Is contact with adult mental health services helpful for individuals with a diagnosable BPD? A study of service users views in the UK.
Abstract
BACKGROUND: Previous research in the UK has suggested that individuals with a diagnosable borderline personality disorder (BPD) have often found contact with adult mental health services unhelpful. In 2003, UK government guidance outlined how services might address this issue. Since this guidance, there has been little research that seeks to understand services users' experiences of services and provide information about how services might improve.
AIMS: To explore the experiences of individuals with a diagnosis of BPD in accessing adult mental health services and to better understand which aspects of contact with services can be helpful or unhelpful.
METHODS: Nine service users with a diagnosable BPD were recruited through voluntary sector services in England. Semi-structured interviews were used and interview data was analysed using an inductive thematic analysis.
RESULTS: Three themes were generated including "The diagnostic process influences how service users feel about BPD", "Non-caring care" and "It's all about the relationship".
CONCLUSION: The participants' accounts identify a number of practical points which services could implement to improve the experiences of service users.
Charlotte Morris, Ian Smith & Nic Alwin (2014) Is contact with adult mental health services helpful for individuals with a diagnosable BPD? A study of service users views in the UK, Journal of Mental Health, 23:5, 251-255, DOI: 10.3109/09638237.2014.951483
Key Quotes
"In this study, the participants felt that some of the basic elements that are generally considered necessary for an effective therapeutic alliance (e.g. trust and opportunity to discuss emotional wellbeing) were often lacking in their interactions with staff. Furthermore, participants highlighted the importance of staff who were consistent and who would stay engaged during difficult periods, such as when risk was elevated. These findings mirror conclusions of previous research, which emphasised the value of trusting and accepting relationships with staff as a means of improving service-users self-perceptions."
"... the participants in this study felt that services could be improved if there was a greater focus on the distress, which lay beneath issues of risk, rather than the emphasis being solely on reducing the risk itself."
"Given that interpersonal difficulties tend to represent the core of distress for those attracting a diagnosis of BPD, the focus of care should be to facilitate service users’ engagement in positive relationships with staff. Such an approach would be consistent with emerging research on psychologically informed planned environments for offenders with personality disorders, which emphasise the importance of relationships and positive interactions[...] Negative attitudes seemingly prevail presumably meaning that some staff might have limited empathy and lack the motivation to engage clients with a BPD diagnosis."
Note from PDV!: It is refreshing to find research which actually highlights the experiences and opinions of people diagnosed with BPD. It is a small study, but the results are thoroughly in line with other studies examining similar things and the reported experiences of people I know within the community
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