis and in urgent need of mental health support – who don’t belong in a hospital?

That’s a question being answered by a new project that matches people in emotional distress with support workers that help them find ways to help themselves.

Under the Distress Brief Intervention (DBI) model, frontline service staff such as police officers, GPs, paramedics and A&E workers are trained to offer an initial 'Level 1' compassionate response when they encounter people in distress – defined as ‘an emotional pain for which the person sought, or was referred for, help and which does not require (further) emergency service response’ – with the option of a Level 2 referral to a support team that makes contact in 24 hours and offers a short-term supportive intervention.

It’s currently being trialled at four locations across Scotland, including Aberdeen, where peer recovery practitioner Christy Sandbergen has worked for the project since February 2018.

Speaking to’s Henry Anderson from the Aberdeen office of mental health charity Penumbra one Friday afternoon, she explains people referred to DBI have often hit “crisis point” and feel “like they don’t know what to do” – which often results in an encounter with a frontline service such as the emergency services or visit to the GP.

Once they receive a referral, the first step for the Penumbra DBI team is getting in touch to find out what’s happening for a person, check in with them about their welfare and set up an appointment for further support. This kickstarts a process that can last up to two weeks, followed by the option of further support.

“People can access support as much as they like in those 14 days,” Christy explains. “We’ll see some people just once or twice, and sometimes we’ll see them maybe six times. It really depends on the person and how much support they need.”

There’s no one-size-fits-all approach to the hour-long support sessions, which reflect an individual’s needs and where they might be with their distress and current circumstances.

Nor is there a typical person referred for support, and whatever the reason – often “it’s lots of little things” – Christy says the goal is to empower and support people to become more resilient. 

“We’ll do some work about preparing for future distress – so exploring triggers or early warning signs, which may suggest that a person is starting to become unwell – and identifying who’s in their support network so that they know where they can access help in future.”

And people in need of further help – whether that be financial assistance or specialised support related to self-harm – can be signposted to other support services in the north-east city.

Penumbra is just one of the partners involved in the DBI programme, which is midway through a four-year pilot period underway in Aberdeen, the Borders, Inverness and Lanarkshire that will end in March 2021.

The initiative came after Scottish Government strategies on mental health and suicide prevention revealed a need for ‘quicker access to support and more consistency in the compassion [people in distress] receive’.

Under the ‘ask once get help fast’ approach, GPs, paramedics, police officers and doctors in emergency departments who encounter someone in distress are trained to refer people to specialist third sector partners, like Penumbra in Aberdeen or Support in Mind further north in Inverness.

In Aberdeen, the service has been popular – at one point, training for frontline health and emergency workers to make referrals was paused because demand on support staff was so great.

Speaking to Christy, it’s clear the service fills a gap:

“The whole reason DBI came about was they recognised so many people were in distress and didn’t belong in a cell overnight and didn’t belong in a hospital, didn’t need to be admitted, but they needed support and they needed it quickly.”

It’s this speed, and not having to deal with waiting lists, that people are particularly grateful for, as well as the frequency of appointments.

Of her time working with the service, she says: “I really like it. It’s so different from any other kind of service I’ve worked for…It’s really rewarding to see how much positive change and impact you can see in a short space of time.

“When people first hear ‘14 days’, they may think that doesn’t sound very long but the amount you can accomplish is actually quite a lot.”



Photo: the Penumbra team, with Christy on the right, marking 1,000 referrals across Scotland