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

• Peer support/social activities. Spending time with others who
share similar experiences can be immensely powerful in generating
hope, learning new coping strategies and making connections
with others. The availability of peer support varies across the
country, but your local mental health Trust or service user group
might be able to signpost you to a group/organisation.
• Books. For many who struggle with being among other people,
books provide an ideal way of finding out more about the
diagnosis, reading of other people’s experience, developing
self understanding and new coping strategies. A list of useful
literature is available in Appendix 2.
• Wellness Recovery Action Plan (WRAP). This is an international
resource to support people to think through and develop personal
resources and tools which can be used in situations which the
individual finds difficult. It is designed by people with lived experience
of mental distress and there is now also a WRAP app available.
More information is available at: www.mentalhealthrecovery.com
2) LOCAL MENTAL HEALTH SERVICES
Improving Access to Psychological Therapies (IAPT)
The most easily available and least intensive form of help for mental
health problems is the short-term therapies provided within IAPT
services. These interventions may be for a very short period of time
(4-6 weeks), or medium term (16-20 weeks), depending on the
severity of the problems. They are usually fairly practical
interventions designed to treat anxiety and depression. They are
available through self-referral or referral by a GP. Some people with
personality disorders may benefit from this type of help, if they are
experiencing anxiety and/or depression and their personality
difficulties are not too severe. For others, particularly those who
have difficulties in relationships, such short-term treatments may be
unhelpful. Short-term treatments are very unlikely to help the person
to change their underlying personality difficulties, but may well bring
to the surface very difficult issues without the space to safely explore
these. As a result, treatments of 3 months or less are not recommended
by the NICE guidelines for people with borderline personality disorder.
It is advisable for anyone with more severe personality difficulties to
seek help at the next level up, from secondary mental health services.
Secondary mental
health services
Access to these services almost
always requires a referral by
the person’s GP. Some mental
health services have a specific
team working with people with
complex needs or personality
disorders; in other areas,
generic teams may work with
people with a range of
different problems, but within
the team there will usually be
workers with special expertise
in personality disorder.
When someone first has
contact with a mental health
team, the first step will usually
be an initial appointment or
assessment, when the worker,
who may be a mental health
nurse, a psychologist, a social
worker or a psychiatrist, tries to
get a picture of the person’s
difficulties including their
childhood history, the history
of the problems and what help
has already been tried. They
may draw on information from
relatives, friends or carers, or
they may use some structured
measures like standardised
interviews or questionnaires
to add to this picture. This
information is put together so
as to allow a care plan to be
collaboratively developed with
the service user.
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