Personality disorder services

Personality disorder services

National research highlights that people with ‘complex emotional needs’ associated with a diagnosis of a ‘personality disorder’ experience poor quality treatment, including fragmented and stigmatising care; or are turned away from mental health services (Pettitt et al., 2013; Trevillion et al., 2022). National research shows that people with this diagnosis feel that specialist services can be helpful, although it is often difficult to find long-term support (Pettitt et al., 2013).

In Cambridgeshire and Peterborough, the Personality Disorder Community Service and the Relational & Emotional Difficulties Service offer two separate pathways to help people manage emotional dysregulation, to control unhelpful coping behaviours and improve their ability to sustain meaningful relationship.

  • Personality Disorder Community Service (PDCS) is a secondary care service provided by a multi-disciplinary team. This service supports people who meet the threshold for severe personality disorder over a 6-month pathway, with progression to REDS, group therapy, or REDS with wrap around 1:1 support.
  • Relational & Emotional Difficulties Service (REDS) is a new psychological treatment service for people who have a range of difficulties associated with regulating emotions and who may struggle to negotiate relationships. They offer a DBT skills group and a peer support group programme.

Springbank is a 12-bed recovery unit for women with a diagnosis of emotionally unstable personality disorder (borderline personality disorder or BPD in US terminology) who are struggling to cope with the demands of life outside of hospital, despite the input from community psychiatric services.

Referrals

There has been a sharp increase in the number of referrals to PDCS and REDS from 2020. There was an over 200% increase in the total number of referrals to both services from October 2022 to September 2023.

Figure 22: Referrals to Personality Disorder Community Services (PDCS) and Relational & Emotional Difficulties Service (REDS), January 2020 – September 2023

Note that data was only recorded on this system from January 2020

Who is referred to this service?

These graphs are based on anonymised data from 968 service users who accessed PDCS and REDS between June 2020 and April 2023. This showed that the majority of service users (79%) were from Peterborough, which is because this is where the service was initially piloted.

Figure 23: Proportion of PDCS and REDS service users by locality, June 2020 – April 2023

Note that locality was based on registered GP address rather than the addresses of individual service users.

Around three quarters of people using these services were women (76%).

Figure 24: Proportion of PDCS and REDS service users, June 2020 – April 2023.

People using this service ranged in age from 16 to 63 years old. The mean age was 31 years.

Figure 25: Number of people using PDCS and REDS by age group, June 2020 – April 2023.

This analysis suggested that that people from minority ethnic backgrounds are underrepresented in personality disorder services in Peterborough, but not Cambridgeshire:

  • Ethnicity data were compared to the 2021 Census data for Peterborough and Cambridgeshire using chi-square goodness of fit test or Fisher’s exact test for smaller sample size.
  • All ethnic minority groups except for “mixed or multiple ethnicity” were underrepresented among Peterborough service users. People who identified as “Asian, Asian British or Asian Welsh” were most underrepresented, followed by people who identified as “Black, Black British, Black Welsh, Caribbean or African”. People who identified as “white” were overrepresented.
  • The ethnicity of service users in Cambridgeshire was reflective of the general population; however, people from Cambridgeshire comprise only 19% of service users.
  • This reflects previous research showing lower referral rates for ethnic minorities to UK personality disorder services (Garrett et al., 2011).

What do people say about this service?

Feedback from the Personality Disorder Community Service is highly positive:

Figure 26: Feedback from people who have used the Personality Disorder Community Service

Further experiences, stories and advice from people who have used this service are recorded by CPFT.

Testimonials from women who have stayed on the Springbank ward can be found here.

Additional Resources

References

Full list of references is included at the end of this chapter.

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