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患有人格障碍并寻求心理健康治疗:患者及其家庭成员对自身经历的反思。

Living with personality disorder and seeking mental health treatment: patients and family members reflect on their experiences.

作者信息

Barr Karlen R, Jewell Mahlie, Townsend Michelle L, Grenyer Brin F S

机构信息

School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522 Australia.

Project Air Strategy Consumer and Carer Advisory Committee, Wollongong, NSW Australia.

出版信息

Borderline Personal Disord Emot Dysregul. 2020 Sep 7;7:21. doi: 10.1186/s40479-020-00136-4. eCollection 2020.

Abstract

BACKGROUND

Despite effective treatments for personality disorders being developed, consumers and carers often report negative experiences of mental health services, including challenges accessing these treatments.

METHODS

This qualitative study used separate focus groups to compare the unique perspectives of consumer and carers, and to investigate how to improve services for individuals with personality disorders. Reflexive thematic analysis was used to analyze the data.

RESULTS

Both consumers and carers ( = 15) discussed the value of providing appropriate information to consumers when they are diagnosed with personality disorder. Consumers and carers described the importance of creating a safe environment for consumers when they present to the emergency department. Both groups discussed experiencing positive and negative treatment from mental health professionals, and suggested that professionals should be trained to understand personality disorder. Limited accessibility and quality of services, and offering peer support to consumers were also described by consumers and carers. Consumers and carers also had perspectives which were unique to their group. Consumers identified the importance of psychological treatment, having a strong therapeutic relationship with a mental health professional, and the benefit of long term psychotherapy with the same professional. Broadening the scope of psychotherapies including creative, animal-assisted, and physical therapies was recommended by consumers. Carers described the importance of assessing for personality disorder and intervening early. Involvement in the assessment, diagnosis, and intervention process was important to carers. The desire to be recognized and supported by mental health professionals was discussed by carers.

CONCLUSIONS

This research contributes to the concern that consumers with personality disorder and their carers experience stigma and low quality care within mental health services. In line with these findings, we recommend guidelines for health professionals who work with consumers with personality disorder.

摘要

背景

尽管针对人格障碍的有效治疗方法不断涌现,但消费者和护理人员经常报告心理健康服务的负面经历,包括在获取这些治疗方面面临的挑战。

方法

这项定性研究采用了单独的焦点小组来比较消费者和护理人员的独特观点,并调查如何改善针对人格障碍患者的服务。采用反思性主题分析来分析数据。

结果

消费者和护理人员(各15名)都讨论了在消费者被诊断为人格障碍时向其提供适当信息的价值。消费者和护理人员描述了在消费者前往急诊科时为其营造安全环境的重要性。两组都讨论了从心理健康专业人员那里获得的积极和消极治疗经历,并建议对专业人员进行培训,使其了解人格障碍。消费者和护理人员还提到了服务的可及性和质量有限,以及为消费者提供同伴支持的情况。消费者和护理人员也有各自群体独特的观点。消费者确定了心理治疗的重要性、与心理健康专业人员建立牢固的治疗关系,以及与同一位专业人员进行长期心理治疗的益处。消费者建议拓宽心理治疗的范围,包括创造性治疗、动物辅助治疗和物理治疗。护理人员描述了评估人格障碍并尽早干预的重要性。参与评估、诊断和干预过程对护理人员很重要。护理人员讨论了希望得到心理健康专业人员认可和支持的愿望。

结论

这项研究加剧了人们对人格障碍消费者及其护理人员在心理健康服务中遭受耻辱和低质量护理的担忧。根据这些发现,我们为与人格障碍消费者打交道的健康专业人员推荐了指导方针。

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