Rep36 Understanding Personality Disorder

4.5
People with personality disorder need
multidisciplinary and multiagency services
People with personality disorder have multiple
problems that can undermine their day-to-day
functioning and emotional well-being. Not all
people with these difficulties will be severely
affected by their psychological problems, but for
those who are, a comprehensive range of services
will be needed to meet their complex needs.
Their difficulties may include housing, financial
and legal problems, relationship problems,
depression, anxiety, self-harm and suicidal
thoughts, impulsiveness, conduct disorder and
anger control. There needs to be a concerted
attempt to develop well-integrated
multidisciplinary teams. These teams may need
to incorporate skills from professionals not
usually considered part of mental health
multidisciplinary working. For instance, mental
health services may need to develop close
working relationships with probation officers,
prison staff, police officers, child protection
professionals, and housing services. Forensic
services may need to develop close working
relationships with GPs and local mental health
services. These services will need to provide a
theoretically coherent approach with consistent
and predictable boundaries and be able to
provide long-term intensive treatments. This will
require even more emphasis on effective team
working in mental health and forensic services.
These changes to working practices will also
need active management and development
within individual organisations.
4.6
Communication between forensic and
general mental health services
Services developed within forensic and general
mental health settings have largely developed in
isolation from each other. Forensic services have
developed a treatment focus upon the reduction
of offending behaviour. Therefore, forensic
services have concentrated upon targeting
specific behaviours, such as sexual offending and
anger control, using predominantly cognitive
behavioural treatment models. General mental
health services have concentrated upon
alleviating the distress created by personality
disorders. Therefore, general mental health
services have concentrated upon helping the
individual to gain insight into, reflect upon and
opt to change aspects of their interpersonal
functioning, for example becoming more
assertive, increasing self esteem or challenging