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The Emotional Rollercoaster The setting up of a service. The Dumfries and Galloway Borderline Personality Disorder Service Dr Esther Mackenzie Leanne Gregory. The story so far. A long time age in a health board far far away... Personality disorder working group
The Dumfries and Galloway Borderline Personality Disorder Service
Dr Esther Mackenzie
A long time age in a health board far far away...
Personality disorder working group
September 2010 - PD service proposal
National Institute for Mental Health in England (NIMHE, 2003) –
Clinicians can be reluctant to work with people with PD:
Feel lacking in skills
Need resources for treatment
Westwood and Baker (2010) – further training and supervision needed to improve relationships between staff and service users.
D & G – Lack of training perceived as one of
the biggest challenges in work. 86%
interested in receiving training.
NIMHE (2003) – training
should be team focussed
and tailoredto the needs
of specific services.
significantly higher levels of social distance when it comes to
services users with a BPD
diagnosis compared to those
with other mental health
difficulties (Westwood & Baker,
Service users with a BPD diagnosis attracted more negative responses from staff than those with a diagnosis of depression or schizophrenia (Markham et al., 2003).
Positive therapeutic relationships are well recognised to be associated with positive outcomes for services users.
Therefore, staff training which challenges negative attitudes and encourages consistent and positive relationships may have a significant impact on services user outcome.
AIM: To improve services for those with PD by meeting the training needs of NHS, voluntary and private sector employees in D & GTAILORING: Use various training methods to inform about PD in general, but also to stimulate discussion about:- Staff experiences of PD- Attitudes towards services users with a PD- Difficulties for people with PD when using services- Considering what can be done to improve services
2 = Disagree
3 = Don’t know
4 = Agree
5 = Strongly Agree
Trainers helpful and responsive
Learning activities and content stimulating
97% of additional comments positive
3% offered suggestion of small changes
Bowers, L., Carr-Walker, P., Allan, T., et al (2006). Attitude to personality disorder among prison officers working in a dangerous and sever personality disorder unit. International Journal of Law and Psychiatry, 29, 333-342.
Markham, D. & Trower, P. (2003). The effects of the psychiatric label ‘borderline personality disorder’ on nursing staff’s perceptions and causal attributions for challenging behaviours. British Journal of Clinical Psychology, 42(3), 243-256.
National Institute for Mental Health in England (2003). Personality disorder: No longer a diagnosis of exclusion policy implementation: Guidance for the development of services for people with personality disorder.Department of Health
Skachill, M. & Jenkins, C. (2008). Questionnaire on training needs and interest in personality disorder. Unpublished manuscript, NHS Dumfries and Galloway.
Westwood, L. & Baker, J. (2010). Attitudes and perceptions of mental health nurses towards borderline personality disorder clients in acute mental health settings: a review of the literature. Journal of Psychiatric and Mental Health Nursing, 17, 657-662.