People with a primary diagnosis of personality disorder are frequently unable to access the care they need from secondary mental health services. A few Trusts have dedicated personality disorder services but these are the exception rather than the rule. In many services people with personality disorder are treated at the margins – through A&E, through inappropriate admissions to inpatient psychiatric wards, on the caseloads of community team staff who are likely to prioritise the needs of other clients and may lack the skills to work with them. Within forensic services a number of regional secure units actively exclude patients with a primary diagnosis of personality disorder, because they do not consider this to be their core business. Many clinicians and mental health practitioners are reluctant to work with people with personality disorder because they believe that they have neither the skills, training or resources to provide an adequate service, and because many believe there is nothing that mental health services can offer.

The Department of Health has published Policy Implementation Guidance for Personality disorder: No longer a diagnosis of exclusion (2003) and NIMHE published Breaking the Cycle of Rejection – the Personality Disorder Capabilities Framework (2003). These documents set out a vision for effective service provision for people with personality disorder problems and the need to build a workforce equipped with the appropriate skills, knowledge and attitude to work effectively with personality disordered service users.

This programme aims to support the implementation of this guidance.

The guidance aims are:-

• To assist people with personality disorder who experience significant distress or difficulty to access appropriate clinical care and management from specialist mental health services.
• To ensure that offenders with a personality disorder receive appropriate care from forensic services and interventions designed both to provide treatment and to address their offending behaviour
• To establish the necessary education and training to equip mental health practitioners to provide effective assessment and management.

Key Objectives:

The programme’s key objectives are to:

• Support and oversee community service pilot sites in the Eastern Region (awarded funding from the Department of Health National Personality Disorder Programme)
• Support the development of commissioning guidelines
• Oversee and support cross agency capacity planning
• Develop the Clinical/Professional Personality Disorder Network
• Support the development of a Personality Disorder Service User Network
• Disseminate NICE guidelines for borderline and anti social personality disorder.

Key Activities

• Contribution and co-chairing of the regional specialist interest group for Personality Disorder and regular attendance at county/PCT/organisation steering groups or Personality Disorder specific meetings
• Organising learning activities for the Clinical/Professional Personality Disorder Network (quarterly regional meetings)
• Using the new Personality Plus project and regional activities to support and underpin a regional Personality Disorder Service User support network, both financially and in its planning
• Disseminating NICE guidelines for borderline and anti social personality disorder through networks and facilitating broad consultation across the region.

Key Contacts:

• Patrick McGlynn - Specialist Mental Health Services Programme Manager - patrick.mcglynn@csip.org.uk
• Debbie Marr - Programme Administrator - debbie.marr@csip.org.uk