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Review article

Community mental healthcare for people with severe personality disorder: narrative review

Bauke Koekkoek, Registered Nurse, Community Psychiatric Nurse and Researcher

Department of Community Care Zeist, Altrecht Mental Health Care, and Institute for Professionalisation at Gelderse Roos Mental Health Care, Wolfheze, The Netherlands.

Berno van Meijel, Registered Nurse and Associate Professor

Research Group Mental Health Nursing, Inholland University, Amsterdam, The Netherlands.

Giel Hutschemaekers, Director

Institute for Professionalisation at Gelderse Roos Mental Health Care, Wolfheze, and Professor of Clinical Psychology, Academic Centre of Social Sciences, Radboud University, Nijmegen, The Netherlands.

Declaration of interest None.

Correspondence: Correspondence to Bauke Koekkoek (b.koekkoek{at}altrecht.nl)

Abstract

Aims and method To assess the contents and the theoretical and empirical base of community mental healthcare (CMHC) for people with severe personality disorder. Medline and PsycINFO databases and handbooks were searched from 1980, as well as a recent meta-analysis and systematic review of trials in which CMHC served as the control condition.

Results Community mental healthcare is a long-term community-based treatment within a supportive atmosphere, aimed at stability rather than change. Mostly offered by community psychiatric nurses, occupational therapists and social workers, it lacks a formal structure, as well as theoretical underpinnings that guide interventions.

Clinical implications Community mental healthcare might profit from a more systematic application of effective ingredients from other treatments.