Joint Crisis Plans for people with personality disorders

患有人格障碍的人在与他人交往和体验世界的方式上长期存在问题。由于这些问题，这些人伤害自己的风险更大。对人格障碍患者的治疗进行的研究很少。在这项研究中，我们将开发一种新的干预措施，用于人格障碍患者的管理，并继续在临床试验中测试其有效性。这项研究的主要目的是确定（服务用户和工作人员之间）协商的书面计划是否是帮助人格障碍患者减少自我伤害行为的有效方法。我们将首先与服务用户和工作人员密切合作，以便根据为严重精神疾病患者制定的现有模板调整危机计划。我们会请服务使用者和员工就日后试验采用的最有效研究策略提出意见。在试验中，我们将检验危机计划是否能有效延缓人格障碍患者的自残行为。合适的参与者将被分配接受危机计划或社区精神卫生团队的标准护理。那些被分配到危机计划的人将与他们的心理健康专家参加会议，会议的目的是就危机计划的内容达成一致。所有试验参与者都将接受至少6个月的随访，届时我们将衡量他们自残行为的变化、他们与工作人员关系的质量、他们对护理的满意度以及危机计划的经济成本。这项研究将对服务使用者、卫生专业人员和研究人员产生重要影响。它不仅会提高人们对治疗一种常见且昂贵的精神障碍的理解，而且我们预计，危机计划的使用将促进临床医生和人格障碍服务使用者之间关系的文化改变。

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.