Joint Crisis Plans for people with personality disorders

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People with personality disorders have long-standing problems in the way that they relate to others and experience the world. By virtue of these problems, such people are at greater risk of harming themselves. Little research has been carried out into the treatment of people with personality disorder. In this study, we will develop a new intervention to be used in the management of people with personality disorder and go on to test its effectiveness in a clinical trial. The main aim of the study is to determine whether a negotiated written plan (between a service user and member of staff) is an effective way of helping people with personality disorder to reduce self-harming behaviour. We will begin by working closely with service users and staff in order to adapt the crisis plan from an existing template developed for people with severe mental illness. We will ask service users and staff to give us their views about the most effective research strategies to be adopted in the subsequent trial. In the trial, we will examine whether crisis plans are an effective way of delaying self-harming behaviour in people with personality disorder. Suitable participants will be allocated to receive either the crisis plan or standard care from a community mental health team. Those allocated to the crisis plan will take part in a meeting with their mental health professional, the purpose of which will be to agree the contents of the crisis plan. All trial participants will be followed-up for at least six months, at which point we will measure changes in their self-harming behaviour, the quality of their relationship with staff, their satisfaction with care and the economic cost of the crisis plans. The study will have important consequences for service users, health professionals and researchers. Not only will it improve understanding about the treatment of a common and costly mental disorder, but we anticipate that the use of crisis plans will promote a culture change in the relationship between clinicians and personality-disordered service users.