Making Sense of The Chaos Developing Borderline Personality Disorder Services in Clackmannanshire

Why were here… Who we are, where we are and what were up to

FORTH VALLEY INPATIENT/OUTPATIENT SPLIT MODEL INPATIENT WARDS INTENSIVE HOME TREATMENT TRAUMA CLINIC DYNAMIC PSYCHOTHERAPY SOUTH SECTORNORTH SECTORCLACKMANNANSHIRE

PSYCHIATRY SERVICES COMUNNITY MENTAL HEALTH TEAM DAY UNITOUT PATIENT PSYCHOLOGY GP MENTAL HEALTH SERVICES PHOENIX CENTRECOUNSELLING COMMUNITY ACCESS TEAM CBT SUPPORTED EMPLOYMENT TEAM DEVON HOUSE

GP PRIMARY CARE PSYCHOLOGY ON CALL PSYCHIATRIST MENTAL HEALTH SERVICES PSYCHIATRY SERVICES IHTT LIAISON REHABILITATION TEAM TRAUMA CLINIC INPATIENT CARE: W1, W2, W3 DYNAMIC PSYCHOTHERAPY SERVICES

Service Development Collaboration between psychologists Solution- focused therapy (SFT) group BPD Working Party Training Model of Care

Shared, consistent care Trust and understanding Empowerment and recovery

Service Development Collaboration between psychologists Solution- focused therapy (SFT) group BPD Working Party Training Model of Care Audit Complex Case Discussion Resource Pack Mentalisation Training Groups

A positive, collegial, solution- focused stance Looking for previous solutions Present- and future-focus Use of questions Looking for exceptions Use of compliments Solution- focused goals Guided by Solution-focused principles Main interventions

Group Development Original pilot group Clackmannanshire Second Clackmannanshire group and further SFT training Third group in Clackmannanshire Pilot group within CMHT in Falkirk area Further evaluation of groups

Ongoing Work Groups Database and referral system Dissemination of audit findings Completion of Resource Pack

Outcomes

GP PRIMARY CARE PSYCHOLOGY ON CALL PSYCHIATRIST MENTAL HEALTH SERVICES PSYCHIATRY SERVICES IHTT LIAISON REHABILITATION TEAM TRAUMA CLINIC INPATIENT CARE: W1, W2, W3 DYNAMIC PSYCHOTHERAPY SERVICES

Outcomes (2) My ideal model is similar to the existing model that is in Clacks – a team approach that involves the consultant, psychologist and keyworker…Work should be clear and consistent between the staff team and also with the patient. This approach feels safer for managing risk and clinical judgements because it helps you to feel more supported, more included in decisions, promotes equality amongst staff groups and it helps to provide a consistent and professional approach. Everyone is working in the same way and the patient is aware of this and they learn they need to work within these boundaries. Clinicians perspectives

Outcomes (3) A team approach - honesty in the relationship is valuable. Integrity is fundamental. I've been put back together in a way that is sustainable. I trust the team and know that putting someone together is the treatment. Service- users perspectives It is great to have three competent individuals working with me - a safety net. The four of us work together and conversations go on between all of us. I will take their advice. Sometimes someone lets the safety net go a bit slack but this can be a good learning exercise. I have faith that the safety net is always there.