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A pilot personality disorder outreach service: development, findings and lessons learnt

Tower Hamlets Personality Disorder Service, East London NHS Foundation Trust, Mile End Hospital, London E14DG, email: tennyson.lee{at}eastlondon.nhs.uk

Duncan McLean, Consultant Psychotherapist

Cawley Centre, Maudsley Hospital, London

Paul Moran, Clinical Senior Lecturer

Institute of Psychiatry, London

Hugh Jones, Consultant Psychiatrist

South London & Maudsley NHS Foundation Trust

Anil Kumar, Consultant Psychiatrist

South London & Maudsley NHS Foundation Trust

Declaration of interest

None

AIMS AND METHOD

We describe the development of a pilot personality disorder outreach service. A case series of 13 patients was studied. Data were collected using pro forma, semi-structured interviews and a structured assessment of personality disorder.

RESULTS

All personality disorder clusters were represented among the 13 patients. Treatment recommendations usually supported the existing approach – the ‘added value’of the outreach service was that difficult interpersonal dynamics could be considered and thought through with an objective observer. Opinions differed on whether the service was more useful for the assessment and brief treatment or continuing care teams.

CLINICAL IMPLICATIONS

Personality disorder services need to develop expertise in all clusters. There is a need to moderate the harsh self-critical attitudes of the care coordinators. The national framework for personality disorder is useful for service development, but the services need to be tailored to the individual needs of specific teams.