Need for Scottish mental health charity has never been so great

It is 35 years since Penumbra first began, with the aim of filling gaps in mental health provision in Scotland.

By Julie Currie
Friday, 22nd May 2020, 7:30 am
After a successsful pilot in Aberdeen and Moray, Penumbra is working with NHS 24 and other mental health groups to roll out the Distress Brief Intervention programme across Scotland.

It has grown from one service in Edinburgh to providing help and support in communities the length and breadth of the country.

Sadly, the need for Penumbra’s services has also grown in the last 35 years.

Arguably, though, that need has never been greater than today with the country in the grip of the worst health crisis in living memory.

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A coronavirus advice hub has been created on the Penumbra website to help those who are finding lockdown difficult to cope with.

As such, Penumbra is not doing anything special to celebrate its milestone or mental health awareness week; its 400 members of staff will simply be working to help those who are most in need of support.

The team are also busy establishing the new Distress Brief Intervention (DBI) service in response to the current Covid 19 pandemic.

The DBI programme was operating in four pilot areas but is now being rolled out across Scotland.

It will offer people aged over 16 who are in emotional distress due to Covid-19 the opportunity to speak to specially trained staff.

Stephen Finlayson, head of innovation and improvement at Penumbra, said: “We believe, and statistics show, that people can and do recover from mental illness."

People who are in distress but do not need clinical intervention will be referred to the DBI team by frontline mental health staff.

Penumbra will work closely with the NHS 24 Mental Health Hub on the project, with SAMH, Support in Mind Scotland and some local providers in Lanarkshire all scaling up a telephone and video support service for the DBI roll-out.

Stephen Finlayson, head of innovation and improvement at Penumbra, explained: “We’ve been asked to cover the health board areas of Shetland, Orkney, Grampian, Tayside, Lothian and Ayrshire and Arran.

“This represents about 43 per cent of the population of Scotland. The remainder of the country will be covered by SAMH, Support In Mind and local providers.

“The service will build on our experience of delivering DBI in Aberdeen and Moray over the last few years, as part of the pilot project.

“We will take referrals from the NHS 24 Mental Health Hub, making contact with the referred person within 24 hours to discuss their issues.

“Support will be available to them for up to 14 days from that first contact.

“Specific training will be given to staff providing this service to ensure we provide a consistent, connected, compassionate approach.

“Given the coronavirus, it is envisaged that this service will be provided via telephone or video.

“This is an exciting opportunity to further develop DBI, which has widely been recognised as innovative and pioneering.”

The service has been directly funded by the Scottish Government, initially for one year.

It is part of a £1 million package of support that First Minister Nicola Sturgeon announced last month to help people look after their mental health and well-being during and after the coronavirus pandemic.

Some of that funding was also used for a mental health marketing campaign on TV, radio, print and online.

The First Minister said: “Covid-19 restrictions have affected all of our lives.

“People who may never have been affected by mental health issues in the past are now facing emotional distress due to financial loss, bereavement and social distancing.

“NHS 24 has experienced an increase in calls in recent weeks and we anticipate this will continue to grow.

“It is vital that during this period of uncertainty anyone who requires support for their mental health can receive it.

“Since 2017 more than 6600 people have accessed the DBI programme and I am pleased that people across the country will now be able to access this support.

“Early intervention like this is such an important part of how we treat mental and emotional health.

“DBI is all about equipping people with the skills and support to manage their own health and to prevent future crisis.

“This £1 million investment is in addition to the £3.8 million we invested last month to increase capacity of our telephone and digital mental health services.”

While rolling out the DBI service, Penumbra will also continue to provide the wide range of services it already offers in communities all over the country.

All of those services – from supported accommodation to self-harm and suicide prevention and everything in between – share Penumbra’s mental health recovery ethos.

Stephen said: “We believe, and statistics show, that people can and do recover from mental illness.

“However, recovery means different things to different people because everybody is different.

“So our approach is very much person-centred. We focus on what a good life looks like for each individual.

“We help them plan how they might achieve their goals with the support of those around them.

“Recovery doesn’t necessarily mean being ‘cured’ or living without medication or support.

“It’s about being in charge of your own life, with real choices under your control.”

To achieve that goal, the charity employs its own special tools to help people on the road to recovery.

The Individual Recovery Outcomes Counter (I.ROC) is a questionnaire used to measure a person’s progress.

It works hand in hand with Penumbra’s HOPE philosophy – Home, Opportunity, People, Empowerment.

Stephen said: “These are the fundamental aspects of day to day life that enable people to regain confidence and to move forward.

“They are the four cornerstones of our work and our staff work hard to ensure people get the support they need to develop their skills and abilities.

“For us, hope is a vital part of recovery and supporting people to have, and hold, hope for the future is a key part of our work.

“However, I.ROC was developed to help us measure that work. It’s a way for us to make sure we’re offering the best support but, more importantly, it also allows people to track their own progress and see how life has changed for them.

“Some clients stick it to their fridge; it can be difficult when you’re in the midst of things to see the positives but I.ROC is there as a visual reminder that there is hope.”

While Penumbra has scaled back on its visiting support services, staff are still making home visits.

Additional telephone and video support is being provided and the charity has set up a coronavirus advice hub on its website too.

Stephen added: “We have moved a significant amount of support to the telephone and our website advice hub.

“However, staff are also on the frontline – delivering support to incredibly vulnerable peolpe at home.”

For mental health advice during the lockdown, visit

Charity has innovated to fill gaps in provision

Penumbra began in 1985 by providing the first mental health supported accommodation services in Scotland.

It provided a home in Edinburgh for seven people with long term mental health issues – an alternative, and better, solution to long stay hospital wards.

The charity started as it meant to go on, providing innovative solutions to gaps in mental health support.

By 1998, its services had expanded to more than 170 supported accommodation places operating in ten local authority areas from the central belt to the Western Isles.

Penumbra’s approach is based on the rights of service users to choice, dignity and the expectation of recovery.

The charity has grown to encompass a range of new individual and group projects, as well as negotiating and tendering for work from statutory agencies.

There have been many firsts during its 35 years too. For example, Penumbra Milestone, a new residential unit for people with alcohol-related brain damage (ARBD), opened in 2015.

The ten-bed unit, jointly run by NHS Lothian, City of Edinburgh Council and Penumbra, provides care for vulnerable men and women who no longer require hospital treatment but are not yet ready to go home.

Penumbra also opened Scotland’s first community skin camouflage clinic in 2015 for people with self-harm scarring, run in conjunction with Changing Faces.

All of Penumbra’s services are recovery focused, using its I.ROC and Hope Toolkit.

Today the charity’s range of services across Scotland include supported living, supported accommodation, crisis and short term support, NOVA social inclusion schemes, self-directed support, peer work, homelessness services, self harm and alochol-related brain damage.

Some require a referral but many accept self referrals.

To find out more about the charity’s services, visit