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Royal Commission into Victoria’s Mental Health System

Case study:

Distress Brief Intervention

Distress Brief Intervention is a time‑limited intervention (generally less than 14 days) that provides support for people in psychological distress.

Distress Brief Intervention was developed in Scotland to improve frontline service providers’ response to people presenting in distress. Professor Rory O’Connor, Director of the Suicidal Behaviour Research Laboratory at the University of Glasgow and member of the program board, said the rationale for the program was to ‘catch people who are falling through the gaps who don’t necessarily have a mental health diagnosis’. The program is a collaboration of government (health and emergency) organisations and community‑based organisations.

Distress Brief Intervention has two levels:

  • Level 1: Trained frontline staff (including police, paramedics, emergency department staff, mental health clinicians, substance abuse nurses and GPs) assist people in distress and then ask if they would like further support. If they agree, they are referred to the Distress Brief Intervention service, which will contact them within 24 hours to start providing further face‑to‑face support.
  • Level 2: Trained community sector staff contact the person within 24 hours of referral and provide community‑based problem‑solving support, wellness and distress management planning, supported connections and signposting to other services.

Level 2 services can support consumers with issues such as homelessness, loneliness, relationship issues, bereavement and family violence and connect them to other relevant support organisations, often directly targeting the cause of the distress.

The program defines distress broadly as ‘an emotional pain for which the person sought, or was referred for, help and which does not require (further) emergency service response’, which means support can be offered to a wide range of people, even before defining the source of their distress.

An independent evaluation for Distress Brief Intervention is currently underway, with interim findings showing positive results in a wide range of areas including the following.

Compassion

The Distress Brief Intervention vision is ‘connected compassionate support’, which underpins the approach of shared commitment to collective action. Most participants in the evaluation reported receiving high levels of compassion in their interactions with frontline services (Level 1).

Noting this, Professor O’Connor said, ‘[c]ompassion is at the heart of everything that we do within the Distress Brief Intervention program, from the first contact that a person has with frontline staff to the delivery of the Level 2 support’.

Long-term benefits

Despite Distress Brief Intervention being a short‑term intervention, it may also improve a person’s long‑term capability to manage distress as well as motivation to find a way forward.

Preliminary indications suggest that the [Distress Brief Intervention] programme is providing a starting point for individuals to learn how to understand, manage and seek help effectively for their distress, who otherwise report they would turn to primary care, medication, unhealthy coping skills or suicidal behaviour.

Collaboration

The nature of the program has also brought benefits for collaborative professional environments.

the [Distress Brief Intervention] programme is developing highly effective cross‑sectoral working and extended professional networks both within and across the pilot sites … and provides an excellent example of cross‑sectoral working, which is often hard to achieve.

The Distress Brief Intervention pilot began in 2016 and was scheduled to run until March 2021. However, as part of the Scottish Government’s COVID‑19 response, Distress Brief Intervention has been funded to operate nationwide through the NHS24 Mental Health Hub (a phone helpline) as a Level 1 entry point. The Scottish Government recently announced that the program would be piloted to 14‑ and 15‑year‑old children through their school and child and adolescent mental health services.

Although a relatively new program, more than 12,000 people have been through Distress Brief Intervention in some form, including 19‑year‑old Julia. Following a series of personal setbacks, Julia attempted to end her life. A Distress Brief Intervention trained nurse asked Julia if she would like to be referred to the program. Julia found the program has helped her cope better with life.

I wasn’t sure what to expect, but I was very impressed with the rapid response I received. It was really helpful having someone to talk to and help me work through all the issues that were making me feel the way I did and better understand them.

Sources: RCVMHS meeting with Professor Rory O’Connor, 14 September 2020; Dr Edward Duncan and others, Evaluation of the Distress Brief Intervention Programme: Interim Report, 2020; Distress Brief Intervention, ‘Aim’, [accessed 19 August 2020]; Scottish Government, ‘Media Release: Mental health pilot project extended’, 2019, [accessed 19 August 2020].