May 13, 2024 • 44 mins
In this episode, we're thrilled to welcome Kimberley Irwin and Ian Graham from Change Mental Health in Scotland to talk about the Distress Brief Intervention (DBI) Programme, which was developed and first piloted in 2016 in parts of Scotland to respond to the needs of people experiencing distress.
DBI is now an established part of mental health support in Scotland. The program was highlighted as a model for a similiar service in Victoria in recommendation 27 of the Royal Commission into Victoria’s Mental Health system.
ermha365 provides mental health and disability support for people in Victoria and the Northern Territory. Find out more about our services at our website.
MORE INFO
Find out more about Change Mental Health's origins and journey to where the organisation is today.
More about the DBI Programme in Scotland
Helplines (Australia):
Lifeline 13 11 14
QLIFE 1800 184 527
13 YARN 13 92 76
Suicide Callback Service 1300 659 467
Helplines in the UK
Samaritans 116 123
ermha365 acknowledges that our work in the community takes place on the Traditional Lands of many Aboriginal and Torres Strait Islander Peoples and therefore respectfully recognise their Elders, past and present, and the ongoing Custodianship of the Land and Water by all Members of these Communities.
We recognise people with lived experience who contribute to GET REAL podcast, and those who love, support and care for them. We recognise their strength, courage and unique perspective as a vital contribution so that we can learn, grow and achieve better outcomes together.
ermha365 provides mental health and disability support for people in Victoria and the Northern Territory. Find out more about our services at our website.
Helplines (Australia):
Lifeline 13 11 14
QLIFE 1800 184 527
13 YARN 13 92 76
Suicide Callback Service 1300 659 467
ermha365 acknowledges that our work in the community takes place on the Traditional Lands of many Aboriginal and Torres Strait Islander Peoples and therefore respectfully recognise their Elders, past and present, and the ongoing Custodianship of the Land and Water by all Members of these Communities.
We recognise people with lived experience who contribute to GET REAL podcast, and those who love, support and care for them. We recognise their strength, courage and unique perspective as a vital contribution so that we can learn, grow and achieve better outcomes together.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Team at ermha365 (00:01):
Get Real is recorded on the unceded lands of
the Boon wurrung and Wurundjeripeoples of the Kulin Nation.
We acknowledge and pay ourrespects to their elders, past
and present.
We also acknowledge that theFirst Peoples of Australia are
the first storytellers, thefirst artists and the first
creators of culture, and wecelebrate their enduring
(00:22):
connections to country,knowledge and stories.
Welcome to Get Real talkingmental health and disability
brought to you by the team aterma 365.
Join our hosts, Emily Webb andKarenza Louis-Smith, as we have
frank and fearless conversationswith special guests about all
(00:43):
things mental health andcomplexity.
We recognise people with livedexperience of mental ill health
and disability, as well as theirfamilies and carers.
We recognise their strength,courage and unique perspective
as a vital contribution to thispodcast so we can learn, grow
(01:05):
and achieve better outcomestogether.
Ian Graham (01:12):
When someone's in distress, the fact that we will
speak to them we guarantee wewill speak to you within 24
hours makes a massive difference.
You know their clients.
When we speak to them, they'rethinking they're going to refer
to a GP or a community mentalhealth team.
They don't know how longthey're going to wait.
Wait, but they're gettingsomeone to speak within 24 hours
seeing the difference withinindividuals within those 14 days
(01:34):
.
Kimberley Irwin (01:34):
You're making a difference.
You're giving them hope, you'remaking them feel empowered,
they're taking back control andyou know you could speak to a
client on the first day and onthe last day it is literally
like speaking to a completelydifferent individual.
Emily Webb (01:59):
Welcome to Get Real Talking Mental Health and
Disability.
I'm Emily Webb.
My co-host for this episode isRobyn Haydon, erma365's Chief
Marketing Officer.
When I first started at ermaback in 2021, Robyn was the host
of this podcast, so it's greatto be co-hosting with her today.
Hey Em, it's great to be backand to see you and all of our
(02:22):
guests today.
And we're particularly thrilled to have
international guests for thisepisode Kimberley Irwin and Ian
Graham from Change Mental Healthin Scotland.
We're talking with Kimberleyand Ian to find out more about
the Distress Brief InterventionProgram, which was developed and
piloted in 2016 in parts ofScotland to respond to the needs
(02:46):
of people experiencing distress.
This program is now establishedacross Scotland and here in
Victoria in Australia, where weare.
The program will be pilotednext year in response to the
final advice of the NationalSuicide Prevention Advisor and
the recommendations of the RoyalCommission into Victoria's
(03:07):
mental health system.
So welcome to Get Real podcast,kimberley and Ian.
Ian Graham (03:13):
Hello Emily.
Thank you for the invitation,hello Robyn.
Kimberley Irwin (03:16):
Hi to you both.
It's lovely to be here.
Robyn Haydon (03:18):
We're so very glad to have you.
And some background forlisteners.
Change Mental Health actuallyshares similar origins with
ermha365, so we were bothstarted decades ago as advocacy
and support networks by groupsof people caring for loved ones
with mental ill health.
Change Mental Health has beenaround for more than 50 years
(03:39):
and its foundation was inspiredwhen Scottish journalist John
Pringle wrote an article in theTimes about caring for his son
experiencing schizophrenia.
Hundreds of carers contactedJohn after reading this article
and some of them were thefounders in 1972 of the
Schizophrenia Fellowship, whichevolved into Change Mental
Health.
So Change provides servicesacross Scotland for people
(04:02):
living with mental ill healthand the people who care for them
.
There's a great timeline ofmilestones for the organisation
on its website, which we'll linkto in the show notes for this
episode.
But look, we've spoken enough,we reckon, so let's get into the
conversation with Kimberley andIan.
Emily Webb (04:16):
Looking forward to it.
Let's find out about you both,Kimberley and Ian.
I'll start with you, Kimberley.
What is your role at ChangeMental Health and what's your
background in working in mentalhealth?
Kimberley Irwin (04:27):
Thanks, emily.
Yes, so I am the projectmanager for the Distress Brief
Intervention Service, whichcovers Inverness, the Highlands
and, newly, the Western Isles.
I came from a caring background.
Before joining Change MentalHealth, it was more on a
personal level, for myself andmy family, that drove me to want
(04:48):
to help people within themental health industry.
Emily Webb (04:51):
And what about you, Ian?
Ian Graham (04:53):
So my role is the National Distressed Brief
Intervention Project Lead, so Imanage and oversee the services
for Highland, Western Isles,Ardell and Bute and Dumfries and
Galloway.
So we have project managers atKimberley so I manage the entire
service.
My background is completelydifferent to working in mental
health.
I was a police officer, retiredjust a couple of years ago, so
(05:15):
I've worked all over theHighlands, was a firearms
officer, child protectionofficer and also worked through
management up to chief inspector.
So I became involved in sort ofthe DBI through work in 2017
when I first came to Inverness.
I've seen it set up and othermental health pilots in the area
to see what can be done to liftthe pressure off the frontline
services and support peoplebetter at that point of impact.
(05:35):
So I worked in road safety fora short period and then I seen
the opportunity to come tochange mental health and work
through the stress-freeintervention.
Emily Webb (05:43):
And Ian, you did mention the areas that your
program covers and I have heardof these areas in Scotland, even
though I haven't seen a lot ofScotland and you're the lead
agency, as you said, in theHighlands, dumfries and Galloway
, argyle and Bute and WesternIsles, which all sound actually
quite amazing.
Can you tell us about thesecommunities, especially for
(06:05):
listeners in Australia, and wedo have listeners all over the
world?
Ian Graham (06:09):
We'll start with the Western Isles, which I'm
from originally.
It's a population of 26,000,but it's really geographically
diverse.
It's a huge string of islandsalso called the Outer Hebrides.
We've got the main town ofStornoway, so we've just started
going in there.
They've got our big communityaround crofting fishing
tourism's really starting totake off as well.
But, like everywhere else, it'sgot rural challenges with trips
(06:30):
to and from the mainland and Iworked previously within the
police, so a really goodrelationship with local health
providers and our geographicalawareness of the island.
So it's really nice to bestarting there.
Highlands it's got the capitalof inverness, which is really
well known, real big tourist hub.
We've also got heavy ofInverness, which is a really
well known, real big tourist hubwith also a heavy industry.
But it's for quite diversecommunities from Fort William
and Glencoe through to Aviemoreand up to Caithness at the top
(06:52):
of the Highland area.
So the population is quitespread out.
So that's quite a challenge forall the public services to
support and also for thepopulation, due to some of the
rural areas are starting to thepopulation's coming more into
the centre, so finding staff topromote and support them.
So we're quite, really usefulwith the DBI with the service,
the way we can do it over thephone, and also we have staff
within the areas Argyll and Bute, just attached to Highland,
(07:15):
population of near 90,000, andit's along the west coast of
Scotland.
Again, it's a massivegeographical area.
It's one of the largest inScotland in terms of the length
and the population is spreadvery diverse throughout the
latest towns and villages.
So again, we work reallyclosely.
With our knowledge of workingin Highland and the Western
Isles, it becomes really usefulfor how we work with staff.
And then Dumfries and Galloway,which is a large farming and
(07:37):
rural community.
It's a large coastline andthey've got a population
approaching 150,000.
They're down the bottom ofScotland, the border with
England, a lot of littlechallenges within it.
But we have staff based on allthese areas so that we really do
geographic knowledge.
When they're dealing withclients they hear their voices
to find out where they're from.
So it works really well whenwe're providing the service
(07:59):
locally.
Robyn Haydon (08:00):
Sounds like there's some really diverse
areas, so that's reallyinteresting in and of itself,
but you're the lead agency forthis program, so what does that
mean?
If you could explain for ourlisteners Ian or Kimberley
either one of you can take thisquestion how do you actually
work as a lead agency to bringthis program together?
Ian Graham (08:19):
When we're chosen to provide the service within an
area, we link in with our NHScolleagues, our colleagues
within the Scottish AmbulanceService, police Scotland, local
GP surgeries, community mentalhealth teams, and Kimberly would
set up an implementation groupmeeting with them.
So we discuss what the distresstreatment intervention model
will bring, how it will work.
Then we would discuss whatpathways to open and how we
(08:41):
would open them, discuss whatpathways to open and how we
would open them, and then wesort of manage the services come
through, advertising it locally, recruiting staff and showing
the benefits to people of how wewant to work with them.
And then Cumberland and ourteam will do a lot of the work
on the ground, meeting the stafflocally, explaining to them
it's providing a compassionateresponse at the first level and
then the teams locally provideservice.
(09:02):
And you just work through amonth-by-month schedule,
introducing more pathways,starting to get more people on
board, answering questions, andthen just continue to drive the
service.
And one of the key pointsKimberly does is doing buzz
sessions.
She does this face-to-facemeetings with staff in the other
agencies, answers any questionsand brings them up to speed and
showing how the service isgoing to work and getting it on
the ground and advertising it,showing the benefits of it and
(09:24):
how.
We're quite unique in the24-hour call and the quick
14-day package.
So I think that's one of thekey things for us.
Delivering, I mean the leadagency.
We take all the questions, comein.
We're expected to push it thewhole time but also work with
other agencies in the publicsector to expand it and
constantly meet the demandthat's out there.
Robyn Haydon (09:49):
Sounds like there's always something to do
with this program and a lot tocoordinate and bring together.
Kimberley, what's that like foryou on the ground?
Kimberley Irwin (09:53):
and as part of the lead agency delivering this.
There's a lot that goes on inthe background for the program
and really the most importantcomponent of being the lead
agency is relationships,partnership working, supporting
each other.
And the idea of me going outabout in the communities with
the frontline, with the buzzsessions, is essentially, you
know, going through referrals,going through how they looked,
(10:16):
going through you know whattheir numbers were, really
keeping them up to speed withhow their DBI kind of looks.
What's also really important isbeing there for support.
You know, refreshing them withthe distress brief intervention
model, how it works, whathappens on our end when we
receive a referral, so they geta full picture.
(10:36):
I also very much promote youknow, if you are on the front
line and you're not really toosure, pick up the phone, give me
a call, we'll have a chat.
It's important to have reallygood, strong relationships and
that's something that I've beenworking really hard within the
background so that we're allworking collaboratively together
(10:56):
.
Robyn Haydon (10:58):
Sounds like it's a very relationship driven
program and a lot of sort ofreal time learning too.
That's going on on the groundand there's a lot of partners of
real-time learning too that'sgoing on on the ground and
there's a lot of partners, Ithink, to coordinate.
It might be worth, just for thesake of our listeners who are
not familiar with this, the DBIprograms come to our attention
in Australia because, after theRoyal Commission into Victoria's
mental health system whichhappened a few years ago now it
(11:20):
was in 2019 and 2020, theintroduction of this kind of
program, a distress briefintervention program, was
actually one of therecommendations of the Royal
Commission's final report and itwas specifically to improve our
suicide prevention serviceshere in Victoria.
So we actually haverepresentatives from our state
government travel to Scotland tofind out more about this
(11:42):
program.
So can you explain how DBIworks in terms of what you do at
Change Mental Health?
So how does it work as aprogram within itself and then
how does it fit with your othersuite of services?
Kimberley Irwin (11:57):
The premise is pretty simple with distress
brief intervention.
It's connected, compassionate,immediate response within 24
hours and it's provided 365 daysof the year.
It's a two-level approach, sowe have level one and we have
level two.
So level one would be all ourfrontline workers and level two
are all our DBI practitioners.
(12:18):
We have a DBI model.
So the DBI model is the 14-daybrief intervention.
It it's person-centred, so it'sdependent on the individual's
situation and what's going onwith them and what their needs
are.
What we would do during thatsupport whereby it goes into
(12:42):
their background.
What's going on for them rightnow, what's causing the distress
?
Where do we need to look to seewhat we can help you with.
That is a main component of thedistress management plan, but
the most important part of thedistress management plan is how
to improve.
So with that, we will look atworking with distress brief
(13:04):
intervention tools.
So there's an array of differenttools, from looking at distress
triggers, if then coping skills, confidence rulers, smart goals
.
There's a lot of planning andwe will also use decider skills.
So you know, looking atbreathing exercises as well,
like looking at what's going tohelp them right in that moment
(13:25):
of that time, that when they canfeel their distress occurring.
We very much also look attriggers and behaviours so then
we can identify what tools wouldbe best for an individual.
We'll look at practical side ofthings as well, you know.
So a lot of signposting happensand everything that we give
support on with an individualwill go on their distress
(13:45):
management plan and thatdistress management plan is
theirs for the future, so theyget to take that away with them
at the end of support.
Ian, do you want to chip inwith anything else?
Ian Graham (13:56):
I think the key thing for us is a couple of
things the 24-hour response whensomeone's in distress, the fact
that we will speak to them.
We guarantee we will speak toyou within 24 hours.
There's a massive difference.
You know the clients when wespeak to them, they're thinking
they're getting referred to a GPor a community mental health
team.
They don't know how longthey're going to wait, but
they're getting someone to speakwithin 24 hours.
The way our staff are justreally good listeners, really
(14:17):
good communicators, so they'reable to immediately recognize
the person's distress levels,discuss with them, explain what
we do.
We had a really good example ofone of our staff.
They had a very distressedindividual on the phone like
what can I do, what do I need todo?
What do you want me to do?
And the member of staff justsaid just answer the phone.
All you have to do is answerthe phone to me and I'll talk to
you.
And they just talk throughright, right, what's your
(14:39):
distress, what's causing it?
And just about turning thatperson around within that period
of a couple of phone calls orface-to-face meeting or virtual.
It's about listening to themand saying, right, what's
causing the distress, what canwe do to alleviate it and what
can we do in the short-termperiod to do so?
And I think the fact that we'reguaranteeing phone calls within
not just the 24, but the nextcouple of days and four, maybe
(15:01):
five phone calls over a two-weekperiod, do you know it really
works for them and I've onlybeen in the service a few months
.
I've seen clients coming inreally in a state of distress
and after a few discussions withour staff you see them going
out to a different person.
They're saying hello to you onthe way past.
They're recognizing there'ssomeone out there to listen to
and they're recognizing what'scausing the distress.
And the dbi model allows thestaff to do that in a structured
way, but it's their personalskills following the structure
(15:23):
that makes a big difference andwe see that in the reviews and
feedback that we get.
I would always say to peoplethat initial 24-hour call
followed by a couple of phonecalls that's the key of the
distress brief interventionmodel and when we really sell
that to clients and to the otheragencies that we provide that,
you can see the demand growing.
But I think that's one of thekey things, as long as we're
able to maintain that and to beable to sell it to staff and get
(15:45):
the clients on board and getthe feedback.
I think the model works reallywell.
Every evaluation that's donehas shown it really works.
Robyn Haydon (15:51):
Yeah, absolutely, and obviously a very successful
program, which is why we'relooking to emulate it here and
well-established now.
And I'm wondering if you thinkback to when the program was
first introduced and I thinkprobably you've alluded to this
already, in the sense that youknow there was a gap in that
being able to provide a briefintervention quickly to people
(16:13):
who might have kind of fallenthrough the cracks because they
weren't able to get to a GP.
They weren't actually able toget the support quickly enough.
Was that the reason why theprogram was developed in the
first place, or what was theneed that was originally
identified that then became thedistress brief intervention
program?
Ian Graham (16:32):
Yeah, the Scottish government, you know, from the
1990s onwards, were looking atthe distress brief to see what
was happening, what was causingdistress in the communities,
what pressure was within thefrontline providers, getting the
feedback from clients, gettingthe feedback from the providers.
And they looked all around theglobe.
They looked at various studies,various researchers, they
looked at the internationalliterature that was out there,
(16:53):
trying to decide what model willwork best in Scotland.
A timely, compassionateresponse was key.
Also, maintaining longer-termcontact with the clients by what
we do, by putting the plansback to the GPs to show them
we've met with the client.
This is what we've done withthem Giving them signposting to
show them what's available outthere if they're not already
aware.
What will work for thefrontline and will also work for
(17:14):
the client in coming back andsupporting the frontline
services.
So the gap was identified.
This was the main one thenumber of people that were
approaching GPs emergencyservices in a state of distress.
So they thought, right, thiscould be a good model to bring
in.
So, 2016, they come up with apilot.
We have members of staff, ourmanager.
She's been on the DBI since itfirst started.
(17:34):
So she started the small modelas it rolled out and immediately
they could see it was startingto work.
Somebody was showing menewsletters today from a couple
of years ago which showed howthe numbers have started to grow
to what we are now.
We're up to approaching 2,400 ayear now within our bit of DBI,
and that's just over a numberof little areas Nationally.
I think it's over 62,000referrals since 2017.
(17:55):
So it's growing year on year.
So I think that was it.
It's been brought in to meetthe demand.
But the good thing with the DBIthey're always looking to
improve.
So they're always keen forfeedback working with Glasgow
University to get more tools towork with the staff, listen to
the staff on the ground and thestaff come up always some
excellent suggestions.
So they're always looking toimprove.
So I think from that start, aslong ago as the 1990s to the
(18:17):
model in 2016, one One of thekey points has been it's not a
set model.
It works under a structure, butthey're always looking to
improve it and how to develop itbetter.
Robyn Haydon (18:27):
Kimberly, do you have anything to add to that?
Just in terms of the originsand where the need first evolved
for this programme.
Kimberley Irwin (18:34):
Ian gave a really good explanation there,
and it's all in aid of trying toget as much support for
individuals as possible, as wellas as helping frontline,
because we know, especiallythrough times over four years
ago, everything went a bit crazyand they need support now more
than ever, and I think that'sreally the crucial thing as well
, that this DBI program is hereto support them too, and it
(18:58):
works beautifully.
As Ian said, you know the model.
The model works and if itdidn't work then it wouldn't
have succeeded to the extentthat it has to date and it's
been wonderful to have been partof it and its growth.
Dbi is a fantastic model.
Emily Webb (19:15):
You mentioned, gps are a really crucial part of
this program and your frontlineworkers?
Gps are a really crucial partof this program and your
frontline workers?
Emergency services like police,fire, ambulance.
So I'm guessing when you talkabout support for them, it's
because they're interacting withpeople in extreme distress, so
it's helping to take, I guess,some pressure off those services
(19:35):
.
So community partners arereally important for this
program, from everything thatI've read and I'm listening to
you.
So who are the the mainreferrers or partners and how
does it work?
Kimberley Irwin (19:49):
We have different pathways, so with
Inverness and Highland inparticular.
Yes, gps, they are sort of ourour main referrers.
You know we will have some GPswithin a year that are reaching
sort of the 150 for referralsfor that year, which is great.
On averaging of 10 to 12 amonth.
We also work very closely withmental health teams so they can
(20:11):
also refer custody link workerswithin the police station and we
also have relationships withthe police and the ambulance.
Last year we also haverelationships with the police
and the ambulance.
Last year we also have achildren and young persons
pathway.
So we are within Inverness HighSchools whereby those partners
for me are the wonderfulguidance teachers and that's
(20:32):
been really successful so far.
We also work alongside CAMHS aswell With our national
programme which came about inthe COVID response because you
know the world sort of shut downin a sense.
We took on the NHS 24 mentalhealth hub so that actually
covers a wider area of all ofthe four areas of Inverness
(20:53):
outside Inverness, within theHighlands, dumfries and Galloway
, argyll and Bute and WesternIsles, so it's really a larger
area.
There are so it;s really alarger area there and we also
get from the police and that'sopen to ambulance as well.
Argyle and Bute, dumfries andGalloway and Western Isles they
have their own individual localpathways.
So they work again with anarray of different partners.
(21:15):
Every front line service has tobe DBI level one, trained,
before they can make a referralinto the service whereby maybe
you know we see a lot,especially with GPs.
They're sort of moving aroundfrom practice to practice or
they're moving on elsewhere orwe're getting quite a lot of new
GPs.
So my role is to keep on top ofthat to make sure all the GPs
(21:37):
within surgeries you know theyare up to date with the DBI
training and they're fullyrefreshed constantly.
Usually I go into GPs quarterlywhere I'll go in with a little
bit of a newsletter, give them arundown of the referrals of
that quarter top referrer,champion kind of thing.
Just to make it a little bitinteresting.
We all work with the frontlinereally quite closely and it's
(22:00):
also making sure that they'reaware of the DBI programme in
the sense of how it's helpingindividuals.
That's genuinely how it workswith the frontline and obviously
with Western Isles.
We've started with the police,which has gone really well with
training.
We've done some buzz sessionsalready.
So it's just about keeping ontop of that and constantly
(22:22):
expanding and building thoserelationships up and ian, did
you want to add anything there?
Ian Graham (22:29):
yeah, I think, as kimberly said, the relationships
are key, but it's also gettingthe buy-in from the frontline
services.
You're wanting them tounderstand just that
compassionate response.
I was frontline you line withthe police.
We would go to someone who wasin a state of distress and we'd
say how can we best help them?
The police is not best suited.
They don't require to go to thehospital, it's out of hours so
(22:49):
we can't get maybe the rightcommunity psychiatric services
available for them.
So we would just sit down withthe person and say that we could
suggest you go forward to thisprogram where someone will phone
you.
It's called the stress briefintervention model.
They get a wee handout given tothem and just doing that five
to ten minute time to sit downwith a person gives them some
hope that someone's going tocall them the next day and the
frontline provider can go awayand think right, I've done
(23:11):
something really positive withthat person, you know, and they
may not be phoning back two orthree times during the night to
other services.
As Kimberly said, once you getthe frontline provider on board
and they start to see thebenefits and they get the
feedback from the clientsthemselves when they come into
the GP practice or something.
The referral starts to comefrom that particular practice or
from that particular officer orfrom the Scottish Ambulance
(23:31):
Service NHS24.
And word soon spreads thatthere's more of this available
and I think the work withKimberly and the staff here and
throughout the other areas thatwe cover and meeting with the
frontline it really gets thebuy-in from them and it's the
chance for them to understandwhat we hear and why we're here
and that we provide that quickresponse.
It's not just a case ofsomething's going to phone you
in a few weeks.
It's a quick response.
It's the key thing for thefrontline provider and we do see
(24:05):
the practitioners and more andmore people referring.
As a result of that.
We also have more peoplewanting to become a referrer.
Up here we've had the localprisons asking can they get in
touch.
It's word of mouth that spreadsand they start to pick up
quickly how the DBI model worksand all the evaluation has shown
that it works and the key is inthe frontline buy-in to get
that started and then get themover to us for the discussion.
So it really works well and therelationship with the providers
works really well, especiallyin our areas.
We're quite rural and diverse.
So the fact that staff livethere, they know the staff, they
(24:26):
know the people, we can go faceto face with them in whatever
they're based, that's a keyselling point for us.
Emily Webb (24:32):
Yeah, it sounds like the word of mouth element of
this program and the communitypartnerships and training to
equip people to actually referin is really fascinating.
And from the research aroundthis program and Robin's been
doing some as well it's myunderstanding that some people
who are accessing DBI and beingsupported by it actually maybe
(24:53):
haven't had much interactionwith a mental health program or
service or maybe have neveridentified in themselves that
they are having, I guess, amental health crisis or service,
or maybe have never identifiedin themselves that they are
having, I guess, a mental healthcrisis or a distress or
something like that.
Can you explain a bit moreabout this and, I guess, the
stresses and the general reasonsbroadly that you're seeing
people referred for this program, and whether or not what I said
(25:16):
is correct or not?
Kimberley Irwin (25:18):
So, yeah, what you're saying is is correct, but
we also see it on the flip side, that there can be quite a
generous amount of time onwaiting lists within the
highlands for different programsand we will be approached with
an individual who is, you know,distressed because of having to
wait X amount of time to be ableto get some support With a team
(25:40):
on the ground.
When we first initially speakwith an individual, you know
we're listening, we're beingcompassionate, we're giving them
that time and space to enablethem to, you know, go through
that frustrations, because weunderstand.
But what we do on our end ofthings is provide expectations
Okay, tell them exactly what DBIis, what it's not, how it's
(26:03):
going to work throughout theirsupport, but also giving them
the hope that we can do so muchwithin 14 days to enable to
equip you to wait to go on foryour next support service.
And we see that a lot comingthrough with the referrals and
it's just about the team beingable to handle and manage when
individuals are coming throughwith distress, of frustration.
(26:25):
Essentially, we see an array ofdifferent reasons why
individuals would be distressedlow mood, depression,
relationships, financial familybereavement.
You know that list is reallyquite endless when it comes to
the stressors, becauseeverybody's distress is
(26:45):
different and everybody'sdistress is relevant to that
individual.
So you and I might be goingthrough the same situation but
react completely differently,and it's really important to
remember that everybody'sdistress is valid and it's just
about us taking the time andlistening to what it is that
their needs are.
(27:08):
Two of the most common,unfortunately, factors within
referrals is self-harm andsuicidal ideation.
We have tools that can help uswith those.
We have a safety plan that wego through with individuals,
whereby it talks about theirmood, their feelings, emotions,
how they're feeling right atthat moment and time of you know
(27:30):
being able to identify feelingthat way in the moment.
Then we'll look at copingstrategies.
I think it's also reallyvaluable to to ask the
individual you know what do youdo at that moment?
Because if it's something thatthey are automatically doing
themselves, it's very much worthmaking sure that that is within
a safety plan, because it'ssomething they're already
(27:51):
currently doing to enable themto sort of balance the
triggering and the behaviors.
Then we'll look at supportoptions.
So who can you call, whetherthat would be family, friends,
places that provide you with adistraction, and then, obviously
, other support services thatwould be available.
So, with those particular types, there's training in place and
(28:11):
there's tools in place to spendtime with an individual, to go
through all of those, so theyare equipped for feeling that
way.
Ian Graham (28:19):
I think one of the key things with DBI as well, we
started to pick up trends.
Rural isolation, that featuresfor us.
Gambling and debt are startingto feature with us.
So we start looking at that andwe look to see where can we go
for advice for our staff.
So we work with the CitizensAdvice Bureau for that.
I think the question you hadabout people coming to us who
haven't had much interactionwith mental health services
(28:40):
before.
When we have clients coming in,we fill in forms to see who
we've spoken to.
Do they have a diagnosis?
A significant amount of peopledo not have diagnosis for mental
health.
They are suffering purely fromanxiety and distress and they're
concerned then that they'recoming to a mental health
charity.
But the staff are really goodin speaking to them to explain
it's distress.
This is what some people do.
(29:02):
You might just be a case of acoping method when they come to
us.
You know we're non-judgmental.
We'll work with anyone.
We go from complex to people whohaven't had dealings with
mental health services beforeand they may never again.
You know our hope is someonecan go away and use the coping
tools.
The studies we've done showthat people do keep the distress
management plan with them for anumber of months and they do
(29:22):
work through with them.
So we're always looking to seeright that's really good work,
what works for you or doesn'twork.
Staff are always identifyingtools to deal with some of the
stressors that come in.
So it's always moving forward,it's always evaluating, it's
always looking to see where thetrends are.
The stressors list seems to getlarger and larger.
It's different ages as well.
We've got people in their 90scoming to us, down to people
(29:43):
still in school.
Robyn Haydon (29:44):
And it sounds like from what you're saying, Ian,
that sense of normalising thehelp-seeking behaviour,
especially for people who arenot normally in contact with
mental health services, andreducing some of the stigma and
normalising that so that peoplecan feel better about what
they're going through andgetting that help, even if it is
simply all they need, issomething that's brief and
(30:06):
really curious to know.
Since you've been providingthis programme at Change Mental
Health.
How has the DBI programmeevolved and, as you said, it's
changing?
Is the need growing?
In what areas are you seeingthat happening?
Kimberley Irwin (30:20):
yeah.
So I've been with dbi coming upthree years this year and I
came in as a coordinator and thegrowth, even within that time,
has been immense and it's beenan absolute honor to watch and
be part of.
We were looking at thisyesterday myself, myself and Ian
found about 100% growth sinceit went live in 2016.
(30:42):
The DBI has an average ofaround 220 odd referrals a month
and Inverness take around 105of those.
So when the front line areseeing DBI, seeing the immediate
response, seeing the 24 hours,they're intrigued.
And we do get people emailing.
You know, outside can we refer?
(31:02):
Not only that, we get a lot ofwhen I go to do visits with GPs
they'll say I had so-and-so comein, you know, and they were
explaining how amazing theservice was, what it did for
them.
They're providing feedback.
That's not something that weget often from individuals who
come to DBI, but when we do,it's really important to take
that and feel empowered with itthat we're making a difference
(31:25):
in individuals' lives, theprogramme itself, even from
referrals from when I was hereas a coordinator.
The amount of stressors thathave grown since then have
changed.
Like Ian was saying, the listhas always been added to with
different things and we alwaystake a look at that with the
trends that are coming into theservice.
(31:46):
So overall the growth has beenmassive and I have absolutely no
doubt that it will continue togrow.
Robyn Haydon (31:55):
Ian, anything you'd like to add to that?
Ian Graham (31:58):
Mental health distance and still Distress is
always changing throughout theyear.
We see peaks and troughsthroughout the year.
So we're probablyprofessionalising as we do along
as well.
We've done from the pilotproject, but we also have other
third sector providers.
We meet regularly I think it'sonce every six months
Distress-based practice.
We discuss what's happening,what the trends are, who's doing
things.
You're always looking for ideasfor how to improve the service
(32:19):
that you give to the clients.
The staff are always coming upwith ideas, so the need's
definitely growing.
We're looking at things like, Ithink, DBI Plus for the future.
What will that meet?
What else can we do?
What can we provide Because itworks?
People look to us and say,right, right, what are you doing
as a service that works and howare you providing that service
and what do you think we can seeto improve?
(32:39):
And within the whole DBIcommunity in Scotland it's
always looking for right.
Where's the next best idea goingto come from?
Where's the next best provisiongoing to be?
What are you seeing that works?
What are you seeing thatdoesn't work?
Where can we go next?
What can we do to support thefront line?
Who else should we besupporting when we go to our
health and social carepartnerships.
With our data, with our numbersand with where we're going.
You know they can see thepositives of it.
(33:01):
We have a plan to support theirservice going forward.
So I think it's really good.
I think we all see thepositives of it and we just see
it constantly starting to grow,and so I was really keen to see
it going elsewhere.
We always like to share work aswe go around things as well and
things you've identified thatmaybe we haven't thought of.
So I think it's a really goodservice to work in and we're
always selling the positives forit.
Robyn Haydon (33:22):
Clearly a very, very successful program and one
that you should be very, veryproud of, and it's really
exciting to hear, kimberleyyou've been working on this for,
you know, three years and Ianfor just a few months.
You know, you're already,you're seeing the great demand
that exists for the DBI program.
I'm wondering very curious, ifyou could kind of wave a magic
(33:49):
wand and do anything differently.
What advice would you provideto us here in Australia Is there
anything that you would changeor do differently?
What are the most importantthings that you think that we
need to focus on to really makethis program work for people who
are experiencing distress?
Ian Graham (34:09):
A couple of things.
One is the funding.
You know, longer term fundingmodel, not year to year, five to
10 year funding model, I thinkprovides more service, provides
more continuity, provides betterassurance for the staff working
within the team, provides thefrontline providers with every
assurance you're going to bethere year on year, that you're
going to grow with them.
And the other one is gettinginto the frontline providers
(34:30):
early doors, whether you make acompulsory that they are on
board.
Kimberly recently done apresentation to trainee adults,
mental health nurses, at one ofthe local colleges here you know
, and that's a room of about 100people who are just about to
qualify as nurses, listening towhat we provide.
You want to get them early.
Once they start to hear theword DBI, you know going around
in their head, they know it's areally good model and use what's
(34:51):
worked elsewhere, use thebranding, the name.
The DBI is really distinctive.
The one thing I'm sure you'veread all the evaluation reports.
We're one of the third sectorproviders and it's all run
through a thing called DBICentral.
It's like the hub and spokemodel and that's been really key
.
It's not been absorbed into oneparticular health board but
having that one central office.
(35:12):
But they're really open tothinking it's been really
beneficial.
They're looking to grow it butcontain the growth so that
everyone's sharing from the samething, and I think all the
evaluations are pointed to thesame thing.
That model works really well.
That provides that level ofcontrol, stability, governance
that's needed in the backgroundbehind this and that's been one
of the positives.
So if you set it up using thatsort of model and the other
(35:32):
points, I think you'll haveloads of success for the future.
Emily Webb (35:36):
You've both got a lot of experience in community
services.
Really, your careers arededicated to it, kimberly, in
mental health.
Ian, you've come from apolicing background.
It's a really dynamic,rewarding space, but also, you
know it can be tough and it canbe stressful.
So I just want to know what isit that keeps both of you doing
(35:58):
the work that you're doing withyour communities?
Kimberly, I'll start with you.
Kimberley Irwin (36:03):
You're right, it can be tough, but for me
personally, it's seeing thedifference within individuals.
Within those 14 days.
You're making a difference.
You're giving them hope, you'remaking them feel empowered,
they're taking back control andyou know you could speak to a
client on the first day and onthe last day it is literally
(36:27):
like speaking to a completelydifferent individual.
They are making the changes.
They've done things withintheir plan and for me, you know,
feedback is amazing to hear.
I don't work directly so muchwith clients anymore, that is
with my team, and the feedbackthat they get is so heartwarming
(36:47):
to see as well.
It's about, you know, Iobviously I'm working with the
team in the sense of making surethey're good, their welfare is
good, making sure they're good,their welfare is good, making
sure they're fully up to speedwith training, making sure
everybody's connected.
I've kind of gone from the onethat's providing, you know, the
support to clients but now I'mproviding the support to the
(37:09):
team, seeing the team as well.
You know, come back with.
I've had this email.
This is what it says.
You know, they're so proud,they're so proud.
It's just an amazing program tobe a part of Change.
Mental Health is an amazingorganisation to be part of, and
that really is why I'm stillhere, nearly three years on, and
I'm very, very passionate aboutthe service.
Emily Webb (37:31):
It sounds incredible and, yeah, like there's many
similarities with Irma365 andChange Mental Health when I was
looking at stuff.
It's quite interesting, Ian,what about you?
Because you've had a prettyintensive career dedicated to
the community.
Ian Graham (37:47):
Yes, policing is especially in the Highlands.
You're working with largecommunities like Inverness, or
you're working in smallcommunities with the only police
officer on an island of 1,200people and that's really intense
.
You need to build up thatrelationship with people.
You just be there to help andsupport people.
If someone's in distress, oreven in the police, if someone
needs help, they need to knowsomeone's there for them.
I think that's one of the keythings of all the emergency
(38:08):
service and frontline providersand the mental health community
sector.
I remember coming in for myinterview and I had to.
I got interviewed by, I think Ihad to go into the tea room and
speak to all the staff as welland asking them what their
background was, and it's allvaried backgrounds.
You know, there's not like 10people there that have been
through university and have donethe degrees here.
They've all got differentbackgrounds but they're really
good speakers.
They want to help people.
(38:29):
You can't help everyone,unfortunately.
You are going to find clientsthat will come back or will
finish the period of support,but it's the rest of the staff.
You know, when they come on atthe end of the day for our
meetings, it's the staffspeaking to them to say, yeah,
they're there to support them,they're there to listen to them.
So supportive staff.
But yeah, mental health isabout purely helping people.
We can do what we can.
Dbi works.
(38:53):
Change.
Mental health has come througha huge change period over the
last few years.
You, you know our branding, ourlogo, the way we do things with
our chief exec is alwayspushing the service.
Every time you listen to him,you feel more inspired each time
and that's what you want in ourorganization.
So we're always looking to seehow we can help and working
within change and working here.
It is the positive feedback.
Having worked for years withinthe police, we didn't get a lot
of positive feedback, eventhough we're there 24 7 for
(39:16):
people.
So, the little things here.
There was a card receivedyesterday for a member of staff.
It was really nice, you know.
It was really touching.
They also sent a packet ofbiscuits, so we're looking
forward to that as well.
Obviously, we'll share thatamong staff.
But, yeah, I think the staffare really positive.
You have your morning chat, themorning meeting.
It's still very stressful, it'sstill very busy.
They're still challenging ascomplex individuals, but the
(39:36):
positiveness of the staff andthe small difference we can make
.
It's just the little things tohelp the community, little
things to help someone.
You may not have been able tohelp them as much as you want,
but they've had someone to speakto.
I'm always speaking tocolleagues who left the police
to do other jobs just to sayit's a brilliant organisation to
work for because you can make adifference and that's you know.
That's quite unique, this test.
Robyn Haydon (39:56):
Absolutely.
It is unique and it's veryrewarding work, very meaningful
work and very necessary work.
It can be challenging work attimes, as we all know.
So really interested in how youlook after yourselves and we
ask this question of all of ourguests what do you do to take
care of your own mental healthand wellbeing?
(40:17):
Ian, I might start with you.
What do you do to look afteryourself, your own?
Ian Graham (40:21):
mental health and well-being.
Ian, I might start with you.
What do you do to look afteryourself?
I do a lot of sport, so I go tothe gym.
We've done a cycle around LochNess on the weekend, so where
they close the roads, 66-milecycle challenge.
I do a lot of running.
I think, as I'm getting older,I'm doing more sport and more
fitness because I realise thebenefits that it brings to you
and that'll be my main thing forkeeping my mental health and
wellbeing going.
Robyn Haydon (40:39):
Offsets all the biscuits too.
Ian Graham (40:41):
Well, we're looking forward to them still arriving,
but yes, they will help.
Robyn Haydon (40:45):
What about you, Kimberly?
Kimberley Irwin (40:47):
I'm a busy mum of three, so I have three
children at home.
So I did say to Ian yesterdaywhat is it I do?
And he said your familyholidays.
I look forward.
Every single year we book anice family holiday to get away
to spend some quality timetogether, because it's very busy
, you know, by the time you gethome with with three children.
What I do think is really quiteimportant, though and I've
(41:09):
learned quite a lot myself sincejoining DBI with their tools
and things is a lot of staff doit as well as we're using them.
So I've learned quite a lotabout my own triggers and my own
behaviors where I need to takea little bit of a step back and
input in my decider skill or aDBI tool.
So essentially, I don't reallydo match, apart from making sure
(41:32):
that I'm having good fun withwith my children, because
they're growing up and it'simportant to make sure that I
capture that time before theyflee the nest.
Robyn Haydon (41:42):
Yeah, absolutely Connecting with what's really
important to you as well, as youknow, doing the great work that
you are both doing in thisspace.
Really appreciate your timetoday and we're coming to the
end of this chat it always goesso quickly Wondering if you have
any final thoughts forlisteners or anything that you'd
like to to mention that wedidn't cover today for me.
Ian Graham (42:05):
It's just you can tell from us we enjoy working
with dbi.
We really enjoy working withchange mental health.
It's exciting times we'rereally.
You know, when we got the callfrom yourselves, your
communications team can reallywanted to go to Australia to do
it but unfortunately I said no.
So we're really excited to seethe DPI model moving.
It's you know it's going toparts of England, Obviously down
with yourselves.
(42:25):
It's been recommended elsewhere.
There's a lot of internationalcoverage for it.
We've both got life experience.
We've worked in variousoccupations, We've come here.
We see the benefit it brings topeople.
So we're really delighted tosee that it is spreading
elsewhere and we look forward toseeing the results and
listening to the reviews and thefeedback and seeing how it goes
elsewhere.
So it's a really good chance tospeak to yourselves today and
(42:47):
just to follow how you stood onin the future as well.
Robyn Haydon (42:50):
Kimberly.
Any final thoughts from you?
Kimberley Irwin (42:52):
Firstly, just to clarify Ian does keep saying
no, but I keep saying yes, weare going to Australia, but no,
it's been an absolute honour tobe asked to come and speak with
you today.
You can tell that obviously I'mvery passionate about DBI and
how it works and you know I'malso here for any questions on
how our day-to-day running works, always here to offer a hand.
(43:13):
That relationship working again, and it's been fantastic to
spend some time with you thismorning.
Robyn Haydon (43:18):
That relationship working again and it's been
fantastic to spend some timewith you this morning, and
absolutely with both of you.
A big thank you to you both andwe would love to welcome you to
Melbourne and to VictoriaAnytime you want to come over.
You'll have a place with us andwe'd love to show you some of
the work that we are doing here.
(43:47):
So thank you both.
We've been talking to Ian andKimberley from the Distress
Brief Intervention Team atChange Mental Health in Scotland
, so we will have details in theshow notes for this episode so
listeners can find out moreabout Change Mental Health and
some of the things we've spokenabout.
Thanks for listening and ifyou're enjoying this podcast,
please tell your friends, yourfamily, your colleagues any and
(44:09):
all of them and rate or reviewon your podcast listening
platform.
Emily Webb (44:16):
If you've been affected by anything discussed
in this podcast, you can phonelifeline on 13, 11, 14 or go to
lifelineorgau you've beenlistening to get real talking
mental health and disability,brought to you by the team at
irma 365.
Team at ermha365 (44:36):
Get Real is produced and presented by Emily
Webb, with Corenza Louis-Smithand special guests.
Thanks for listening and we'llsee you next time.
Get Real is recorded on the unceded lands of
the Boon wurrung and Wurundjeripeoples of the Kulin Nation.
We acknowledge and pay ourrespects to their elders, past
and present.
We also acknowledge that theFirst Peoples of Australia are
the first storytellers, thefirst artists and the first
creators of culture, and wecelebrate their enduring
(00:22):
connections to country,knowledge and stories.
Welcome to Get Real talkingmental health and disability
brought to you by the team aterma 365.
Join our hosts, Emily Webb andKarenza Louis-Smith, as we have
frank and fearless conversationswith special guests about all
(00:43):
things mental health andcomplexity.
We recognise people with livedexperience of mental ill health
and disability, as well as theirfamilies and carers.
We recognise their strength,courage and unique perspective
as a vital contribution to thispodcast so we can learn, grow
(01:05):
and achieve better outcomestogether.
Ian Graham (01:12):
When someone's in distress, the fact that we will
speak to them we guarantee wewill speak to you within 24
hours makes a massive difference.
You know their clients.
When we speak to them, they'rethinking they're going to refer
to a GP or a community mentalhealth team.
They don't know how longthey're going to wait.
Wait, but they're gettingsomeone to speak within 24 hours
seeing the difference withinindividuals within those 14 days
(01:34):
.
Kimberley Irwin (01:34):
You're making a difference.
You're giving them hope, you'remaking them feel empowered,
they're taking back control andyou know you could speak to a
client on the first day and onthe last day it is literally
like speaking to a completelydifferent individual.
Emily Webb (01:59):
Welcome to Get Real Talking Mental Health and
Disability.
I'm Emily Webb.
My co-host for this episode isRobyn Haydon, erma365's Chief
Marketing Officer.
When I first started at ermaback in 2021, Robyn was the host
of this podcast, so it's greatto be co-hosting with her today.
Hey Em, it's great to be backand to see you and all of our
(02:22):
guests today.
And we're particularly thrilled to have
international guests for thisepisode Kimberley Irwin and Ian
Graham from Change Mental Healthin Scotland.
We're talking with Kimberleyand Ian to find out more about
the Distress Brief InterventionProgram, which was developed and
piloted in 2016 in parts ofScotland to respond to the needs
(02:46):
of people experiencing distress.
This program is now establishedacross Scotland and here in
Victoria in Australia, where weare.
The program will be pilotednext year in response to the
final advice of the NationalSuicide Prevention Advisor and
the recommendations of the RoyalCommission into Victoria's
(03:07):
mental health system.
So welcome to Get Real podcast,kimberley and Ian.
Ian Graham (03:13):
Hello Emily.
Thank you for the invitation,hello Robyn.
Kimberley Irwin (03:16):
Hi to you both.
It's lovely to be here.
Robyn Haydon (03:18):
We're so very glad to have you.
And some background forlisteners.
Change Mental Health actuallyshares similar origins with
ermha365, so we were bothstarted decades ago as advocacy
and support networks by groupsof people caring for loved ones
with mental ill health.
Change Mental Health has beenaround for more than 50 years
(03:39):
and its foundation was inspiredwhen Scottish journalist John
Pringle wrote an article in theTimes about caring for his son
experiencing schizophrenia.
Hundreds of carers contactedJohn after reading this article
and some of them were thefounders in 1972 of the
Schizophrenia Fellowship, whichevolved into Change Mental
Health.
So Change provides servicesacross Scotland for people
(04:02):
living with mental ill healthand the people who care for them
.
There's a great timeline ofmilestones for the organisation
on its website, which we'll linkto in the show notes for this
episode.
But look, we've spoken enough,we reckon, so let's get into the
conversation with Kimberley andIan.
Emily Webb (04:16):
Looking forward to it.
Let's find out about you both,Kimberley and Ian.
I'll start with you, Kimberley.
What is your role at ChangeMental Health and what's your
background in working in mentalhealth?
Kimberley Irwin (04:27):
Thanks, emily.
Yes, so I am the projectmanager for the Distress Brief
Intervention Service, whichcovers Inverness, the Highlands
and, newly, the Western Isles.
I came from a caring background.
Before joining Change MentalHealth, it was more on a
personal level, for myself andmy family, that drove me to want
(04:48):
to help people within themental health industry.
Emily Webb (04:51):
And what about you, Ian?
Ian Graham (04:53):
So my role is the National Distressed Brief
Intervention Project Lead, so Imanage and oversee the services
for Highland, Western Isles,Ardell and Bute and Dumfries and
Galloway.
So we have project managers atKimberley so I manage the entire
service.
My background is completelydifferent to working in mental
health.
I was a police officer, retiredjust a couple of years ago, so
(05:15):
I've worked all over theHighlands, was a firearms
officer, child protectionofficer and also worked through
management up to chief inspector.
So I became involved in sort ofthe DBI through work in 2017
when I first came to Inverness.
I've seen it set up and othermental health pilots in the area
to see what can be done to liftthe pressure off the frontline
services and support peoplebetter at that point of impact.
(05:35):
So I worked in road safety fora short period and then I seen
the opportunity to come tochange mental health and work
through the stress-freeintervention.
Emily Webb (05:43):
And Ian, you did mention the areas that your
program covers and I have heardof these areas in Scotland, even
though I haven't seen a lot ofScotland and you're the lead
agency, as you said, in theHighlands, dumfries and Galloway
, argyle and Bute and WesternIsles, which all sound actually
quite amazing.
Can you tell us about thesecommunities, especially for
(06:05):
listeners in Australia, and wedo have listeners all over the
world?
Ian Graham (06:09):
We'll start with the Western Isles, which I'm
from originally.
It's a population of 26,000,but it's really geographically
diverse.
It's a huge string of islandsalso called the Outer Hebrides.
We've got the main town ofStornoway, so we've just started
going in there.
They've got our big communityaround crofting fishing
tourism's really starting totake off as well.
But, like everywhere else, it'sgot rural challenges with trips
(06:30):
to and from the mainland and Iworked previously within the
police, so a really goodrelationship with local health
providers and our geographicalawareness of the island.
So it's really nice to bestarting there.
Highlands it's got the capitalof inverness, which is really
well known, real big tourist hub.
We've also got heavy ofInverness, which is a really
well known, real big tourist hubwith also a heavy industry.
But it's for quite diversecommunities from Fort William
and Glencoe through to Aviemoreand up to Caithness at the top
(06:52):
of the Highland area.
So the population is quitespread out.
So that's quite a challenge forall the public services to
support and also for thepopulation, due to some of the
rural areas are starting to thepopulation's coming more into
the centre, so finding staff topromote and support them.
So we're quite, really usefulwith the DBI with the service,
the way we can do it over thephone, and also we have staff
within the areas Argyll and Bute, just attached to Highland,
(07:15):
population of near 90,000, andit's along the west coast of
Scotland.
Again, it's a massivegeographical area.
It's one of the largest inScotland in terms of the length
and the population is spreadvery diverse throughout the
latest towns and villages.
So again, we work reallyclosely.
With our knowledge of workingin Highland and the Western
Isles, it becomes really usefulfor how we work with staff.
And then Dumfries and Galloway,which is a large farming and
(07:37):
rural community.
It's a large coastline andthey've got a population
approaching 150,000.
They're down the bottom ofScotland, the border with
England, a lot of littlechallenges within it.
But we have staff based on allthese areas so that we really do
geographic knowledge.
When they're dealing withclients they hear their voices
to find out where they're from.
So it works really well whenwe're providing the service
(07:59):
locally.
Robyn Haydon (08:00):
Sounds like there's some really diverse
areas, so that's reallyinteresting in and of itself,
but you're the lead agency forthis program, so what does that
mean?
If you could explain for ourlisteners Ian or Kimberley
either one of you can take thisquestion how do you actually
work as a lead agency to bringthis program together?
Ian Graham (08:19):
When we're chosen to provide the service within an
area, we link in with our NHScolleagues, our colleagues
within the Scottish AmbulanceService, police Scotland, local
GP surgeries, community mentalhealth teams, and Kimberly would
set up an implementation groupmeeting with them.
So we discuss what the distresstreatment intervention model
will bring, how it will work.
Then we would discuss whatpathways to open and how we
(08:41):
would open them, discuss whatpathways to open and how we
would open them, and then wesort of manage the services come
through, advertising it locally, recruiting staff and showing
the benefits to people of how wewant to work with them.
And then Cumberland and ourteam will do a lot of the work
on the ground, meeting the stafflocally, explaining to them
it's providing a compassionateresponse at the first level and
then the teams locally provideservice.
(09:02):
And you just work through amonth-by-month schedule,
introducing more pathways,starting to get more people on
board, answering questions, andthen just continue to drive the
service.
And one of the key pointsKimberly does is doing buzz
sessions.
She does this face-to-facemeetings with staff in the other
agencies, answers any questionsand brings them up to speed and
showing how the service isgoing to work and getting it on
the ground and advertising it,showing the benefits of it and
(09:24):
how.
We're quite unique in the24-hour call and the quick
14-day package.
So I think that's one of thekey things for us.
Delivering, I mean the leadagency.
We take all the questions, comein.
We're expected to push it thewhole time but also work with
other agencies in the publicsector to expand it and
constantly meet the demandthat's out there.
Robyn Haydon (09:49):
Sounds like there's always something to do
with this program and a lot tocoordinate and bring together.
Kimberley, what's that like foryou on the ground?
Kimberley Irwin (09:53):
and as part of the lead agency delivering this.
There's a lot that goes on inthe background for the program
and really the most importantcomponent of being the lead
agency is relationships,partnership working, supporting
each other.
And the idea of me going outabout in the communities with
the frontline, with the buzzsessions, is essentially, you
know, going through referrals,going through how they looked,
(10:16):
going through you know whattheir numbers were, really
keeping them up to speed withhow their DBI kind of looks.
What's also really important isbeing there for support.
You know, refreshing them withthe distress brief intervention
model, how it works, whathappens on our end when we
receive a referral, so they geta full picture.
(10:36):
I also very much promote youknow, if you are on the front
line and you're not really toosure, pick up the phone, give me
a call, we'll have a chat.
It's important to have reallygood, strong relationships and
that's something that I've beenworking really hard within the
background so that we're allworking collaboratively together
(10:56):
.
Robyn Haydon (10:58):
Sounds like it's a very relationship driven
program and a lot of sort ofreal time learning too.
That's going on on the groundand there's a lot of partners of
real-time learning too that'sgoing on on the ground and
there's a lot of partners, Ithink, to coordinate.
It might be worth, just for thesake of our listeners who are
not familiar with this, the DBIprograms come to our attention
in Australia because, after theRoyal Commission into Victoria's
mental health system whichhappened a few years ago now it
(11:20):
was in 2019 and 2020, theintroduction of this kind of
program, a distress briefintervention program, was
actually one of therecommendations of the Royal
Commission's final report and itwas specifically to improve our
suicide prevention serviceshere in Victoria.
So we actually haverepresentatives from our state
government travel to Scotland tofind out more about this
(11:42):
program.
So can you explain how DBIworks in terms of what you do at
Change Mental Health?
So how does it work as aprogram within itself and then
how does it fit with your othersuite of services?
Kimberley Irwin (11:57):
The premise is pretty simple with distress
brief intervention.
It's connected, compassionate,immediate response within 24
hours and it's provided 365 daysof the year.
It's a two-level approach, sowe have level one and we have
level two.
So level one would be all ourfrontline workers and level two
are all our DBI practitioners.
(12:18):
We have a DBI model.
So the DBI model is the 14-daybrief intervention.
It it's person-centred, so it'sdependent on the individual's
situation and what's going onwith them and what their needs
are.
What we would do during thatsupport whereby it goes into
(12:42):
their background.
What's going on for them rightnow, what's causing the distress
?
Where do we need to look to seewhat we can help you with.
That is a main component of thedistress management plan, but
the most important part of thedistress management plan is how
to improve.
So with that, we will look atworking with distress brief
(13:04):
intervention tools.
So there's an array of differenttools, from looking at distress
triggers, if then coping skills, confidence rulers, smart goals
.
There's a lot of planning andwe will also use decider skills.
So you know, looking atbreathing exercises as well,
like looking at what's going tohelp them right in that moment
(13:25):
of that time, that when they canfeel their distress occurring.
We very much also look attriggers and behaviours so then
we can identify what tools wouldbe best for an individual.
We'll look at practical side ofthings as well, you know.
So a lot of signposting happensand everything that we give
support on with an individualwill go on their distress
(13:45):
management plan and thatdistress management plan is
theirs for the future, so theyget to take that away with them
at the end of support.
Ian, do you want to chip inwith anything else?
Ian Graham (13:56):
I think the key thing for us is a couple of
things the 24-hour response whensomeone's in distress, the fact
that we will speak to them.
We guarantee we will speak toyou within 24 hours.
There's a massive difference.
You know the clients when wespeak to them, they're thinking
they're getting referred to a GPor a community mental health
team.
They don't know how longthey're going to wait, but
they're getting someone to speakwithin 24 hours.
The way our staff are justreally good listeners, really
(14:17):
good communicators, so they'reable to immediately recognize
the person's distress levels,discuss with them, explain what
we do.
We had a really good example ofone of our staff.
They had a very distressedindividual on the phone like
what can I do, what do I need todo?
What do you want me to do?
And the member of staff justsaid just answer the phone.
All you have to do is answerthe phone to me and I'll talk to
you.
And they just talk throughright, right, what's your
(14:39):
distress, what's causing it?
And just about turning thatperson around within that period
of a couple of phone calls orface-to-face meeting or virtual.
It's about listening to themand saying, right, what's
causing the distress, what canwe do to alleviate it and what
can we do in the short-termperiod to do so?
And I think the fact that we'reguaranteeing phone calls within
not just the 24, but the nextcouple of days and four, maybe
(15:01):
five phone calls over a two-weekperiod, do you know it really
works for them and I've onlybeen in the service a few months
.
I've seen clients coming inreally in a state of distress
and after a few discussions withour staff you see them going
out to a different person.
They're saying hello to you onthe way past.
They're recognizing there'ssomeone out there to listen to
and they're recognizing what'scausing the distress.
And the dbi model allows thestaff to do that in a structured
way, but it's their personalskills following the structure
(15:23):
that makes a big difference andwe see that in the reviews and
feedback that we get.
I would always say to peoplethat initial 24-hour call
followed by a couple of phonecalls that's the key of the
distress brief interventionmodel and when we really sell
that to clients and to the otheragencies that we provide that,
you can see the demand growing.
But I think that's one of thekey things, as long as we're
able to maintain that and to beable to sell it to staff and get
(15:45):
the clients on board and getthe feedback.
I think the model works reallywell.
Every evaluation that's donehas shown it really works.
Robyn Haydon (15:51):
Yeah, absolutely, and obviously a very successful
program, which is why we'relooking to emulate it here and
well-established now.
And I'm wondering if you thinkback to when the program was
first introduced and I thinkprobably you've alluded to this
already, in the sense that youknow there was a gap in that
being able to provide a briefintervention quickly to people
(16:13):
who might have kind of fallenthrough the cracks because they
weren't able to get to a GP.
They weren't actually able toget the support quickly enough.
Was that the reason why theprogram was developed in the
first place, or what was theneed that was originally
identified that then became thedistress brief intervention
program?
Ian Graham (16:32):
Yeah, the Scottish government, you know, from the
1990s onwards, were looking atthe distress brief to see what
was happening, what was causingdistress in the communities,
what pressure was within thefrontline providers, getting the
feedback from clients, gettingthe feedback from the providers.
And they looked all around theglobe.
They looked at various studies,various researchers, they
looked at the internationalliterature that was out there,
(16:53):
trying to decide what model willwork best in Scotland.
A timely, compassionateresponse was key.
Also, maintaining longer-termcontact with the clients by what
we do, by putting the plansback to the GPs to show them
we've met with the client.
This is what we've done withthem Giving them signposting to
show them what's available outthere if they're not already
aware.
What will work for thefrontline and will also work for
(17:14):
the client in coming back andsupporting the frontline
services.
So the gap was identified.
This was the main one thenumber of people that were
approaching GPs emergencyservices in a state of distress.
So they thought, right, thiscould be a good model to bring
in.
So, 2016, they come up with apilot.
We have members of staff, ourmanager.
She's been on the DBI since itfirst started.
(17:34):
So she started the small modelas it rolled out and immediately
they could see it was startingto work.
Somebody was showing menewsletters today from a couple
of years ago which showed howthe numbers have started to grow
to what we are now.
We're up to approaching 2,400 ayear now within our bit of DBI,
and that's just over a numberof little areas Nationally.
I think it's over 62,000referrals since 2017.
(17:55):
So it's growing year on year.
So I think that was it.
It's been brought in to meetthe demand.
But the good thing with the DBIthey're always looking to
improve.
So they're always keen forfeedback working with Glasgow
University to get more tools towork with the staff, listen to
the staff on the ground and thestaff come up always some
excellent suggestions.
So they're always looking toimprove.
So I think from that start, aslong ago as the 1990s to the
(18:17):
model in 2016, one One of thekey points has been it's not a
set model.
It works under a structure, butthey're always looking to
improve it and how to develop itbetter.
Robyn Haydon (18:27):
Kimberly, do you have anything to add to that?
Just in terms of the originsand where the need first evolved
for this programme.
Kimberley Irwin (18:34):
Ian gave a really good explanation there,
and it's all in aid of trying toget as much support for
individuals as possible, as wellas as helping frontline,
because we know, especiallythrough times over four years
ago, everything went a bit crazyand they need support now more
than ever, and I think that'sreally the crucial thing as well
, that this DBI program is hereto support them too, and it
(18:58):
works beautifully.
As Ian said, you know the model.
The model works and if itdidn't work then it wouldn't
have succeeded to the extentthat it has to date and it's
been wonderful to have been partof it and its growth.
Dbi is a fantastic model.
Emily Webb (19:15):
You mentioned, gps are a really crucial part of
this program and your frontlineworkers?
Gps are a really crucial partof this program and your
frontline workers?
Emergency services like police,fire, ambulance.
So I'm guessing when you talkabout support for them, it's
because they're interacting withpeople in extreme distress, so
it's helping to take, I guess,some pressure off those services
(19:35):
.
So community partners arereally important for this
program, from everything thatI've read and I'm listening to
you.
So who are the the mainreferrers or partners and how
does it work?
Kimberley Irwin (19:49):
We have different pathways, so with
Inverness and Highland inparticular.
Yes, gps, they are sort of ourour main referrers.
You know we will have some GPswithin a year that are reaching
sort of the 150 for referralsfor that year, which is great.
On averaging of 10 to 12 amonth.
We also work very closely withmental health teams so they can
(20:11):
also refer custody link workerswithin the police station and we
also have relationships withthe police and the ambulance.
Last year we also haverelationships with the police
and the ambulance.
Last year we also have achildren and young persons
pathway.
So we are within Inverness HighSchools whereby those partners
for me are the wonderfulguidance teachers and that's
(20:32):
been really successful so far.
We also work alongside CAMHS aswell With our national
programme which came about inthe COVID response because you
know the world sort of shut downin a sense.
We took on the NHS 24 mentalhealth hub so that actually
covers a wider area of all ofthe four areas of Inverness
(20:53):
outside Inverness, within theHighlands, dumfries and Galloway
, argyll and Bute and WesternIsles, so it's really a larger
area.
There are so it;s really alarger area there and we also
get from the police and that'sopen to ambulance as well.
Argyle and Bute, dumfries andGalloway and Western Isles they
have their own individual localpathways.
So they work again with anarray of different partners.
(21:15):
Every front line service has tobe DBI level one, trained,
before they can make a referralinto the service whereby maybe
you know we see a lot,especially with GPs.
They're sort of moving aroundfrom practice to practice or
they're moving on elsewhere orwe're getting quite a lot of new
GPs.
So my role is to keep on top ofthat to make sure all the GPs
(21:37):
within surgeries you know theyare up to date with the DBI
training and they're fullyrefreshed constantly.
Usually I go into GPs quarterlywhere I'll go in with a little
bit of a newsletter, give them arundown of the referrals of
that quarter top referrer,champion kind of thing.
Just to make it a little bitinteresting.
We all work with the frontlinereally quite closely and it's
(22:00):
also making sure that they'reaware of the DBI programme in
the sense of how it's helpingindividuals.
That's genuinely how it workswith the frontline and obviously
with Western Isles.
We've started with the police,which has gone really well with
training.
We've done some buzz sessionsalready.
So it's just about keeping ontop of that and constantly
(22:22):
expanding and building thoserelationships up and ian, did
you want to add anything there?
Ian Graham (22:29):
yeah, I think, as kimberly said, the relationships
are key, but it's also gettingthe buy-in from the frontline
services.
You're wanting them tounderstand just that
compassionate response.
I was frontline you line withthe police.
We would go to someone who wasin a state of distress and we'd
say how can we best help them?
The police is not best suited.
They don't require to go to thehospital, it's out of hours so
(22:49):
we can't get maybe the rightcommunity psychiatric services
available for them.
So we would just sit down withthe person and say that we could
suggest you go forward to thisprogram where someone will phone
you.
It's called the stress briefintervention model.
They get a wee handout given tothem and just doing that five
to ten minute time to sit downwith a person gives them some
hope that someone's going tocall them the next day and the
frontline provider can go awayand think right, I've done
(23:11):
something really positive withthat person, you know, and they
may not be phoning back two orthree times during the night to
other services.
As Kimberly said, once you getthe frontline provider on board
and they start to see thebenefits and they get the
feedback from the clientsthemselves when they come into
the GP practice or something.
The referral starts to comefrom that particular practice or
from that particular officer orfrom the Scottish Ambulance
(23:31):
Service NHS24.
And word soon spreads thatthere's more of this available
and I think the work withKimberly and the staff here and
throughout the other areas thatwe cover and meeting with the
frontline it really gets thebuy-in from them and it's the
chance for them to understandwhat we hear and why we're here
and that we provide that quickresponse.
It's not just a case ofsomething's going to phone you
in a few weeks.
It's a quick response.
It's the key thing for thefrontline provider and we do see
(24:05):
the practitioners and more andmore people referring.
As a result of that.
We also have more peoplewanting to become a referrer.
Up here we've had the localprisons asking can they get in
touch.
It's word of mouth that spreadsand they start to pick up
quickly how the DBI model worksand all the evaluation has shown
that it works and the key is inthe frontline buy-in to get
that started and then get themover to us for the discussion.
So it really works well and therelationship with the providers
works really well, especiallyin our areas.
We're quite rural and diverse.
So the fact that staff livethere, they know the staff, they
(24:26):
know the people, we can go faceto face with them in whatever
they're based, that's a keyselling point for us.
Emily Webb (24:32):
Yeah, it sounds like the word of mouth element of
this program and the communitypartnerships and training to
equip people to actually referin is really fascinating.
And from the research aroundthis program and Robin's been
doing some as well it's myunderstanding that some people
who are accessing DBI and beingsupported by it actually maybe
(24:53):
haven't had much interactionwith a mental health program or
service or maybe have neveridentified in themselves that
they are having, I guess, amental health crisis or service,
or maybe have never identifiedin themselves that they are
having, I guess, a mental healthcrisis or a distress or
something like that.
Can you explain a bit moreabout this and, I guess, the
stresses and the general reasonsbroadly that you're seeing
people referred for this program, and whether or not what I said
(25:16):
is correct or not?
Kimberley Irwin (25:18):
So, yeah, what you're saying is is correct, but
we also see it on the flip side, that there can be quite a
generous amount of time onwaiting lists within the
highlands for different programsand we will be approached with
an individual who is, you know,distressed because of having to
wait X amount of time to be ableto get some support With a team
(25:40):
on the ground.
When we first initially speakwith an individual, you know
we're listening, we're beingcompassionate, we're giving them
that time and space to enablethem to, you know, go through
that frustrations, because weunderstand.
But what we do on our end ofthings is provide expectations
Okay, tell them exactly what DBIis, what it's not, how it's
(26:03):
going to work throughout theirsupport, but also giving them
the hope that we can do so muchwithin 14 days to enable to
equip you to wait to go on foryour next support service.
And we see that a lot comingthrough with the referrals and
it's just about the team beingable to handle and manage when
individuals are coming throughwith distress, of frustration.
(26:25):
Essentially, we see an array ofdifferent reasons why
individuals would be distressedlow mood, depression,
relationships, financial familybereavement.
You know that list is reallyquite endless when it comes to
the stressors, becauseeverybody's distress is
(26:45):
different and everybody'sdistress is relevant to that
individual.
So you and I might be goingthrough the same situation but
react completely differently,and it's really important to
remember that everybody'sdistress is valid and it's just
about us taking the time andlistening to what it is that
their needs are.
(27:08):
Two of the most common,unfortunately, factors within
referrals is self-harm andsuicidal ideation.
We have tools that can help uswith those.
We have a safety plan that wego through with individuals,
whereby it talks about theirmood, their feelings, emotions,
how they're feeling right atthat moment and time of you know
(27:30):
being able to identify feelingthat way in the moment.
Then we'll look at copingstrategies.
I think it's also reallyvaluable to to ask the
individual you know what do youdo at that moment?
Because if it's something thatthey are automatically doing
themselves, it's very much worthmaking sure that that is within
a safety plan, because it'ssomething they're already
(27:51):
currently doing to enable themto sort of balance the
triggering and the behaviors.
Then we'll look at supportoptions.
So who can you call, whetherthat would be family, friends,
places that provide you with adistraction, and then, obviously
, other support services thatwould be available.
So, with those particular types, there's training in place and
(28:11):
there's tools in place to spendtime with an individual, to go
through all of those, so theyare equipped for feeling that
way.
Ian Graham (28:19):
I think one of the key things with DBI as well, we
started to pick up trends.
Rural isolation, that featuresfor us.
Gambling and debt are startingto feature with us.
So we start looking at that andwe look to see where can we go
for advice for our staff.
So we work with the CitizensAdvice Bureau for that.
I think the question you hadabout people coming to us who
haven't had much interactionwith mental health services
(28:40):
before.
When we have clients coming in,we fill in forms to see who
we've spoken to.
Do they have a diagnosis?
A significant amount of peopledo not have diagnosis for mental
health.
They are suffering purely fromanxiety and distress and they're
concerned then that they'recoming to a mental health
charity.
But the staff are really goodin speaking to them to explain
it's distress.
This is what some people do.
(29:02):
You might just be a case of acoping method when they come to
us.
You know we're non-judgmental.
We'll work with anyone.
We go from complex to people whohaven't had dealings with
mental health services beforeand they may never again.
You know our hope is someonecan go away and use the coping
tools.
The studies we've done showthat people do keep the distress
management plan with them for anumber of months and they do
(29:22):
work through with them.
So we're always looking to seeright that's really good work,
what works for you or doesn'twork.
Staff are always identifyingtools to deal with some of the
stressors that come in.
So it's always moving forward,it's always evaluating, it's
always looking to see where thetrends are.
The stressors list seems to getlarger and larger.
It's different ages as well.
We've got people in their 90scoming to us, down to people
(29:43):
still in school.
Robyn Haydon (29:44):
And it sounds like from what you're saying, Ian,
that sense of normalising thehelp-seeking behaviour,
especially for people who arenot normally in contact with
mental health services, andreducing some of the stigma and
normalising that so that peoplecan feel better about what
they're going through andgetting that help, even if it is
simply all they need, issomething that's brief and
(30:06):
really curious to know.
Since you've been providingthis programme at Change Mental
Health.
How has the DBI programmeevolved and, as you said, it's
changing?
Is the need growing?
In what areas are you seeingthat happening?
Kimberley Irwin (30:20):
yeah.
So I've been with dbi coming upthree years this year and I
came in as a coordinator and thegrowth, even within that time,
has been immense and it's beenan absolute honor to watch and
be part of.
We were looking at thisyesterday myself, myself and Ian
found about 100% growth sinceit went live in 2016.
(30:42):
The DBI has an average ofaround 220 odd referrals a month
and Inverness take around 105of those.
So when the front line areseeing DBI, seeing the immediate
response, seeing the 24 hours,they're intrigued.
And we do get people emailing.
You know, outside can we refer?
(31:02):
Not only that, we get a lot ofwhen I go to do visits with GPs
they'll say I had so-and-so comein, you know, and they were
explaining how amazing theservice was, what it did for
them.
They're providing feedback.
That's not something that weget often from individuals who
come to DBI, but when we do,it's really important to take
that and feel empowered with itthat we're making a difference
(31:25):
in individuals' lives, theprogramme itself, even from
referrals from when I was hereas a coordinator.
The amount of stressors thathave grown since then have
changed.
Like Ian was saying, the listhas always been added to with
different things and we alwaystake a look at that with the
trends that are coming into theservice.
(31:46):
So overall the growth has beenmassive and I have absolutely no
doubt that it will continue togrow.
Robyn Haydon (31:55):
Ian, anything you'd like to add to that?
Ian Graham (31:58):
Mental health distance and still Distress is
always changing throughout theyear.
We see peaks and troughsthroughout the year.
So we're probablyprofessionalising as we do along
as well.
We've done from the pilotproject, but we also have other
third sector providers.
We meet regularly I think it'sonce every six months
Distress-based practice.
We discuss what's happening,what the trends are, who's doing
things.
You're always looking for ideasfor how to improve the service
(32:19):
that you give to the clients.
The staff are always coming upwith ideas, so the need's
definitely growing.
We're looking at things like, Ithink, DBI Plus for the future.
What will that meet?
What else can we do?
What can we provide Because itworks?
People look to us and say,right, right, what are you doing
as a service that works and howare you providing that service
and what do you think we can seeto improve?
(32:39):
And within the whole DBIcommunity in Scotland it's
always looking for right.
Where's the next best idea goingto come from?
Where's the next best provisiongoing to be?
What are you seeing that works?
What are you seeing thatdoesn't work?
Where can we go next?
What can we do to support thefront line?
Who else should we besupporting when we go to our
health and social carepartnerships.
With our data, with our numbersand with where we're going.
You know they can see thepositives of it.
(33:01):
We have a plan to support theirservice going forward.
So I think it's really good.
I think we all see thepositives of it and we just see
it constantly starting to grow,and so I was really keen to see
it going elsewhere.
We always like to share work aswe go around things as well and
things you've identified thatmaybe we haven't thought of.
So I think it's a really goodservice to work in and we're
always selling the positives forit.
Robyn Haydon (33:22):
Clearly a very, very successful program and one
that you should be very, veryproud of, and it's really
exciting to hear, kimberleyyou've been working on this for,
you know, three years and Ianfor just a few months.
You know, you're already,you're seeing the great demand
that exists for the DBI program.
I'm wondering very curious, ifyou could kind of wave a magic
(33:49):
wand and do anything differently.
What advice would you provideto us here in Australia Is there
anything that you would changeor do differently?
What are the most importantthings that you think that we
need to focus on to really makethis program work for people who
are experiencing distress?
Ian Graham (34:09):
A couple of things.
One is the funding.
You know, longer term fundingmodel, not year to year, five to
10 year funding model, I thinkprovides more service, provides
more continuity, provides betterassurance for the staff working
within the team, provides thefrontline providers with every
assurance you're going to bethere year on year, that you're
going to grow with them.
And the other one is gettinginto the frontline providers
(34:30):
early doors, whether you make acompulsory that they are on
board.
Kimberly recently done apresentation to trainee adults,
mental health nurses, at one ofthe local colleges here you know
, and that's a room of about 100people who are just about to
qualify as nurses, listening towhat we provide.
You want to get them early.
Once they start to hear theword DBI, you know going around
in their head, they know it's areally good model and use what's
(34:51):
worked elsewhere, use thebranding, the name.
The DBI is really distinctive.
The one thing I'm sure you'veread all the evaluation reports.
We're one of the third sectorproviders and it's all run
through a thing called DBICentral.
It's like the hub and spokemodel and that's been really key
.
It's not been absorbed into oneparticular health board but
having that one central office.
(35:12):
But they're really open tothinking it's been really
beneficial.
They're looking to grow it butcontain the growth so that
everyone's sharing from the samething, and I think all the
evaluations are pointed to thesame thing.
That model works really well.
That provides that level ofcontrol, stability, governance
that's needed in the backgroundbehind this and that's been one
of the positives.
So if you set it up using thatsort of model and the other
(35:32):
points, I think you'll haveloads of success for the future.
Emily Webb (35:36):
You've both got a lot of experience in community
services.
Really, your careers arededicated to it, kimberly, in
mental health.
Ian, you've come from apolicing background.
It's a really dynamic,rewarding space, but also, you
know it can be tough and it canbe stressful.
So I just want to know what isit that keeps both of you doing
(35:58):
the work that you're doing withyour communities?
Kimberly, I'll start with you.
Kimberley Irwin (36:03):
You're right, it can be tough, but for me
personally, it's seeing thedifference within individuals.
Within those 14 days.
You're making a difference.
You're giving them hope, you'remaking them feel empowered,
they're taking back control andyou know you could speak to a
client on the first day and onthe last day it is literally
(36:27):
like speaking to a completelydifferent individual.
They are making the changes.
They've done things withintheir plan and for me, you know,
feedback is amazing to hear.
I don't work directly so muchwith clients anymore, that is
with my team, and the feedbackthat they get is so heartwarming
(36:47):
to see as well.
It's about, you know, Iobviously I'm working with the
team in the sense of making surethey're good, their welfare is
good, making sure they're good,their welfare is good, making
sure they're fully up to speedwith training, making sure
everybody's connected.
I've kind of gone from the onethat's providing, you know, the
support to clients but now I'mproviding the support to the
(37:09):
team, seeing the team as well.
You know, come back with.
I've had this email.
This is what it says.
You know, they're so proud,they're so proud.
It's just an amazing program tobe a part of Change.
Mental Health is an amazingorganisation to be part of, and
that really is why I'm stillhere, nearly three years on, and
I'm very, very passionate aboutthe service.
Emily Webb (37:31):
It sounds incredible and, yeah, like there's many
similarities with Irma365 andChange Mental Health when I was
looking at stuff.
It's quite interesting, Ian,what about you?
Because you've had a prettyintensive career dedicated to
the community.
Ian Graham (37:47):
Yes, policing is especially in the Highlands.
You're working with largecommunities like Inverness, or
you're working in smallcommunities with the only police
officer on an island of 1,200people and that's really intense
.
You need to build up thatrelationship with people.
You just be there to help andsupport people.
If someone's in distress, oreven in the police, if someone
needs help, they need to knowsomeone's there for them.
I think that's one of the keythings of all the emergency
(38:08):
service and frontline providersand the mental health community
sector.
I remember coming in for myinterview and I had to.
I got interviewed by, I think Ihad to go into the tea room and
speak to all the staff as welland asking them what their
background was, and it's allvaried backgrounds.
You know, there's not like 10people there that have been
through university and have donethe degrees here.
They've all got differentbackgrounds but they're really
good speakers.
They want to help people.
(38:29):
You can't help everyone,unfortunately.
You are going to find clientsthat will come back or will
finish the period of support,but it's the rest of the staff.
You know, when they come on atthe end of the day for our
meetings, it's the staffspeaking to them to say, yeah,
they're there to support them,they're there to listen to them.
So supportive staff.
But yeah, mental health isabout purely helping people.
We can do what we can.
Dbi works.
(38:53):
Change.
Mental health has come througha huge change period over the
last few years.
You, you know our branding, ourlogo, the way we do things with
our chief exec is alwayspushing the service.
Every time you listen to him,you feel more inspired each time
and that's what you want in ourorganization.
So we're always looking to seehow we can help and working
within change and working here.
It is the positive feedback.
Having worked for years withinthe police, we didn't get a lot
of positive feedback, eventhough we're there 24 7 for
(39:16):
people.
So, the little things here.
There was a card receivedyesterday for a member of staff.
It was really nice, you know.
It was really touching.
They also sent a packet ofbiscuits, so we're looking
forward to that as well.
Obviously, we'll share thatamong staff.
But, yeah, I think the staffare really positive.
You have your morning chat, themorning meeting.
It's still very stressful, it'sstill very busy.
They're still challenging ascomplex individuals, but the
(39:36):
positiveness of the staff andthe small difference we can make
.
It's just the little things tohelp the community, little
things to help someone.
You may not have been able tohelp them as much as you want,
but they've had someone to speakto.
I'm always speaking tocolleagues who left the police
to do other jobs just to sayit's a brilliant organisation to
work for because you can make adifference and that's you know.
That's quite unique, this test.
Robyn Haydon (39:56):
Absolutely.
It is unique and it's veryrewarding work, very meaningful
work and very necessary work.
It can be challenging work attimes, as we all know.
So really interested in how youlook after yourselves and we
ask this question of all of ourguests what do you do to take
care of your own mental healthand wellbeing?
(40:17):
Ian, I might start with you.
What do you do to look afteryourself, your own?
Ian Graham (40:21):
mental health and well-being.
Ian, I might start with you.
What do you do to look afteryourself?
I do a lot of sport, so I go tothe gym.
We've done a cycle around LochNess on the weekend, so where
they close the roads, 66-milecycle challenge.
I do a lot of running.
I think, as I'm getting older,I'm doing more sport and more
fitness because I realise thebenefits that it brings to you
and that'll be my main thing forkeeping my mental health and
wellbeing going.
Robyn Haydon (40:39):
Offsets all the biscuits too.
Ian Graham (40:41):
Well, we're looking forward to them still arriving,
but yes, they will help.
Robyn Haydon (40:45):
What about you, Kimberly?
Kimberley Irwin (40:47):
I'm a busy mum of three, so I have three
children at home.
So I did say to Ian yesterdaywhat is it I do?
And he said your familyholidays.
I look forward.
Every single year we book anice family holiday to get away
to spend some quality timetogether, because it's very busy
, you know, by the time you gethome with with three children.
What I do think is really quiteimportant, though and I've
(41:09):
learned quite a lot myself sincejoining DBI with their tools
and things is a lot of staff doit as well as we're using them.
So I've learned quite a lotabout my own triggers and my own
behaviors where I need to takea little bit of a step back and
input in my decider skill or aDBI tool.
So essentially, I don't reallydo match, apart from making sure
(41:32):
that I'm having good fun withwith my children, because
they're growing up and it'simportant to make sure that I
capture that time before theyflee the nest.
Robyn Haydon (41:42):
Yeah, absolutely Connecting with what's really
important to you as well, as youknow, doing the great work that
you are both doing in thisspace.
Really appreciate your timetoday and we're coming to the
end of this chat it always goesso quickly Wondering if you have
any final thoughts forlisteners or anything that you'd
like to to mention that wedidn't cover today for me.
Ian Graham (42:05):
It's just you can tell from us we enjoy working
with dbi.
We really enjoy working withchange mental health.
It's exciting times we'rereally.
You know, when we got the callfrom yourselves, your
communications team can reallywanted to go to Australia to do
it but unfortunately I said no.
So we're really excited to seethe DPI model moving.
It's you know it's going toparts of England, Obviously down
with yourselves.
(42:25):
It's been recommended elsewhere.
There's a lot of internationalcoverage for it.
We've both got life experience.
We've worked in variousoccupations, We've come here.
We see the benefit it brings topeople.
So we're really delighted tosee that it is spreading
elsewhere and we look forward toseeing the results and
listening to the reviews and thefeedback and seeing how it goes
elsewhere.
So it's a really good chance tospeak to yourselves today and
(42:47):
just to follow how you stood onin the future as well.
Robyn Haydon (42:50):
Kimberly.
Any final thoughts from you?
Kimberley Irwin (42:52):
Firstly, just to clarify Ian does keep saying
no, but I keep saying yes, weare going to Australia, but no,
it's been an absolute honour tobe asked to come and speak with
you today.
You can tell that obviously I'mvery passionate about DBI and
how it works and you know I'malso here for any questions on
how our day-to-day running works, always here to offer a hand.
(43:13):
That relationship working again, and it's been fantastic to
spend some time with you thismorning.
Robyn Haydon (43:18):
That relationship working again and it's been
fantastic to spend some timewith you this morning, and
absolutely with both of you.
A big thank you to you both andwe would love to welcome you to
Melbourne and to VictoriaAnytime you want to come over.
You'll have a place with us andwe'd love to show you some of
the work that we are doing here.
(43:47):
So thank you both.
We've been talking to Ian andKimberley from the Distress
Brief Intervention Team atChange Mental Health in Scotland
, so we will have details in theshow notes for this episode so
listeners can find out moreabout Change Mental Health and
some of the things we've spokenabout.
Thanks for listening and ifyou're enjoying this podcast,
please tell your friends, yourfamily, your colleagues any and
(44:09):
all of them and rate or reviewon your podcast listening
platform.
Emily Webb (44:16):
If you've been affected by anything discussed
in this podcast, you can phonelifeline on 13, 11, 14 or go to
lifelineorgau you've beenlistening to get real talking
mental health and disability,brought to you by the team at
irma 365.
Team at ermha365 (44:36):
Get Real is produced and presented by Emily
Webb, with Corenza Louis-Smithand special guests.
Thanks for listening and we'llsee you next time.
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