
Personality Disorder Service
In 2019, the Personality Disorder Service (PDS) received funding as part of a pilot program by the Victorian Department of Health and the Office of the Chief Psychiatrist.
The initiative aims to enhance specialist capabilities of public mental health clinicians to assess, treat and support people with severe personality disorder who are at high risk of suicide or high lethality self-harm and/or aggressive behaviour. Due to the success of the PDS, at the conclusion of the four-year pilot, Northern Health maintained the funding to provide ongoing specialist input within Northern Area Mental Health Service (NAMHS).
Since its inception, the PDS has used the principles-based model of Good Psychiatric Management as a framework for service delivery to expand accessibility for consumers and increase mental health professionals’ ability to assess, treat and support consumers with a personality disorder. Service provision provided by the PDS across NAMHS includes primary consultation and treatment (both group and individual), second opinions for diagnostic clarification, secondary consultation and training across the Mental Health Division.
This October, there are two national events taking place that raise awareness of mental health conditions, including Borderline Personality Disorder (BPD):
- National Multicultural Mental Health Month- Celebrating Diversity and Healing Together – The Mental Health Foundation Australia (MHFA) has announced October as the National Multicultural Mental Health Month 2024, to celebrate the rich cultural diversity of Australia, while promoting mental health awareness and support within multicultural communities.
- BPD Awareness Week (1-7 October): Living life well, Recovery and BPD – The BPD Awareness Week theme for 2024 is focused on living life well. Everyone’s recovery journey is uniquely their own, so the word ‘recovery’ means different things to different people. Research shows that, with appropriate treatment and support, people with BPD, ‘recover,’ and lead a life that’s meaningful to them.
In unifying these themes, the PDS highlights in its service provision the importance of understanding and respecting the diversity of experiences, perspectives, identities and relationships of individuals in their recovery from BPD.
Culture is central to who we are and shapes our identity and ways of living. Each culture, with its unique history, values and practices, influences individuals and their families in diverse ways that also affect personality functioning. This means that cultural context and norms are extremely important in understanding personality functioning – what living life well looks like varies from culture-to-culture.
In addition, processes such as migration and acculturation can place further strains on personality functioning that require culturally sensitive approaches, particularly in the context of Australia’s history with minority groups who have experienced cultural dispossession, escape from war and poverty and significant trauma (Ronningstam et al., 2018).
Recent studies have impressed the importance of understanding consumers in their socio-cultural context, identifying the dynamic interactions between personality traits, developmental histories and adversities within the current social situation (Ryder, 2015).
NAMHS service participants belong to a broad range of cultural backgrounds. The PDS endeavours to support the mental health division in its work with consumers with BPD to develop individualised shared formulations, which incorporates cultural understandings, to guide collaborative treatment approaches to recovery. For example, understanding the function of non-suicidal self-injury (NSSI) and chronic suicidality for people with BPD requires a culturally sensitive inquiry into their circumstances as what might look like NSSI based on psychopathology may actually relate to a culturally appropriate expression of grief (Fromene et al., 2014). Cultural diversity and perspectives are further considered in secondary consultation, reflective practice and training offered by the PDS to promote holistic and culturally sensitive service provision.
The understanding and acknowledgement of diversity is vital in supporting consumers with personality disorder, to build trust, convey empathy and ensure the values and beliefs of the individual are respected and at the forefront of communication. Learning about other cultures, and how these unique cultural experiences may impact their mental health and help-seeking fosters recovery, thus, supporting the individual to lead a life that is meaningful to them.
For further information visit-https://intranet.nh.org.au/departments-and-services/mental-health-services-mhs/mh-services-internal-how-to-refer/personality-disorder-service/
or email: Jacinta Clemente – (Lead Personality Disorder Clinical Specialist/Clinical Psychologist) via email Jacinta.clemente@nh.org.au
Picture shows from left to right: Peter Smith (Personality Disorder Clinical Specialist/Social Worker), Jacinta Clemente (Lead Personality Disorder Clinical Specialist/Clinical Psychologist), and Dr Ajay Vijayakrishnan (Consultant Psychiatrist Personality Disorder Specialist)