What is it about?
In 2016 we established a community personality disorder case management team at Spring House in Liverpool, UK. In 2017 the service extended to include a combined day and crisis service. This paper is evaluation of our combined services, with 3 years of data. The aim in establishing our services was to help people live locally in the community, rather than be sent out of area to locked units or have long local psychiatric inpatient admissions.
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Why is it important?
Many of the people under the care of our teams had found themselves trapped within inpatient settings, this situation being potentiated by high-risk behaviours by service users and a risk avoidance approach by professionals. Our service users are generally those too unstable to engage initially in a psychological intervention, needing instead a period of support to gain stabilisation.
Perspectives
We report that it has been possible to support and maintain people with severe personality disorder to live in their local community. Since the services were established all out of area treatments (OATs) were repatriated and no one else has been set out of area. Additionally, local inpatient admissions reduced (12-months: 49%; 24-months: 64%; and 36-months: 74%). We also report on associated cost savings
Simon Graham
Mersey Care NHS Foundation Trust
Read the Original
This page is a summary of: Designing Community Services for People With Borderline Personality Disorder to Reduce Hospitalizations, Psychiatric Services, February 2024, American Psychiatric Association,
DOI: 10.1176/appi.ps.20230028.
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