Evaluation of the Distress Brief Intervention Pilot Programme

Distress Brief Interventions (DBI) is a Scottish Government funded programme which aims to provide a framework for improved inter-agency coordination, collaboration and cooperation across a wide range of care settings, interventions and community supports for people who present in distress.

About the study

The overarching aims of this evaluation were:

• To determine the extent to which the DBI programme was implemented as intended, identify variation and any associated impacts.
• To determine the impacts of the DBI programme on services, practitioners and individuals.

Findings

Overall, DBI has proved to be successful in offering support to those in distress. Most individuals received a compassionate and practical response that contributed to their ability to manage and reduce their distress in the short, and for some, in the longer term.  This is particularly encouraging as the rationale for the development of DBI was a recognition that previous services did not meet the needs of many people, which could lead them to feel let down, vulnerable or at risk.

A key strength of DBI is its flexibility to be tailored to the individual, thus meeting the needs of a wide range of individuals in distress who present with an array of different characteristics, life circumstances and problems. However, while DBI met the needs of many, it worked less well for some.

While not originally envisaged as a core component of DBI, the role of DBI Central in coordinating services, facilitating effective and efficient inter-and intra-agency networking, enabling open communication, information sharing, and problem-solving was an essential component of the DBI programme’s success.

When considering the future rollout of DBI services careful consideration should be given to choices about the organisation of resources and modes of service delivery. Future provision of DBI should consider the availability of community services in local areas and the risks of increased demand for services and the impact on their waiting lists as a result of DBI interventions.

Methodology

A research approach known as realist evaluation (Pawson & Tilley 1997) was used. This enabled the exploration of both the way that DBI was delivered and understood and the extent to which it worked as intended (Cresswell et al. 2011). The realist evaluation approach provided insight into what aspects of DBI worked, for whom, and under what circumstances. A mixed-method data collection approach was used between 1^st January 2019 and 30^th April 2020 including:

• Gathering, analysing, and synthesising data collected as a routine part of the DBI programme and publicly available. 
• Asking individuals who had received DBI to complete questionnaires at the start, end and three months after they had completed DBI and linking this to their routine DBI data.
• Interviewing people who delivered DBI at Levels 1 and 2, key stakeholders who managed DBI and related services, and people who had received a DBI intervention. 

Throughout the evaluation, findings were fed back to the DBI programme to enable them to make informed decisions about improvements they could make.

External researchers:

Prof. Edward Duncan (Principal Investigator), Dr. Fiona Harris, Eileen Calveley, Prof. Margaret Maxwell (all University of Stirling) Prof. Helen Mason, Dr Linda Fenocchi, Dr Sarkis Manoukian (all Glasgow Caledonian University) Chris White, Mental Health Foundation.