Views and experiences of the under 18s elements of DBI

About the study

Distress Brief Intervention (DBI) is Scotland’s unique response to distress and involves collaboration between the Scottish Government, frontline services including the NHS and Police Scotland, third sector organisations, and the University of Glasgow. DBI provides two levels of support for people in distress: Level 1 involves an immediate compassionate response from trained staff such as police and healthcare providers and an appropriate referral to Level 2. Level 2 offers around 14 days of compassionate, community-based, person-centred support from third sector organisations working in the mental health and wellbeing field.

In 2019, DBI was expanded to include individuals aged 16 and over who were referred via the routes into DBI which were already in place for people over 18 (referred to as the adult pathway). Since 2021, a controlled ‘test of change’ has been trialling DBI delivery to young people in S3 and above (ages 13–18) via a new referral pathway involving schools and CAMHS.

The purpose of this evaluation was to understand whether DBI can be an effective intervention for use with young adults aged under 18, to produce evidence-based recommendations for the continued development of the DBI Under 18s programme and inform associated policy and practice decision making. The evaluation was led by the Scottish Centre for Social Research in collaboration with the University of Stirling and Children in Scotland.

Findings

The findings provide evidence of promising practice, and indications that DBI can be an effective intervention for young people.

• Overall, young people’s distress levels had decreased by the end of Level 2 support and young people felt able to manage their current and future distress.
• The promise of immediate support was valued by young people and referrers. Being able to refer young people to a service which provides immediate support with no waiting list was extremely helpful for school-based Level 1 referrers.
• Young people appreciated flexibility in scheduling and modes of support, though consistency varied. Most young people expressed a preference for in-person support, although this was not always offered.
• A positive relationship with DBI practitioners was crucial for engagement, providing a safe space to talk and feel validated.
• Young people valued the coping strategies provided, though some found generic advice less helpful or the use of worksheets to get in the way of talking about the things which were important to them.
• Young people would have preferred longer support durations, feeling the 14-day limit left issues unresolved. Practitioners found the model to be working well but often extended support beyond the standard 14 days due to the longer time taken to build rapport with young people compared with adults, and suggested that longer durations of support should be formalised.
• School staff described how DBI had, to an extent, reduced their workload. By having DBI support, staff felt reassured that the young person was supported when their own time is limited.

Methodology

The evaluation team used a mixed-methods approach, combining qualitative research with quantitative data review and stakeholder consultation. After an initial scoping phase — including workshops and development of a Theory of Change for under-18s — fieldwork was carried out with young people and with professionals involved in delivering or shaping DBI.

One-to-one interviews were conducted in-person, by telephone, or WhatsApp text messages, according to the young person’s preference, with 20 young people aged 13 to 18 who received support from DBI. Interviews and focus groups were also conducted with 32 individuals involved in the design and delivery of DBI and/or the test of change, including Level 1 referrers from schools and CAMHS, Level 2 practitioners and strategic stakeholders and a parent.

Aggregate data tables for the data routinely collected by DBI Level 2 services were supplied by Public Health Scotland for all under 18-year-olds referred to DBI between 31st May 2019 to 30th September 2024 (n=2219).