Meeting-The-Challenge-Making-a-Difference-Practitioner-Guide

BACKGROUND
The notion of treatability
For many years, people given the diagnosis of personality disorder
were regarded as ‘untreatable’ and were either excluded from
services or severely marginalized within them. On the edges of
services, psychotherapists and psychologists had been providing
treatment to people who had problems associated with the
diagnosis for many years. By the 1990s, evidence was beginning to
emerge from a number of research trials that some of these
psychological treatments were effective. But generic mental
health services continued to regard the problems associated with
personality disorder as untreatable. This seems to be because the
notion of treatability was largely defined medically within the 1983
Mental Health Act. It meant treatable by medication. No one
thinks the psychological and emotional difficulties of personality
disorder can be cured by medication (though some aspects, like
symptoms of depression or anxiety, can be helped by medication).
So people with personality disorder were dealt a double blow: they
were stigmatized by a diagnosis that many experienced as
attacking of personal identity, and without access to any form of
help or treatment.
Over the last 10 years, this has changed to a degree. A
combination of government policy and some investment in
innovative specialist personality disorder services has increased
the range of provision and gone some way towards improving
accessibility (see Appendix 2 for links to policy documents that
were important in bringing about change, such as ‘Personality
Disorder: No longer a diagnosis of exclusion’). However, provision
and accessibility remain extremely patchy. Where a person lives still
determines whether they can get treatment and support from
statutory services.
Why give a
diagnosis of
personality
disorder?
While many people believe the
diagnosis is not useful or valid,
others feel a sense of relief on
receiving it. The label can be
stigmatizing but the diagnosis
also helps some people to
make sense of their experience
and enables them to put a
name to things they grapple
with but are difficult to
explain. Being given a
diagnosis also enables people
to become more informed
about different treatment
options, what other people
have found helpful and about
the issues themselves. It can
also help people feel less
alone, and more part of a
community of likeminded
others. It enables people to
seek out peer support and
connect with others who have
a shared experience, which can
be extremely powerful. Where
there is local specialist service
provision, a diagnosis is also
the key to unlocking this.
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