Personality disorders NHS services

People with EUPD have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse and eating disorders, along with self-harm and suicidal behaviours. As many as 80% of people with EUPD have suicidal behaviours, and about 4% to 9% commit suicide, stressing the importance of gaining the correct help. 

There is a range of different treatment approaches for EUPD, including dialectical behaviour therapy (DBT). There is research evidence to support the use of DBT as a treatment for EUPD and this is the treatment model used within Priory’s specialist personality disorder services.

DBT is a comprehensive programme of care providing multiple treatment modalities that address the key skills and motivational deficits presented by patients with a diagnosis of emotionally unstable personality disorders (EUPD). The programme has the following components:

• Skills training (normally delivered within a group setting)
• Individual DBT to help patients identify and solve problems while changing their behaviour
• Ward settings designed to generalise new skills into the patient’s behavioural repertoire
• Access to DBT skills-coaching, either on the ward or via telephone consultation
• Consultation meetings where the therapists receive supervision and consultation on their clinical work

The DBT Programme consists of the following three stages:

Pre-treatment – this is where the patient is orientated to the treatment, and is prepared to undertake the therapy

Stage 1 – this centres on the stabilisation of the individual, with a focus on decreasing para-suicidal behaviours and increasing behavioural skills

Stage 2 – commenced when the individual is able to regulate their behavior and keep themselves safe. This stage focuses on emotionally processing the past, which is particularly relevant to individuals with complex post-traumatic stress disorder (PTSD) or history of trauma.

We accept referrals UK-wide. Information received by a site upon referral will initially be reviewed by an appropriate clinician, who will ascertain if the patient is suitable for the service. They will then discuss the case with the wider team and identify suitable staff members to carry out an assessment, taking into consideration any specific needs of the individual.

The assessing team will carry out a thorough assessment and discuss their findings with the multidisciplinary team which will determine if the service can meet the needs of the individual.  We aim to carry out the assessment within two working days of receiving the referral. Once completed, a full assessment report, including costings, will be provided to the referrer.

Once an admission is agreed, the patient will be provided with information about the service and will be given the opportunity to ask any questions. The patient (along with their family and/or carers) is welcome to visit the service at any point on the referral journey. We understand that coming to a new service can be a stressful experience for some and therefore we encourage the use of familiarisation visits where appropriate.

We accept referrals from:

• Provider trusts and local systems
• NHS England specialised mental health case managers
• Community mental health teams
• Medium secure settings
• Mental health acute/psychiatric intensive care units (PICUs)/secure inpatient
• Prisons and courts
• Social services and the police