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Personality Disorder Everybody’s Business

Personality Disorder Everybody’s Business. July 2009. The impact of PD.

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Personality Disorder Everybody’s Business

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  1. Personality DisorderEverybody’s Business July 2009

  2. The impact of PD People with personality disorder may suffer lives of rejection, anguish and alienation. The effects on individuals, families and society can be pervasive, chaotic and expensive - and cross many organisations, services and systems.

  3. The context …. • Policy guidance in 1999 & 2003 has led to considerable progress • but locally services are still patchy • 2009 brings together key guidance • to support change and leadership • at regional and local levels A ‘tipping point’ for personality disorder…

  4. Focus for the day NICE Guidelines Bradley Review Knowledge and Understanding Framework Recognising Complexity Personality Disorder is everybody’s business Implementation

  5. What’s driving this? • National PD programme set up to establish evidence on: • Public protection • Health and social outcomes – ongoing research programme • Social inclusion Within the legislative framework of human rights, mental health & criminal justice

  6. Why is PD important? 5 – 13% general population 20 – 50% substance misuse attenders 50 – 78% of prisoners 47 – 77% of people who commit suicide 50% of children with conduct disorder and many care leavers

  7. Recognising ComplexityCommissioning guidance for PD services

  8. Recognising ComplexityCommissioning guidance for PD services Aims to support commissioners to work collaboratively to address need and improve outcomes for people with PD

  9. Recognising ComplexityBenefits of effective commissioning • Can lead to improved quality of life for individuals and families • Get people back to work and education • Reduce pressure on staff and public sector organisations

  10. Recognising ComplexityPublic service targets • PSA 12 • emotional health and well-being of children and young people • PSA 14 • increase number of children and young people on path to success • PSA 16 • increase proportion of socially excluded adults in settled accommodation, employment, education and training

  11. Recognising ComplexityPublic service targets • PSA 18 • promote better health and well-being for all • PSA 23 • make communities safer • PSA 25 • reduce harm caused by alcohol and drugs

  12. Recognising ComplexityCommissioning for complexity • Recognising overlapping client groups with: • learning disability • substance misuse • offending behaviour • think PD • Encouraging effective pathways • think cooperation, co-production • As part of other required duties and needs assessments • think PD • Equalities matter • think PD

  13. Recognising ComplexityEffective commissioning • Service user and carer involvement • Commissioning for outcomes • Quality and skills of staff

  14. Recognising ComplexityWorld class commissioning • Leadership • Collaboration • Involve patients/communities • Engage with clinicians

  15. Recognising ComplexityPotential cost benefits Reduction in conduct disorder Less educational disruption Less educational failure Fewer children taken into care More young people on the path to success Prevention and early intervention with children, young people and families

  16. Recognising ComplexityPotential cost benefits appropriate use of Primary care Reduced Prescribing Reduced harm from drug and alcohol abuse Reduced risk of offending Reduction in A&E use Improved Family life, education and employment Improved staff retention Community PD services (Tiers 1 to 3)

  17. Recognising ComplexityPotential cost benefits Severe and complex PD (Tier 4) Less escalation to more secure/intensive services Reduced risk to self or others Managing the challenge to services

  18. Recognising ComplexityPotential cost benefits Severe PD, high risk of harm to others (Tier 5) Less escalation to prison, segregation, secure or forensic placements Strengthened community management More rational use of high cost placements

  19. How is this useful to you? • It will support you in • Whole systems thinking • Collaboration across sectors • Involvement of service users • Leadership • Better outcomes for people

  20. Policy in the futureBradley • Evaluation of treatment options for prisoners • Evaluation of Dangerous and Severe Personality Disorder programme • Interdepartmental strategy

  21. Policy in the futureNew horizons A new vision and strategy for mental health and well-being, putting mental health in context of the family, society, employment and the environment. Due out for consultation in July at www.dh.gov.uk

  22. Questions? nick.benefield@dh.gsi.gov.uk rexhaigh@nhs.net clare.stafford@dh.gsi.gov.uk www.personalitydisorder.org.uk

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