Improving Access to Psychological Therapies for individuals with a Personality Disorder
Providing services for the treatment seeking population
Identifying strategies for engaging with the treatment reluctant population
Working within the current economic position
What direct therapies does IMPART provide?
• Fully programmatic and adherent Dialectical Behavioural Therapy• Cognitive Behavioural Therapy adapted for Personality Disorder• Mindfulness Based Cognitive Therapy• Mindfulness skills group• Managing Emotions group (in-patient)• Motivational Interviewing• Psychoeducational groups (anxiety, anger, healthy lifestyle)• Supporters (carers) evenings• Supporters (carers) DBT skills workshops
Improving Access means inclusivity
IMPART works with:
8 of the 10 DSM-IV Personality Disorders*
Older adultsmild learning disabilitiesco-morbid substance abusehigh risk
* The clinical and business case for ASPD has been developed andis being discussed with leadership and commissioners
0
20
40
60
80
100
120 Primary PD Diagnosis
IMPART Direct Provision
2010 – 2011 1245 Open cases [13.1 wte]2011 – 2012 921 Open cases
6m of IAPT 177 new referrals accepted374 discharged cases602 open cases
22 – average caseload
10.7 wte staff
Indirect provision
• Training on working effectively with PDMental Health ServicesPsychiatric Liaison and A&E staffHousing workersSocial ServicesChild protection servicesProbationMagistrates GPsHealth visitors
Improving Access needs robust pathways
Mental HealthMental Health
Primary Care
Primary Care
Local Authority
Local Authority
Criminal JusticeCriminal Justice
WeeklyPsychologyReferrals Panels*
WeeklyPsychologyReferrals Panels*
Psychology DepartmentsPsychology
Departments
IMPARTIMPART
GPGP
Fewer assessmentsReduced waiting times
CAMHSCAMHS
Engaging with the treatment reluctant population
In-patient IMPART Therapistassessments facilitating pathways to community treatmentmotivational enhancementpsychoeducation and coping skillsstaff support groupsward based DBT skills groups
Working within the current economic position
Providing the case for redeployment of resources
Mental Health CostsReturn of OAT contracts Reduction in ISA placementsReduction in bed days
Social Care CostsIncreasing employmentStabilizing housingReducing children in care
2010-2011
660 less bed days4 ISA returns
Cost savings:£443,765
30% SU gained employment or education during treatment
Measuring Outcomes
IAPT Dataset
PHQ-9IAPT employment statusWSAS (Work and Social Adjustment)EQ-5D (Quality of Life)WEMWBS (Warwick-Edinburgh Mental Well Being Scale)SAPAS (Standardized Assessment of Personality)Rates of self harm and suicide attemptsService utilization
IMPART dataset
SCID I and IIStaxi (Speilberger Anger Scale)Christo (modified drug/alcohol)Treatment history (one year)
Challenges faced by IMPART
Demands to see individuals with ASPDCare coordination – pressures on the systemRequests for more training /consultation/supervisionContinual restructuring – disrupted care pathwaysManaging a wait list – high risk clients
Key Deliverables
• psychological therapy – across PDs• training package - ‘Recognizing and Working with PD’• Handbook - ‘Setting up an IMPART’• Consultation service for Trusts developing IAPT SMI (PD) services• Increasing access for difficult to engage population
South AsiansMothers with BPDHigh comorbidity
IMPART Open Day
Tuesday 9th April, 2013 9:30am-4:30pm
Ford Sports Centre, Aldborough Rd S, Ilford, Essex IG3 8HG - near Newbury Park Tube Station
RSVP – [email protected]; 0300 555 1213
I want to live, I want to die.A silent tear, I need to cry.A pain so deep, so ragged and raw,it feels like an open infected sore.
Help is at hand, it is there for you.Learn to trust, and let it through, to have a future free from pain,and a life worth living once again. I need you IMPART and the group.The things you teach are starting to rootinto little buds, starting to shoot.Soon a tree I will see, and future on thehorizon of where I want to be.
JM 2012
