Innovation in integration at Aberdeen’s Penumbra DBI service

DBI is a prime example of partnership working, bringing together multidisciplinary teams that work in a supportive and collaborative manner

The Distress Brief Intervention (DBI) programme is a Scottish Government initiative set up to improve the support to those in distress.

It provides frontline emergency staff – such as police, A&E, primary care and Scottish Ambulance Service (SAS) staff – with an additional mental health support tool which was constructed to fill an identified service gap. It is currently being piloted in four partnership sites.

DBI has two parts. Part 1 sees specially trained frontline A&E, GP, police and SAS staff help to ease an individual’s immediate distress when they are presented with these situations. They then ask the person if they would like further support and if the person agrees, they refer them to the DBI service with a promise of contact within the next 24 hours to start providing further face-to-face support.

Part 2 is provided by commissioned and trained third sector staff like mental health charity Penumbra who contact the person within 24-hours of referral and provide the person with community-based problem solving support, wellness and distress management planning, supported connections and signposting. They also help the person come up with a ‘distress management plan’ to prevent future crisis.

In Aberdeen City, mental health charity Penumbra runs the DBI service in partnership with the frontline agencies.  Prior to being appointed, Penumbra had strong links in the community through its existing support services which paved the way for the organisation taking the helm of the DBI service in the area.

Rachel Middleton, manager of the DBI service with Penumbra speaks of the enthusiasm among partners: “People were extremely excited, it was extremely easy to see how it could benefit someone and the consensus across every agency was that they could see how it could support them in their job role as a frontline provider”.

What is different about DBI is the role of the frontline partners in providing links to mental health services in the third sector. Each frontline partner in Aberdeen was trained through the National DBI Programme by Penumbra in working with people in distress, enabling them to support people well and with compassion at the first point of contact and how to then refer them to Penumbra for further support.

Rachael continued: “One of the strengths of DBI is that there is a great deal of trust among the partners

“All frontline partners can be confident that the referrals they make will be contacted within 24hrs.

“During the pilot so far, this target has been met 100% of the time.”

After the initial referral is taken up, each person accessing the service is supported to develop their own distress management plan following welfare checks. The DBI support helps the person explore ways to manage their current distress and importantly plan for and reduce future episodes of distress. The support is designed to last for around 14 days but can be more or less, depending on the needs of the individual.

Brian Cumming, Police Sergeant at the Community Safety Hub in Aberdeen, said; “What’s really at the heart of the DBI service is compassion, dealing with the person in a very compassionate manner and looking at the person’s needs and understanding their behaviour better.

“I don’t think I’ve been involved in a project or service that seems to have been so universally positive.”  On partnership working with Penumbra, Brian reports that the relationship is excellent and that the team provided the police with great assistance in initial training. The teams keep in contact with one another and Penumbra provides appropriate feedback on referrals meaning the police can share in the positive outcomes.

Rachel added: “We’re really enthusiastic about the longer-term impacts of DBI whereby Penumbra links in to the surrounding third sector community based on what input might aid a person’s recovery.

“Ultimately, what makes DBI work from end to end is the commitment of all involved with frontline providers showing passion for their role in the service.

“DBI is a prime example of partnership working, bringing together multidisciplinary teams that work in a supportive and collaborative manner to improve the outcomes for those accessing services.

“As an example of integrated working it shows how successful integration can be.”