Luke Sheridan Rains1, Athena Echave2, Jessica Rees2, Hannah Rachel Scott2, Billie Lever Taylor1, Eva Broeckelmann3, Thomas Steare1, Phoebe Barnett4, Chris Cooper4, Tamar Jeynes3, Jessica Russell3, Sian Oram5, Sarah Rowe2, Sonia Johnson1,6. 1. Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, United Kingdom. 2. Division of Psychiatry, University College London, London, United Kingdom. 3. Health Service and Population Research Department, NIHR Mental Health Policy Research Unit Complex Emotional Needs Lived Experience Working Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. 4. Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom. 5. Health Service and Population Research Department, NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. 6. Camden and Islington NHS Foundation Trust, London, United Kingdom.
Abstract
BACKGROUND: There is a recognised need to develop clear service models and pathways to provide high quality care in the community for people with complex emotional needs, who may have been given a "personality disorder" diagnosis. Services should be informed by the views of people with these experiences. AIMS: To identify and synthesise qualitative studies on service user experiences of community mental health care for Complex Emotional Needs. METHODS: We searched six bibliographic databases for papers published since 2003. We included peer reviewed studies reporting data on service user experiences and views about good care from community-based mental health services for adults with CEN, including generic mental health services and specialist "personality disorder" services. Studies using any qualitative method were included and thematic synthesis used to identify over-arching themes. RESULTS: Forty-seven papers were included. Main themes were: 1) The need for a long-term perspective on treatment journeys; 2) The need for individualised and holistic care; 3) Large variations in accessibility and quality of mental health services; 4) The centrality of therapeutic relationships; 5) Impacts of 'personality disorder' diagnosis. Themes tended to recur across studies from different countries and years. DISCUSSION: Recurrent major themes included wanting support that is individualised and holistic, provides continuity over long journeys towards recovery, and that is delivered by empathetic and well-informed clinicians who are hopeful but realistic about the prospects of treatment. Care that met these simple and clearly stated priorities tended to be restricted to often limited periods of treatment by specialist "personality disorder" services: generic and primary care services were often reported as far from adequate. There is an urgent need to co-design and test strategies for improving long-term support and treatment care for people with "personality disorders" throughout the mental health care system.
BACKGROUND: There is a recognised need to develop clear service models and pathways to provide high quality care in the community for people with complex emotional needs, who may have been given a "personality disorder" diagnosis. Services should be informed by the views of people with these experiences. AIMS: To identify and synthesise qualitative studies on service user experiences of community mental health care for Complex Emotional Needs. METHODS: We searched six bibliographic databases for papers published since 2003. We included peer reviewed studies reporting data on service user experiences and views about good care from community-based mental health services for adults with CEN, including generic mental health services and specialist "personality disorder" services. Studies using any qualitative method were included and thematic synthesis used to identify over-arching themes. RESULTS: Forty-seven papers were included. Main themes were: 1) The need for a long-term perspective on treatment journeys; 2) The need for individualised and holistic care; 3) Large variations in accessibility and quality of mental health services; 4) The centrality of therapeutic relationships; 5) Impacts of 'personality disorder' diagnosis. Themes tended to recur across studies from different countries and years. DISCUSSION: Recurrent major themes included wanting support that is individualised and holistic, provides continuity over long journeys towards recovery, and that is delivered by empathetic and well-informed clinicians who are hopeful but realistic about the prospects of treatment. Care that met these simple and clearly stated priorities tended to be restricted to often limited periods of treatment by specialist "personality disorder" services: generic and primary care services were often reported as far from adequate. There is an urgent need to co-design and test strategies for improving long-term support and treatment care for people with "personality disorders" throughout the mental health care system.
Authors: Kylee Trevillion; Ruth Stuart; Josephine Ocloo; Eva Broeckelmann; Stephen Jeffreys; Tamar Jeynes; Dawn Allen; Jessica Russell; Jo Billings; Mike J Crawford; Oliver Dale; Rex Haigh; Paul Moran; Shirley McNicholas; Vicky Nicholls; Una Foye; Alan Simpson; Brynmor Lloyd-Evans; Sonia Johnson; Sian Oram Journal: BMC Psychiatry Date: 2022-01-27 Impact factor: 3.630
Authors: Una Foye; Ruth Stuart; Kylee Trevillion; Sian Oram; Dawn Allen; Eva Broeckelmann; Stephen Jeffreys; Tamar Jeynes; Mike J Crawford; Paul Moran; Shirley McNicholas; Jo Billings; Oliver Dale; Alan Simpson; Sonia Johnson Journal: BMC Psychiatry Date: 2022-01-28 Impact factor: 3.630
Authors: Kristiana DeLeo; Lucy Maconick; Rose McCabe; Eva Broeckelmann; Luke Sheridan Rains; Sarah Rowe; Sonia Johnson Journal: BJPsych Open Date: 2022-02-24
Authors: Jordan Troup; Billie Lever Taylor; Luke Sheridan Rains; Eva Broeckelmann; Jessica Russell; Tamar Jeynes; Chris Cooper; Thomas Steare; Zainab Dedat; Shirley McNicholas; Sian Oram; Oliver Dale; Sonia Johnson Journal: PLoS One Date: 2022-05-05 Impact factor: 3.752
Authors: Sarah Ledden; Luke Sheridan Rains; Merle Schlief; Phoebe Barnett; Brian Chi Fung Ching; Brendan Hallam; Mia Maria Günak; Thomas Steare; Jennie Parker; Sarah Labovitch; Sian Oram; Steve Pilling; Sonia Johnson Journal: BMC Psychiatry Date: 2022-09-05 Impact factor: 4.144