Devon Partnership NHS Trust, The University of Exeter School of Psychology.
School of Psychology and Counselling, The Open University, Milton Keynes, UK.
Personal Ment Health. 2025 Feb;19(1):e1649. doi: 10.1002/pmh.1649.
The use of Out of Area (OoA) psychiatric placements for people with "Personality Disorder" (PD) is widespread in the UK. An innovative local intensive psychotherapeutic service, adapted to the transdiagnostic presentations of the most complex PD patients, likely to be placed out of the area, was devised in the English County of Devon. This paper reports the findings of a Freedom of Information (FOI) request to commissioners attempting to quantify PD OoA placements in England and the cost offset of the local therapeutic alternative to OoA placements in Devon.
Data from FOI requests was combined with publicly available sources to assess the scale of OoA placements for people with PD in England. OoA service use and cost data were used to examine the cost offset and effectiveness of the local alternative to OoA placements in Devon. The results found a lack of transparency and excessive use of OoA placements despite UK Government intentions. Data from the local therapeutic service demonstrated cost-effectiveness, reducing OoA placements and increasing the availability of psychotherapeutic services. This paper suggests the number of OoA placements can be reduced for people with severe and complex PD. The local therapeutic service provides a model for future rehabilitation pathways.
在英国，“人格障碍”（PD）患者的“异地”（OoA）精神科安置使用广泛。德文郡在英国开发了一种创新性的本地强化心理治疗服务，适用于最复杂 PD 患者的跨诊断表现，这些患者很可能会被安置在异地之外。本文报告了一项信息自由（FOI）请求的调查结果，该请求旨在量化英格兰 PD 患者的异地安置情况以及德文郡替代异地安置的本地治疗方案的成本节约情况。
将 FOI 请求中的数据与公开来源的数据相结合，以评估英格兰 PD 患者异地安置的规模。异地服务使用和成本数据用于评估德文郡替代异地安置的本地方案的成本效益和效果。结果发现，尽管英国政府有意图，但异地安置的透明度不足且使用过度。来自本地治疗服务的数据表明其具有成本效益，可以减少异地安置并增加心理治疗服务的可及性。本文提出，对于严重和复杂的 PD 患者，可以减少异地安置的数量。本地治疗服务为未来的康复途径提供了一个模型。
