scholarly journals Mental health services, care provision, and professional support for people diagnosed with borderline personality disorder: systematic review of service-user, family, and carer perspectives

2019 ◽  
pp. 1-15 ◽  
Author(s):  
Emma Lamont ◽  
Geoffrey L. Dickens
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Service User ◽  
Borderline Personality ◽  
Professional Support ◽  
Care Provision

Low Vocational Outcome Among People Diagnosed With Borderline Personality Disorder During First Admission to Mental Health Services in Denmark: A Nationwide 9-Year Register-Based Study

2019 ◽  
Vol 33 (3) ◽  
pp. 326-340 ◽  
Author(s):  
Lene Halling Hastrup ◽  
Mickey T. Kongerslev ◽  
Erik Simonsen
Keyword(s):  
Mental Health ◽  
Labor Market ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Borderline Personality ◽  
Vocational Outcome ◽  
First Admission

Earlier studies report that although people with borderline personality disorder (BPD) experience symptom reduction in the long term, they continue to have difficulties in work recovery. This nationwide 9-year register-based study (N = 67,075) investigated the long-term labor-market attachment of all individuals diagnosed with BPD during first admission to Danish mental health services in comparison with other psychiatric disorders. Controlling for baseline characteristics and co-occurring secondary psychiatric diagnoses, the BPD group had 32% lower odds (OR = 0.68; 95% CI [0.61, 0.76]) of being in work/under education after 9 years. Individuals diagnosed with BPD also showed more impairment in long-term vocational outcome than other personality disorders, and lower labor-market attachment than other psychiatric disorders except for schizophrenia, schizotypal and delusional disorders, and mental and behavioral disorders due to psychoactive substance use. Intervention programs addressing social psychiatric aspects of BPD in terms of work functioning is henceforth an important area for future research.

Borderline Personality Disorder

2017 ◽  
pp. 199-204
Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Poor Prognosis ◽  
Social Supports ◽  
Borderline Personality ◽  
Definitive Trial ◽  
Interpersonal Situations

Borderline personality disorder (BPD) is a prevalent, debilitating syndrome. Patients with BPD heavily utilize mental health services and have historically had a poor prognosis. In the IPT adaptation for BPD, the therapist presents BPD to the patient as a poorly named syndrome that has a significant depressive component. The goals of IPT in this population are threefold: to link mood (including anger) to interpersonal situations, to find better ways of handling such situations, and to build better social supports and skills. When patient–therapist problems crop up, the therapist addresses them in a here-and-now, interpersonal fashion rather than making psychodynamic interpretations. Because patients with BPD are sensitive to abandonment, termination is discussed early and often. Research on the use of IPT in patients with BPD is tantalizing but fragmentary, in need of a larger and more definitive trial.

Ten-Year Use of Mental Health Services by Patients With Borderline Personality Disorder and With Other Axis II Disorders

2010 ◽  
Vol 61 (6) ◽  
pp. 612-616 ◽  
Author(s):  
Susanne Hörz ◽  
Mary C. Zanarini ◽  
Frances R. Frankenburg ◽  
D. Bradford Reich ◽  
Garrett Fitzmaurice
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Borderline Personality ◽  
Axis Ii

scholarly journals Service user experiences of community services for complex emotional needs: A qualitative thematic synthesis

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248316
Author(s):  
Luke Sheridan Rains ◽  
Athena Echave ◽  
Jessica Rees ◽  
Hannah Rachel Scott ◽  
Billie Lever Taylor ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Service User ◽  
Emotional Needs ◽  
User Experiences

Background There is a recognised need to develop clear service models and pathways to provide high quality care in the community for people with complex emotional needs, who may have been given a “personality disorder” diagnosis. Services should be informed by the views of people with these experiences. Aims To identify and synthesise qualitative studies on service user experiences of community mental health care for Complex Emotional Needs. Methods We searched six bibliographic databases for papers published since 2003. We included peer reviewed studies reporting data on service user experiences and views about good care from community-based mental health services for adults with CEN, including generic mental health services and specialist “personality disorder” services. Studies using any qualitative method were included and thematic synthesis used to identify over-arching themes. Results Forty-seven papers were included. Main themes were: 1) The need for a long-term perspective on treatment journeys; 2) The need for individualised and holistic care; 3) Large variations in accessibility and quality of mental health services; 4) The centrality of therapeutic relationships; 5) Impacts of ‘personality disorder’ diagnosis. Themes tended to recur across studies from different countries and years. Discussion Recurrent major themes included wanting support that is individualised and holistic, provides continuity over long journeys towards recovery, and that is delivered by empathetic and well-informed clinicians who are hopeful but realistic about the prospects of treatment. Care that met these simple and clearly stated priorities tended to be restricted to often limited periods of treatment by specialist “personality disorder” services: generic and primary care services were often reported as far from adequate. There is an urgent need to co-design and test strategies for improving long-term support and treatment care for people with “personality disorders” throughout the mental health care system.

scholarly journals Assessing the efficacy of a stepped-care group treatment programme for borderline personality disorder: study protocol for a pragmatic trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Judy A. Pickard ◽  
Adam Finch ◽  
Elizabeth Huxley ◽  
Michelle L. Townsend ◽  
Stephanie Deuchar ◽  
...  
Keyword(s):  
Mental Health ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Community Mental Health ◽  
Health Services ◽  
Group Treatment ◽  
Pragmatic Trial ◽  
Borderline Personality ◽  
Stepped Care ◽  
Care Group

Abstract Background Borderline personality disorder (BPD) is a high prevalence and serious mental health disorder that has historically challenged the finite resources of health services. Despite empirical evidence supporting structured psychological therapy as the first line of treatment, there remains significant barriers in providing timely access to evidence-based treatment for this population. The primary aim of this study is to evaluate the effectiveness of providing a stepped-care structured psychological group treatment to individuals with BPD within local mental health services. The secondary aims of the study are to identify the variables that predict the need to step up or down in care and the effectiveness of treatment on psychosocial functioning. Methods Participants seeking treatment at two community mental health services will be invited to participate. Randomised controlled trial assignment will be to either (i) group skills treatment or (ii) treatment as usual. Group treatment will be offered via a stepped-care pathway with participants initially attending a 12-week group with the option of a subsequent 16-week group. The criteria for inclusion in continuing treatment includes meeting > 4 BPD diagnostic criteria or severity on GAF (< 65) at the completion of the 12-week group. Data will be collected at baseline and at five follow-up time points over a 12-month period. Discussion This pragmatic trial will provide valuable information regarding the effectiveness of a progressive stepped-care group treatment for individuals with BPD in the real-world setting of a community mental health service. It will further the current understanding of variables that predict treatment dose and duration. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618000477224. Registered on 3 April 2018

scholarly journals Service user experiences of community services for Complex Emotional Needs: A qualitative thematic synthesis

2020 ◽  
Author(s):  
Luke Sheridan Rains ◽  
Athena Echave ◽  
Jessica Rees ◽  
Hannah Rachel Scott ◽  
Billie Lever-Taylor ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Service User ◽  
Emotional Needs ◽  
User Experiences

AbstractBackgroundThere is a recognised need to develop clear service models and pathways to provide high quality care in the community for people with complex emotional needs, who may have been given a “personality disorder” diagnosis. Services should be informed by the views of people with these experiences.AimsTo systematically review and synthesise qualitative studies on service user experiences of community mental health care for Complex Emotional Needs.MethodsWe searched six bibliographic databases for papers published since 2003. We included peer reviewed studies reporting data on service user experiences and views about good care from community-based mental health services for adults with CEN, including generic mental health services and specialist “personality disorder” services. Studies using any qualitative method were included and thematic synthesis used to identify over-arching themes.ResultsForty-seven papers were included. Main themes were: 1) The need for a long-term perspective on treatment journeys; 2) The need for individualised and holistic care; 3) Large variations in accessibility and quality of mental health services; 4) The centrality of therapeutic relationships; 5) Impacts of ‘personality disorder’ diagnosis. Themes tended to recur across studies from different countries and years.DiscussionRecurrent major themes included wanting support that is individualised and holistic, provides continuity over long journeys towards recovery, and that is delivered by empathetic and well-informed clinicians who are hopeful but realistic about the prospects of treatment. Care that met these simple and clearly stated priorities tended to be restricted to often limited periods of treatment by specialist “personality disorder” services: generic and primary care services were often reported as far from adequate. There is an urgent need to co-design and test strategies for improving long-term support and treatment care for people with “personality disorders” throughout the mental health care system.

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