Individuals with Personality Disorder (PD) have an "enduring pattern of inner experience and behaviour" that causes extreme distress and impairs social functioning and are therefore more likely to suffer mental illness, substance misuse and social problems.
The policy document "Personality Disorder: No Longer a Diagnosis of Exclusion" (for full document click here) found that people with a primary diagnosis of personality disorder are frequently unable to access the care they need (NIMHE, 2003a). Many people go through cycles of engagement with services, presenting in crisis and entering the mental health system through police and emergency services, and experiencing an ongoing cycle of rejection when specialist services reject them and refer them back to GPs (NIMHE, 2003a).
The LiveWork project is part of a wider joint local initiative between two Primary Care Trusts, the voluntary sector and mental health specialist services to achieve a managed clinical network of services of care for people with personality disorder in
The model to equip staff in front line voluntary and primary care services to work more effectively with service users with PD is based on the following assumptions:
1. A person’s pattern of behaviour and way of relate to others, particularly if in response to strong emotions, has the function of meeting their underlying primary needs, whether the person is aware of it or not. For example, the need for importance, dignity, choice, truth, trust, safety or connection with others. This is true of all people, including those with personality disorder; it is just that their strategies for meeting these needs over a long period of time have become persistent and problematic across many areas of their life.
2. By adopting an individually tailored approach to working with the person, frontline staff can start to respond to the underlying primary needs rather than just the surface-level problematic behaviours.
3. Frontline staff can facilitate alternative and healthier ways for the person to meet their primary needs and by doing so will reduce the risk of harm to self and others in the longer-term.