Abstract
Aims and method We aimed to evaluate the availability and nature of services for people affected by personality disorder in England by conducting a survey of English National Health Service (NHS) mental health trusts and independent organisations.Results In England, 84% of organisations reported having at least one dedicated personality disorder service. This represents a fivefold increase compared with a 2002 survey. However, only 55% of organisations reported that patients had equal access across localities to these dedicated services. Dedicated services commonly had good levels of service use and carer involvement, and engagement in education, research and training. However, a wider multidisciplinary team and a greater number of biopsychosocial interventions were available through generic services.Clinical implications There has been a substantial increase in service provision for people affected by personality disorder, but continued variability in the availability of services is apparent and it remains unclear whether quality of care has improved.
Highlights
The primary aim of this study was to describe a number of organisations which provided care for those affected by personality disorder and whether this care was delivered through dedicated personality disorder services, generic services or both
Of the 56 organisations that responded to the survey, 47 (84%) reported having at least one dedicated personality disorder service and 43 (77%) reported having both generic and dedicated services
Nine organisations (16%) did not have any dedicated personality disorder services, and all of these stated that their generic services catered to personality disorder
Summary
Respondents Of the 57 relevant English mental health NHS trusts, 52 responded (response rate 91%) and of the 10 independent service providers approached 4 responded (response rate 40%). Of the 56 organisations that responded to the survey, 47 (84%) reported having at least one dedicated personality disorder service and 43 (77%) reported having both generic and dedicated services. The remaining 4 organisations (7%) stated that they did not have any generic services and that all services were specialist; all offered dedicated personality disorder services. Patients were reported to have equal access to dedicated personality disorder services in 31 (55%) of the organisations surveyed. The number of dedicated personality disorder services per organisation ranged from 1 to 5 Across the 52 English mental health NHS trusts, 71 dedicated personality disorder services and 48 generic services were described, a mean of 1.37 dedicated service per organisation (range 0-5). The four independent service providers described ten dedicated personality disorder services; a mean of 2.50 dedicated service per organisation (range 1-5).
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