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 🤔
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
2 billion on private placements…but is every patient being treated equally here?
I’d suggest not. The NHS inpatient provision for those I work with is a handful of beds. Those displaying recurrent self harm and suicide (all female trauma survivors)…
…are near exclusively given inpatient treatment in the private sector.
How much does it cost? It’s hard to get a clear answer but no one seems to disagree with £300,000 a year per person.
Is it good value?
Well you’d assume so for £300,000 a year. Unfortunately you become a specialist unit by saying you are one. You can hear about the specialist providers mentioned above here
Some studies of those told they have BPD put experiences of abuse at over 80%. Zanarini did a study of over 300 inpatients told they had BPD and found over 90% reported childhood abuse. So to reframe the article lets explore
"Why do survivors of childhood abuse tend to lie?
"they tend to lie, which ruins trust and intimacy, fosters resentment, and harms the very relationships they fear losing." - this statement isn't cited. If there is evidence to back it up, the author opts not to use it.
It was great to see this article in @OTnews this month. Why? Because the @BIG_SPD conference was resplendent with Occupational Therapist people not only attending, but heavily contributing.
Is this new? 🧵
Not new maybe, but this was from the conference in 2015 - 1 OT present and a poor example of one at that!
This year we got OT Student @ZM_LXP describing her research on the impact of a personality disorder label. “Accused of being ill, commanded to be well” was an ace title
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.
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…
It is #WorldMentalHealthDay with a focus on Mental Health being a universal human right.
If you're struggling, remember to ask for help.
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"
You'll also find a notional emergency going on with 1 in 5 mental health nurses vacancies unfilled in the NHS
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..