Barriers and facilitators to the implementation of a stepped care intervention for personality disorder in mental health services

Journal article


Pigot, Melissa, Miller, Caitlin E., Brockman, Robert and Grenyer, Brin F. S.. (2019). Barriers and facilitators to the implementation of a stepped care intervention for personality disorder in mental health services. Personality and Mental Health. 13(4), pp. 230 - 238. https://doi.org/10.1002/pmh.1467
AuthorsPigot, Melissa, Miller, Caitlin E., Brockman, Robert and Grenyer, Brin F. S.
Abstract

Background: Individuals with personality disorders—particularly borderline personality disorder—are high users of mental health treatment services. Emergency service responses often focus on crisis management, and there are limited opportunities to provide appropriate longer term evidence‐based treatment. Many individuals with personality disorders find themselves in a revolving cycle between emergency departments and waiting for community treatment. A stepped care approach may help to triage clients and allow access to interventions with minimal client, clinician and system burden. This study aims to understand the facilitators and barriers to real‐world implementation of a stepped care approach to treating personality disorders. Methods: Managers and clinicians of health services engaged in implementation were interviewed to obtain accounts of experiences. Interviews were transcribed and thematically analysed to generate themes describing barriers and facilitators. Results: Participants identified personal attitudes, knowledge and skills as important for successful implementation. Existing positive attitudes and beliefs about treating people with a personality disorder contributed to the emergence of clinical champions. Training facilitated positive attitudes by justifying the psychological approach. Management support was found to bi‐directionally effect implementation. Conclusions: This study suggests specific organizational and individual factors may increase timely and efficient implementation of interventions for people with personality disorders. © 2019 John Wiley & Sons, Ltd.

Year2019
JournalPersonality and Mental Health
Journal citation13 (4), pp. 230 - 238
PublisherJohn Wiley & Sons Ltd
ISSN1932-8621
Digital Object Identifier (DOI)https://doi.org/10.1002/pmh.1467
Scopus EID2-s2.0-85070746608
Page range230 - 238
Research GroupInstitute for Positive Psychology and Education
Publisher's version
File Access Level
Controlled
Place of publicationUnited Kingdom
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