Innovation in Action: Review of the Effectiveness of Centrally Commissioned Community Personality Disorder Services

The ‘Innovation in Action‘ report, written by Dr Lisa Wilson and Dr Rex Haigh,  presents a summary of the findings of the review of National Community Personality Disorder Pilots commissioned by the Department of Health in 2004.

The aim of the commissioning of these pilots was to identify practice-based evidence regarding effective therapeutic interventions with individuals experiencing complex emotional needs. This was identified in Personality Disorder: No Longer a Diagnosis of Exclusion (2003) as an area of unmet need for a significant proportion of the national population.

‘Innovation in Action’ outlines the outcomes of the pilots with regards to quality, innovation, productivity and prevention. A number of key findings are identified that should inform the future development of policy and practice for this clinical population; furthermore a number of recommendations are made with regard to developing future services and the importance of maintaining those already in operation.

Map of the PD pilots

The ‘Innovation in Action’ report highlights the following points:

  • Significant progress has been made towards the establishment of practice-based evidence for providing a therapeutic service for individuals with complex emotional needs. This evidence base can guide the development of future evidence based practice as well as service development.
  • A range of service models and theoretical orientations were implemented by different services, and while no specific model amongst these emerged as superior, there were a number of general therapeutic conditions that were common to all the services.
  • The pilot services all demonstrated the following fundamental assumptions to delivering the treatment.
  • The importance of:
    human relationships
    the psychosocial environment
    investment in the programme
    importance of leadership
    effective team work
    establishing good networks and partnerships.
  • The national pilots have achieved significant results in relation to both human and economic cost savings.
  • There is good evidence amongst the pilots of the prevention of continuing harm and the prevention of deterioration of conditions.
  • The services have enabled individuals to access employment and work-related activities, as well as reducing the demands on a range of agencies.