Watchdog says services for personality disorder ‘not good enough’

A leading health watchdog has found that treatment and support for people living with borderline personality disorder is 'not good enough', in the first ever report specifically examining the condition.
A leading health watchdog has found that treatment and support for people living with borderline personality disorder is 'not good enough', in the first ever report specifically examining the condition.
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A leading health watchdog has found that treatment and support for people living with borderline personality disorder is “not good enough”, in the first ever report specifically examining the condition.

The Mental Welfare Commission study highlighted that people’s experiences of receiving their diagnosis were varied, with many speaking of feeling let down in this aspect of their care.

Often there were delays in receiving a diagnosis, and there was found to be a lack of sensitivity in the way the news was relayed.

Borderline personality disorder (BDP) is characterised by a long-term pattern of unstable relationships with other people, an unstable sense of self and fragile ­emotions.

The Commission staff spoke to more than 70 people with the diagnosis in Scotland, and surveyed 119 GPs, 110 A&E staff, and 84 psychiatrists. Family members, carers and people providing therapies were also asked for their views.

The report also found that specialist resources remain scarce, and general mental health services were often reported as difficult to access and inconsistently available.

GPs often found it difficult to access mental health service support for their patients locally. Police and other emergency services also found it hard to access appropriate help for people in crisis.

The stigma attached to BPD has a dramatic affect on the lives of those with the disorder and was the most commonly reported trigger for a crisis.

Perceived stigma from professional staff left some with difficulties in maintaining and developing relationships, and in participating in treatment.

People with BDP reported that they were often treated with less sympathy and understanding than people with other mental health problems.

Alison Thomson, executive director (nursing) at the Mental Welfare Commission, said: “We found that stigma is a reality in the lives of people with borderline personality disorder, and its effects can be dramatic. It affects confidence and self-esteem, and it was the most commonly reported issue to trigger a crisis.

“We found many challenges – services in some areas are not good enough. Addressing our recommendations for change will need a concerted effort by organisations across Scotland.

“But the report also shows what can be achieved when people with BPD do have access to effective therapy, support and understanding.

“I hope that this fact will help drive all parties to make these changes, so they can improve the outcome for people with this diagnosis.”

It is estimated that 75 per cent of people with BPD engage in deliberate self-harm and the lifetime suicide risk in BPD is estimated between 8 per cent and 10 per cent.

Scottish Conservatives health spokesman Miles Briggs MSP said: “This reports demonstrates just how far SNP ministers need to go to deliver on the pledges they have made to improve mental health services.

“I hope this report will act as a catalyst to improve treatment and support for people living with borderline personality disorder, and most importantly perhaps address some of the stigma which people living with borderline personality disorder often face.”