Keir Harding Profile picture
Oct 27, 2022 25 tweets 13 min read Read on X
And we are here (late!) To the @rcpsych GAP conference. So far we think we've spotted @lovebillybragg and @SameiHuda. Looking forward to an interesting day #rcpg #rcpsychgap2022
Some talk about the long term plan. Years ago "personality disorder" wouldn't have got a mention... #rcpsychgap2022
Up next is @Shrink_at_Large on Changing the Srory around PD #rcpsychgap2022
The pros and cons and diagnosis

"Do better than a thorn in the flesh" #rcpsychgap2022
Does a diagnosis get in the way of the credibility of those it is given to?

#rcpsychgap2022
google.com/amp/s/www.huff…
The borderline pattern collapses the model of the ICD-11 @Shrink_at_Large
The problem with borderline is it links to such a powerful prototype (cartoon?) of manipulative, attention seeking etc...

Is that useful and what does it hide? #rcpsych2022
3/4 people will get a personality disorder label of some description (mild/moderate/severe/difficulties), which is a problem if it links to that prototype/cartoon 🤔

#traumanotpd #rcpsychgap2022
So we need to remember the huge levels of trauma in the lives of those diagnosed with "bpd" (or bpd pattern) #rcpsychgap2022
So what else is hidden in the BPD pattern? Well, there's a lot of ASD around #rcpsychgap2022

Can we see past that cartoon/stereotype?
Do we just need a new name?

1 Personality is not a neutral term.

Others reaction to "personality disoder" ramps up shame.

#rcpsychgap2022
2 You stop being believed

"If you wanted to kill yourself you would have" etc

#rcpsychgap2022
Attempted solutions to manage distress are seen as symptoms of illness/a disordered personality

#rspsychgap2022

Credit to @RRowanOlive
"BPD" reaches back in time and rewrites our history, validating the worst things people have ever taught us #rcpsychgap2022
It is a closed system, everything is understood as bpd. Silent = attention seeking or communicative = manipulative

#rcpsychgap2022
So why isn't there more change? We've been going on about this for years... #rcpsychgap2022
The @rcpsych position statement says great things about relational working, but this diagnosis undermines relationships

#rcpsychgap2022
The thorn in flesh course...

#rcpsychgap2022
The status quo is maintained by the idea that good care is dependent on the diagnosis of personality disorder

It's not just "bad staff". This term allows the pathologisation of difficulty/discomfort

#rcpsychgap2022
Some solutions 👇

#rcpsychgap2022
There's a question along the lines of "but how do we help," is SCM the answer?

In some ways it's a brave question but in others it shows how unprepared services are for helping people who have survived neglect/abandonment and abuse #rcpsychgap2022
If EUPD/BPD doesn't exist how do we account for people benefiting from DBT/MBT?

Those therapies aren't diagnosis specific and offer things helpful to many people. Why can't we offer them without people having to accept a PD label? #rcpsychgap2022
And that is my @Mental_Elf audition over.
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More from @Keirwales

Jul 7
So what do I want from a new government in the world of mental health?

Well, 8500 new people working in mental health. Why is that?

news.sky.com/story/sir-keir…
That's important because the community mental health teams I worked in 10 years ago were drowning in the demand THEN. With the workforce dropping, those who remained have done less with less. Image
The focus on child mental health is important too and it's good to hear them talking about the appalling waiting lists for desperate children and families
google.com/amp/s/amp.theg…
Read 12 tweets
Oct 10, 2023
It is #WorldMentalHealthDay with a focus on Mental Health being a universal human right.

If you're struggling, remember to ask for help. Image
When you ask for help, you'll be joining a fifth of all 16 year old girls in the country:

"16-year-old girls are most likely to be in contact with NHS mental health services - with 22.8% of the population (69,580) having been in contact with these services during 2021-22" Image
You'll also find a notional emergency going on with 1 in 5 mental health nurses vacancies unfilled in the NHS

theguardian.com/society/2023/o…
Read 7 tweets
Sep 23, 2023
Thanks to @BPDFFS @Girl_Interrupt_ and @HoppyPelican for pointing me at this. I don't understand it very well, but I'm going to spell out what I don't understand and what I'm wondering about...
The diagnosis of personality disorder has changed. There are no 'types' any more, just personality disorder mild/moderate/severe. This paper looked at whether you could use honos scores to measure that severity.
This is what a honos section on self harm looks like.. Image
Read 17 tweets
Jul 23, 2023
Here's a thread no one has asked for looking at this from the recent #RCPsychIC conference. Is it BPD or CPTSD?

Let's have a look 👇👇👇
The slide is citing this paper so we shall dive in and see what they say...

ncbi.nlm.nih.gov/pmc/articles/P…
The paper says BPD and CPTSD/PTSD are different. There is a lot of overlap though

29% of people with cptsd met criteria for BPD.
25-58% of those dxed with BPD met criteria for ptsd
Read 20 tweets
Jun 23, 2023
And so we come to the end of the day marking 20 years since No Longer A Diagnosis of Exclusion

Some great people there 🙂

Some reflections on the day...

@HoppyPelican @MEAMcoalition @KKaurWilson @AlexStirzaker @DrSRanote @skalidindi1 @KKaurWilson @NationalKufHub
We looked at some great beacon services. We agreed there was much that could help. We acknowledged the prejudice and discrimination.

This is the same as 20 years ago.
We didn't explore why the stigma and discrimination was still there. Why the recommendations of NLADOE couldn't be followed.

(and if we hadn't had the 'thorn in the flesh' incident, I'm not sure we'd have been here today).
Read 15 tweets
Jun 23, 2023
Second session kicks off with @BIG_SPD presidents @OliverDale10 and Julia Blazdell talking about where there were when No Longer a Diagnosis of Exclusion came out

"Rampant discrimination and prejudice"
These were the recommendations from 2003 👇👇👇
"If you haven't done KUF do it"*

Other co produced training is available 👍beamconsultancy.co.uk/training
Read 10 tweets

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