Personality Disorder Service

Transcription

1 Personality Disorder Service Priory Hospital Cheadle Royal, Opal PROVIDING QUALITY INSPIRING INNOVATION DELIVERING VALUE

2 Personality Disorder Service, Opal Set within large grounds with extensive gardens and with easy access to a thriving community, the Priory Hospital Cheadle Royal offers a comprehensive specialist personality disorder service supporting women to complete a personalised treatment programme and health plan within a locked environment. The goal is to progress the person back to a life outside the hospital environment or to other care environments as part of the care pathway. The new Personality Disorder Service at Opal provides a three stage, 12 month recovery focused programme with Dialectical Behaviour Therapy (DBT) at its therapeutic centre. The skills taught within the DBT programme promote greater self awareness and will also teach the individual to build resilience while managing overwhelming situations more effectively. At the right time, access to the local community is a vital step for promoting service users long-term independence. With access to various activities, shops and community colleges we can ensure that external activities on the programme can be fully tailored to individual s interests. I have found a lot of support with community links. In the final stage of the programme I got a voluntary job in a charity shop and an apartment in the community for weekends 1 The dialectical behaviour therapy programme Through the DBT programme, the multidisciplinary team will support service users to: manage life outside of hospital safely engage in voluntary or paid work enjoy healthy relationships explore their own interests move forward to a future they have planned and worked hard for 1 All service user quotes are their own

3 The programme provides the service user with the opportunity to learn and practice key skills in stage one, and through stages two and three, use these to take positive risks for their future: we believe that exposing individuals to new situations during these last few months is imperative to ensuring a successful discharge. Every service user has a minimum of three service user led Care Programme Approach (CPA) meetings during their treatment programme, at three months, nine months and pre discharge. The final stage of the DBT programme will focus on relapse prevention and the building of life skills in preparation for the community. It is envisaged that during the final stage of the programme, the service user will be considering registering at college and/or looking for voluntary work, based on work completed in the treatment programme, health plans and interests developed during their time on the unit. Milestones will be set at the initial CPA to monitor the service user s progress over the 12 months. A three bedded transitional living unit, The Lodge, is available on the Cheadle site. The unit offers a community placement for those who may need a little more support once they have completed the programme, providing the opportunity to live independently with the support of the same multidisciplinary team if required. Once service users have completed the programme, they will be offered additional DBT sessions on an outpatient basis in order to further the skills they have learnt and to offer further support once they are living independently. It will also provide them with the opportunity to present any difficulties they may be experiencing to the multidisciplinary team (MDT) and to work on an approach to help them manage this. Over the year I have learnt new skills to help me deal with things better

4 Service user profile Service users may have a history of one or more of the following: primary diagnosis of Borderline Personality Disorder (BPD) or emotionally unstable personality disorder presenting symptoms that match the criteria for BPD but without a formal diagnosis numerous contacts or admissions with mental health services co-morbidity with other disorders, such as eating disorders, mood disorder, post-traumatic stress disorder and/or substance misuse a history of trauma and/or abuse a high incidence of risk to self, such as self-harm and/or suicide intent step-down from a low secure BPD treatment programme step-up from an acute service, or transition from an adolescent unit Outcomes: our service users success We regularly monitor our service users physical and mental healthcare needs to ensure that they receive the very best, nationally recognised treatment throughout every stage of their care. The graph below evidences a reduction in the total of deliberate self-harm (DSH) episodes for five service users over a period of ten months from admission at one of the Priory Group s hospitals in Roehampton where the same therapeutic treatment model is employed. 2 Number of episodes of self-harm DSH Episodes Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 2 Outcomes are based on a study at one of the Priory Group s hospitals in Roehampton 2012/13 following the same 12 month recovery-focused programme with Dialectical Behaviour Therapy (DBT) at its therapeutic centre.

5 Rachel s story Rachel* is approaching the end of a year in the DBT programme and is preparing to discharge after more than a decade in hospital. Rachel is a 27 year old female with a diagnosis of borderline personality disorder (BPD), eating disorder and complex post traumatic stress disorder (PTSD). She has no known family history of mental health problems but a breakdown in family relationships from a young age meant she endured emotional, sexual and physical abuse. She has never been employed and been in hospital on a Section 3 since December 2001 when she was 15. She was referred to social services in 1996 for difficulties in school and was detained under the Mental Health Act at the age of 15. She regularly self-harmed and took multiple overdoses in summer 2001 and was subsequently admitted to child and adolescent mental health services (CAMHS) and then at 18 transferred to in-patient adult services. At the age of 24 her behaviour escalated, becoming disturbed and high risk which led to two transfers to manage her risk. She was admitted to one of the Priory Group's hospitals at Roehampton, in July 2012 aged 26. Rachel had refused therapy throughout her 12 years in hospital but accepted therapy within the Priory. She feared rejection and believed she didn t deserve to get better. However, she attended all sessions and completed individual DBT therapy, a DBT skills group, DBT skill coaching group and psychoeducation groups. She engaged in mindfulness therapy every day and extended mindfulness once a week. The therapeutic work aimed to create a life worth living for Rachel by managing her symptoms, building structure, developing skills and to respond to situations through choice. As she prepares for discharge, Rachel is beginning to make links with the community and has established goals for her reintegration. She has developed emotion regulation skills and increased her awareness of unique warning signs. Supportive housing has also been arranged for her. I have found the skills that I have learnt within the programme very helpful and think they will help me to have a much happier life outside of hospital. I am very grateful for these skills. Rachel *Name has been changed to protect identity

6 About our Group The Priory Hospital Cheadle Royal is part of the Priory Group of Companies. From specialist education, to mental healthcare hospitals, care homes and secure services, the Group offers tailored and multidisciplinary programmes of care for individuals. The integrated strength of each service provides a seamless transition for the individual as they progress between higher and lower dependency care and across services. This unique approach ensures that every individual has the opportunity to achieve the best possible outcomes and quality of life with the Priory Group. For more information on our services or to discuss placement options, contact our Business Development Manager on to make a referral call send an to cheadleroyal@priorygroup.com or visit our website at Like us on Facebook and follow us on Twitter As 85% of our services are publicly funded and delivered in partnership with commissioners, our teams work with commissioning bodies across the country to provide transparent pricing models and evidence-based care programmes. The Priory Hospital Cheadle Royal, 100 Wilmslow Road, Cheadle, Cheshire, SK8 3DG PG04442/Sep13