Distress Brief Intervention pilot programme: evaluation

This report presents a realist evaluation of the Distress Brief Intervention (DBI) programme. DBI has been successful in offering support to those in distress, and has contributed to peoples’ ability to manage and reduce their distress in the short term, and for some in the longer term.

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13 Appendix A – DBI Theory of Change and Programme Outcomes

The following are taken from the Evaluability Assessment of the Distress Brief Intervention Programme in Scotland (NHS Health Scotland, 2017):

Distress Brief Intervention Programme: Theory of Change

Distress Brief Intervention Programme: Intended Outcomes

Outcome 1: Pilot sites implement DBI levels 1 and 2 as per the programme design.

Outcome 2: Front-line staff in A&E, police and ambulance services, primary care who have undergone DBI level 1 training have the skills, competencies, and confidence to deliver a DBI 1 level intervention.

Outcome 3: DBI level 2 practitioners have the skills and competencies to deliver a level 2 intervention.

Outcome 4: DBI level 2 services have sufficient numbers of trained and supervised DBI level 2 practitioners to respond to referrals within the timeframe set out in the programme design.

Outcome 5: People presenting in distress (as per the programme definition) to A&E, police, ambulance services, and primary care receive a DBI level 1 response.

Outcome 6 :People referred for a DBI level 2 intervention take up the offer and engage with the DBI level 2 provider for up to the guideline of 14 days including, where the client agrees, developing a distress management plan.

Outcome 7: People receiving a DBI level 2 intervention who require other support are signposted to services appropriate for their needs.

Outcome 8: People who receive a DBI level 2 intervention feel less distressed and more able to manage future episodes of distress.

Outcome 9: The DBI programme provides a more efficient way of responding to people in distress who present to A&E, police and ambulance services, primary care, and other first response services.

Outcome 10: The DBI programme contributes to improved integrated working and local service improvement.

Outcome 11: The DBI programme contributes to an even more compassionate response across the public sector to people presenting in distress.

Outcome 12 :The DBI programme contributes to a reduction in the stigma associated with experiencing and seeking help with distress.

Outcome 13: The DBI programme contributes to improved population wellbeing, including to appropriately manage distress.


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