果冻影院

[Project status 鈥� In dissemination]

We have carried out a substantial programme of research on the needs of people with 鈥渃omplex emotional needs鈥�, who may have received a 鈥減ersonality disorder鈥� diagnosis. This research was initiated to inform policy commitments in the 2018 NHS Long Term Plan.

We adopted the term 鈥渃omplex emotional needs鈥� because of concerns regarding the stigma associated with 鈥減ersonality disorder鈥� diagnosis, and the imprecision of such diagnoses. This followed discussions at an initial workshop, and with experts by experience and profession. We have continued to use it, as increasingly NHS services do, as a way of referring to the broad group of service users who may have received a 鈥減ersonality disorder diagnosis鈥� when using mental health services, or have comparable needs. However, we do not see this as definitively the best choice of terminology, and would very much welcome more work on best ways of assessing and describing needs in this area.

We worked with a group of academic experts, clinicians, and lived experience researchers on this programme, publishing a group of reviews and qualitative studies, as listed below. Some key findings include:

• Service users and clinicians concur on the need for services that prioritise therapeutic relationships, continuity of care, kindness and compassion, and a holistic focus on social and clinical needs. As well as continuity of care, stigmatising views and pessimistic views among health professionals, especially in primary and generic secondary services, are often an impediment to good quality care.
• Therapeutic pessimism is hard to justify, as many participants in studies of 鈥減ersonality disorder鈥� treatments improve substantially with any specialist treatment, or even with none, often to the extent that they no longer meet 鈥減ersonality disorder鈥� criteria.听
• The evidence base on effective and cost-effective services is mainly limited to specialist psychotherapies: most of these are similarly effective, with a lack of evidence on which work better for whom. Research lags behind other areas of mental health care, with a lack of evidence in areas including treatments for people with comorbidities, or younger and older people, trauma-focused and trauma-informed approaches, support for parents, socially-focused and co-produced interventions, and service design.

This overview presentation gives a .

The Centre for Mental Health summarised our work and drew out conclusions for policy and service delivery in their report '

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Engagement and events:

• The MHPRU held a听Community 鈥楶ersonality Disorder鈥� Services Research Workshop听on the 22^nd听of January 2019 to inform the project and review typologies of community 鈥榩ersonality disorder鈥� services
• Centre for Mental Health Briefing of our work and policy recommendations for this area: ""
• : Ending exclusion - Research and care for people with complex emotional needs.听This influential panel discussion included researchers, clinicians and experts through experiential knowledge to explore what should change in support for people with CEN.
• Presentation on
• Briefing about the findings of the
• Breifing by the Centre for Mental Health - ''

• A covering our co-produced interview study on needs and experiences of community mental health care of people with complex emotional needs

• Another has reported on our scoping review of all the published quantitative evidence on community treatment for people with complex emotional needs

• for a systematic review on treatments for complex emotional needs

• This blog summarised an event held by the PRU to disseminate their complex emotional needs programme to policy makers and others in April 2021, including links to key contributions to the event.

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Publications

• A review of qualitative studies on service users鈥� experiences of community services titled ''
• A review of the economic evidence on community interventions for people with complex emotional needs titled ''
• 听A review of qualitative studies on clinicians鈥� perspectives about what good care for people with complex emotional needs looks like titled ''
• 听A major co-produced interview study of service users views about what they need from mental health services and the gap between this and current experiences. Researchers with relevant personal experience carried out the interviews and participated in analysing them. Service user perspectives of community mental health services for people with complex emotional needs: a co-produced qualitative interview study. ''
• A qualitative study of clinicians views about current treatments and care for people with complex emotional needs and how this could be improved. '
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• This was led by two 果冻影院 post-graduate students to address an evidence gap identified in our complex emotional needs programme. One of the students, Dr Lucy Maconick, has now received for a PhD on crisis care for people with complex emotional needs, supervised by Sonia Johnson.
• 听-听This paper by led by Panos Katakis, a post-graduate student, extends our work on effectiveness of interventions with a meta-analysis on effects on symptoms of interventions for complex emotional needs.
• -听Nicholas Wong Zhan Yuen, another 果冻影院 post-graduate student, has also extended MHPRU work in this area with this review of international guidance on treatment and care for people with a "personality disorder" diagnosis.

• - This paper听aimed to estimate the costs of care for people with a personality disorder diagnosis, compare service use and costs for those receiving specialist input, and those receiving generic care.