We offer an integrated psychological therapy, case management, psycho-social intervention service that attempts to engage hard to help service users with severe personality disorder. the service attempts to engage with service users in a variety of flexible ways in order to both provide appropriate, health improving interventions whilst at the same time reducing service users utilisation of psychiatric inpatient beds, A&E and GP attendance
From start: No
During process: Yes
In evaluation: No
PP Collaborative: Yes
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Dr Mark Stowell-Smith - Clinical Lead/Consultant Psychotherapist
We offer an integrated psychological therapy, case management, psycho-social intervention service that attempts to engage hard to help service users with severe personality disorder. the service attempts to engage with service users in a variety of flexible ways in order to both provide appropriate, health improving interventions whilst at the same time reducing service users utilisation of psychiatric inpatient beds, A&E and GP attendance.
Wider Active Support
We have partnership arrangements with third sector organisations, such as the local advocacy service. we are also involved in other multi agency interventions, such as ‘kids time’ (a family focused mental health intervention) which involve joint working with a variety of third secret and local authority based agencies.
We employ an ex-service user as a core member of our team as a ‘recovery mentor’. we also employ, on a freelance basis, an ex-service user to facilitate one of our treatment programmes – a therapeutic community based day programme. We also provide ongoing workshops to service users and carers on the treatment, management and lived experience of personality disorder
Looking Back/Challenges Faced
The commissioning intentions and service plan entails that the service is very oriented towards the reduction of unnecessary service utilisation (e.g. excessive GP and A&E attendance, excessive use of medical and psychiatric inpatient beds etc.) Sometimes it feels as if reducing this type of service utilisation is all that makes a difference in terms of whether the service is recomissioned. At the inception of the service, it might have been opportune to have attempted to have talked up other quality criteria, such as improvements in service users general mental health status and quality of life, so that they some parity with the reduced service utilisation criteria.
We are commissioned on a recurring annual basis through the locally commissioned ‘better care fund’. although we are regarded as a de facto ‘permanent’ service, the nature of the funding arrangements entails that we have to demonstrate our value on an annual basis through reporting of outcome data. It is a challenge to provide annual ‘headline grabbing’ reports in this way. in the context of the current economic climate, the fear is, that to do otherwise, may jeopardise the continuation of the service.
We have a robust set of outcome measures that we complete on a recurring, three monthly basis (see below). we report our progress on a six monthly basis and the nature and organisation of the team suggests that we have been able to sustain a good performance that satisfies the demands of local commissioners.
Team members complete a standardised set of outcome measures on their work with service users on a three monthly basis. The measures are embedded into our electronic care notes system and practitioners are automatically prompted to complete the measures by alerts generated by the electronic data base. Outcome data for service users in treatment can then be aggregated and incorporated into a report for commissioners. we provide an interim report every six months and a more substantial report at the start of each financial year.
We have disseminated our work locally via a series of workshops to local GPs and other health care professionals. we also run a series of open access workshops on personality disorder in which we, amongst other things, discuss our approach to working with personality disorder with service users, carers and mental health professionals.